Pascale Lehoux

Spring

Analyser le degré d'intégration de l'approche écologique dans les programmes de promotion de la santé: le cas des programmations de réduction de tabagisme de deux directions de la santé publique québécoises

Authors:
Pages:
97-123

For many years, the WHO has promoted the implementation of ecological strategies to improve public health, focusing, in particular, on various social and environmental health determinants and settings. Although that approach has raised interest among public health professionals, the conceptual tools to direct its development and evaluation are still lacking. To fill the gap, this article presents a tool for the assessment of the integration of the ecological approach in programs. To illustrate its potential, the smoking reduction programs implemented by two public health departments in Quebec were evaluated using the application, which allows an assessment of the ecological dimension.

Fall

L'évaluation des technologies de la santé: comment l'introduire dans les hôpitaux universitaires du Québec?

Authors:
Pages:
75-98

This article describes the level of implementation of health technology assessment in Quebec university teaching health centres and examines structures that may facilitate its development. The data are from a mail survey sent to respondents in all university teaching health centres (response rate of 83/149 = 56%). Interviews with key actors (n = 4) were also conducted to document the broader context in which health technology assessment is implemented. The main obstacles identified are the lack of human, material, and financial resources. Respondents pre- fer structures where the health technology assessment unit is under either the CEO or the Chief of Medical Staff, both closely linked to the research centre. The results reveal three key challenges: the need to clarify expectations about the role of health technology assessment, the need to seek consensus around health technology assessment, and the need for broad commitment to the selected structure.

Fall

Tracer les parcours d'influence de l'évaluation sur l'utilisation des technologles de la santé

Authors:
Pages:
33-50

In Quebec over the past ten years many medical technology assessment reports have been submitted to decision-makers in government agencies, hospitals, and professionnal associations. This article traces the way evaluation may influence decision-making. Five topics are discussed: 1) the imperfect. Reciprocal relationship between evaluation and technology utilization, 2) the difficulty of moving theoretically and methodologically between central and local perspectives, 3) linkages between evaluation and health policies, 4) linkages between health policies and technology utilization, and finally, 5) follow-up strategies for assessing the influence of evaluation on technology utilization.