Long term global evaluation of a national AIDS prevention strategy: the case of Switzerland.

OBJECTIVES: The Swiss Aids prevention strategy has been subject to a continuous process of evaluation for the past 12 years. This paper describes the conceptual approach, methodology, results obtained and contribution to policy-making of that evaluation.¦DESIGN: The evaluation is on-going, global with respect to all components of the strategy, and utilization-focused. Each successive phase of the evaluation has included 10-20 studies centred either on aspects of process, of outcome or of environmental context. Findings are synthesized at the end of each phase. METHODS: Both quantitative and qualitative methods are used. Studies generally have one of three functions within the overall evaluation: assessment of trends through surveys or other types of repeated studies; evaluation of specific areas through a series of studies from different viewpoints; in-depth investigation or rapid assessment through one-off studies. Various methods of triangulation are used to validate findings. RESULTS: The evaluation has allowed for: the observation of behavioural change in different populations; the availability of scientific data in controversial fields such as drug-use policy; an understanding of the diversity of public appropriation of prevention messages. Recommendations are regularly formulated and have been used by policy-makers and field workers for strategy development. CONCLUSIONS: The global approach adopted corresponds well to the evaluation requirements of an integrated long-term prevention strategy. Cost is low relative to the extent of information provided. Such an evaluation cannot however address the question of causal relationship between the strategy and observed changes. The evaluation has contributed to the development of a culture of evaluation in Swiss AIDS prevention more generally.

Le tabagisme chez les écoliers en Valais: 2002-2010

Introduction: Le tabagisme est une cause majeure de maladies et de décès dans la population en Valais. Près d'un valaisan sur trois et une valaisanne sur quatre sont fumeurs. L'initiation au tabagisme a lieu le plus souvent à l'adolescence. Il est dès lors important de connaître les habitudes tabagiques des écoliers valaisans. Méthodes: Tous les quatre ans, le Valais et les autres cantons suisses participent à l'enquête Health Behaviour in School aged Chidren (HBSC), qui est réalisée dans plus de 40 pays sous l'égide de l'Organisation mondiale de la santé. L'objectif est de récolter et d'analyser des données pertinentes sur les comportements de santé des écoliers de 11 à 15 ans, et notamment sur le tabagisme. L'enquête HBSC 2010 a été menée dans 71 classes auprès de 1'198 écoliers en Valais. Les données ont été récoltées par questionnaire. Résultats: De nombreux écoliers valaisans de 11-15 ans ont déjà fumé au moins une fois dans leur vie. Alors que très peu d'écoliers sont des fumeurs quotidiens avant l'âge de 14 ans, près d'un écolier sur six (17% des garçons et des filles) affirme fumer quotidiennement à 15 ans. Entre 2002 et 2010, les proportions d'écoliers ayant fumé au moins une fois ou fumant quotidiennement ont diminué. Les écoliers de 14-15 ans fumant régulièrement (au moins une fois par semaine) rapportent avoir acheté le plus souvent eux mêmes leurs cigarettes ou se les êtres procurées auprès de connaissances. 42% des écoliers et 44% des écolières ont au moins leur mère, leur père ou un de leurs frères et soeurs qui fument. Conclusions et perspectives : Le tabagisme est fréquent dans la population valaisanne, et ce dès l'adolescence. La prévalence du tabagisme a légèrement diminué chez les écoliers entre 2002 et 2010. Toutefois, l'augmentation marquée de l'initiation tabagique entre 11 et 15 ans et la prévalence importante des fumeurs quotidiens parmi les écoliers de 15 ans confirment que la prévention du tabagisme est nécessaire dès le plus jeune âge. L'accessibilité des écoliers au tabac devrait être évaluée et des mesures devraient être renforcées pour la diminuer.

Evaluation der AIDS-Präventions-Kampagnen in der Schweiz : zweiter zusammenfassender Bericht, 1988

[Inhaltsverzeichnis] Schlussfolgerungen. Empfehlungen. Gegenwärtige Veränderungen in der Schweiz. Erziehungsprozesse. Einflüsse der sozialen Umgebung. ANHANG: Kurze Beschreibung der Studien.

Información para pacientes y educación en la salud de la ciudadanía: a la búsqueda de nuevos usuarios

La elaboración de un marco legal y normativo que fija el derecho de los ciudadanos a una información veraz y adecuada sobre salud y enfermedad implica tener en cuenta estas necesidades informativas desde la doble perspectiva del ¿consumer health¿ y el ¿patient education¿. Se defiende, desde el punto de vista de los profesionales de la información, la materialización de este derecho a la información y a la formación en temas relacionados con la salud y la enfermedad gracias a un mejor aprovechamiento de los recursos informativos disponibles en las bibliotecas médicas y a los profesionales que los gestionan.

Evaluation des campagnes de prévention du SIDA en Suisse : deuxième rapport de synthèse, 1988

[Table des matières] Conclusions (connaissances, attitudes et comportements; processus des campagnes de prévention). Recommandations. Changements en cours en Suisse. Processus éducatifs. Influences de l'environnement social. ANNEXE: Brève description des études.

Evaluation des campagnes de prévention contre le SIDA en Suisse : SIDA-MEDIA : rapport final 1988

L'analyse qui va suivre tentera de donner un panorama de la diffusion et de la répercussion des campagnes de prévention dans les médias. Ce panorama nous permettra d'estimer quantitativement et qualitativement l'impact des messages d'information et de prévention sur les médias.

Cannabis and tobacco use: where are the boundaries? A qualitative study on cannabis consumption modes among adolescents.

The purpose of this article is to identify tobacco and cannabis co-consumptions and consumers' perceptions of each substance. A qualitative research including 22 youths (14 males) aged 15-21 years in seven individual interviews and five focus groups. Discussions were recorded, transcribed verbatim and transferred to Atlas.ti software for narrative analysis. The main consumption mode is cannabis cigarettes which always mix cannabis and tobacco. Participants perceive cannabis much more positively than tobacco, which is considered unnatural, harmful and addictive. Future consumption forecasts thus more often exclude tobacco smoking than cannabis consumption. A substitution phenomenon often takes place between both substances. Given the co-consumption of tobacco and cannabis, in helping youths quit or decrease their consumptions, both substances should be taken into account in a global approach. Cannabis consumers should be made aware of their tobacco use while consuming cannabis and the risk of inducing nicotine addiction through cannabis use, despite the perceived disconnect between the two substances. Prevention programs should correct made-up ideas about cannabis consumption and convey a clear message about its harmful consequences. Our findings support the growing evidence which suggests that nicotine dependence and cigarette smoking may be induced by cannabis consumption.

Evaluation des campagnes de prévention contre le SIDA en Suisse : Rekrutenschule und Aidsprävention : Schlussbericht 1988

Evaluationsstudie 1988 zur Präventionskampagne STOP AIDS des Bundesamtes für Gesundheitswesen und der Aidshilfe Schweiz

The cardiovascular disease situation in Seychelles.

A rising frequency of cardiovascular diseases and related risk factors has been documented in Seychelles. This epidemiological transition to chronic diseases is believed to result from the aging of the population and from changes in lifestyle associated with a rapidly improving standard of living. Since 1990 a long-term national collaborative programme has been established for the prevention and control of cardiovascular diseases. It has been designed with a view to implementing a combination of population-based and specific, high-risk target-group strategies. Objectives have been formulated, and culturally acceptable multisectoral activities have been devised, along with plans for the monitoring of cardiovascular diseases and risk factors and for the evaluation of the programme as it proceeds.

La médecine ambulatoire youth-friendly. [Youth-friendly outpatient care].

Ambulatory pediatric and family medicine takes care of adolescent patients, most of whom regularly consult a physician. Consultations with young people involve issues specifically related to their age. Regarding health care systems and physicians, adolescents' expectations vary from those of adults, not so much in terms of the issues discussed but in terms of the priorities that they give to them. Confidential interviews are not always proposed but are highly appreciated, as are certain personal qualities on the part of the caregivers such as honesty, respect, and friendliness. Finally, easy access to care together with the continuity of care are essential. Prevention of risk behaviors by screening and health education is clearly insufficient. This issue could be approached during the consultation through a psychosocial history. This is a good opportunity to discuss sensitive issues that adolescents seldom bring up themselves. More systematic prevention would probably decrease youth morbidity and mortality, which are both closely related to risk behaviors. To meet these expectations and special health care needs, the World Health Organization has developed the concept of youth-friendly health services. This concept can be applied in both a specialized adolescence center and a pediatric or family practice. Youth-friendly services are still rarely evaluated but seem to bring a clear benefit in terms of patient satisfaction and access to care.

Chronically connected? Internet use among adolescents with chronic conditions.

Little is known about Internet use among adolescents with chronic conditions (CCs). Our results indicate that CC females, but not males, are more likely to be heavy Internet users than their peers. CC youths are also more likely to visit health-related web sites, but less frequently than other sites.