Mediation
Conditions
Keywords
Healthcare utilization, Health mediation, Cancer screening, Complex intervention, realist evaluation, study protocol, underserved populations
Brief summary
The investigators are conducting a longitudinal mixed-method intervention study with a multi-center, multi-case explanatory sequential design. The ECEMSo study aims to identify the impact of health mediation on fostering healthcare utilization, in particular organized cancer screening uptake, by underserved populations living in informal housing in France.
Detailed description
Health mediation may foster underserved populations' healthcare utilization. No study to date has demonstrated its effectiveness in an experimental context. The ECEMSo case study aims to identify the impact of health mediation on fostering healthcare utilization - in particular organized cancer screening uptake - by underserved populations living in informal housing in France. Grounded in a theory-based framework, the ECEMSo case study is a longitudinal mixed-method intervention study with a multi-center, multi-case explanatory sequential design. The study population comprises various participant profiles including health mediators, health workers, social workers, people living in informal housing whom these professionals support, and other stakeholders concerned with underserved populations' health issues. Participants will be recruited in several French regions and divided into three mixed participant profile groups. In group 1, health mediation and the ECEMSo intervention will be implemented. This intervention comprises knowledge mobilization to facilitate the structuring of health mediation throughout France, and the development of an action plan to facilitate cancer screening uptake by people living in informal housing. In group 2, only health mediation will be implemented (i.e., no ECEMSo intervention). In group 3, neither health mediation nor the ECEMSo intervention will be implemented, but health and social workers will implement other health system navigation interventions. Quantitative and qualitative data will be collected by interviewers through face-to-face questionnaires, interviews, observations, focus groups, and tracking tables of health mediation activities over six months. Data collection will be based on the health mediation conceptual framework.
Interventions
BEHAVIORALKnowledge mobilization to facilitate the structuring of health mediation
The ECEMSo intervention involves knowledge mobilization to facilitate the structuring of health mediation throughout French territory, and the development of a co-designed effective action plan to facilitate cancer screening uptake by people living in informal housing. The action plan will, consider territorial specificities at the regional level. The ECEMSo project team will organize a seminar and three workshops. The aim of the seminar and workshops is to mobilize knowledge to facilitate i) the structuring of health mediation in the regions, and ii) the development of an action plan with health mediators and other stakeholders to foster organized cancer screenings uptake by underserved people. This action plan must match with the needs of people living in informal housing, and must be coordinated, suitable and feasible to implement, in terms of knowledge about people living in informal housing specificities and specific local collaborations
Sponsors
University Hospital, Bordeaux
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
Yes
Inclusion criteria
People living in informal housing Inclusion criteria: * Living on the streets, in a shanty house, squat or caravan * Living in an area covered by one of care structures participating in the ECEMSo study * Being over 18 years old * Being able to understand the detailed information provided about the ECEMso study
Exclusion criteria
* Suffering from cognitive and/or psychiatric disorders * Being under guardianship or curatorship Health mediators, heal workers, socials workers Inclusion criteria: * Being a health mediator, a health worker or a social worker belonging to one of the study's participation care structures * Providing support to people living in informal housing
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Impact of health mediation on healthcare utilization in people living in informal housing (PLIH) in France | At six months follow-up | The difference in healthcare utilization by PLIH between groups 2 and group 3 |
| Impact of the intervention on people living in informal housing (PLIH) uptake of organized cancer screening | At six months follow-up | The difference in organized cancer screening uptake (breast cancer, colorectal cancer, cervical cancer) between PLIH in group 1 and PLIH in group 2 |
| Health mediation conditions required to foster utilization of healthcare services among people living in informal housing (PLIH) in France | At six months follow-up | The difference in organized cancer screening uptake (at 2 years since diagnosis for breast cancer and colorectal cancer, at 3 years since diagnosis for cervical cancer) between PLIH in group 1 and people living in informal housing in group 3 |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORJudith Martin-Fernandez, PhD
Equipe Mérisp/PHARES, INSERM, BPH, U1219, University Hospital, Bordeaux
Outcome results
None listed