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Theses

L’étude des conceptions en santé comme préalable à un dispositif de promotion de la santé

Abstract : Our thesis falls within the scope of Health Promotion defined by the World Health Organization. The research activity consists mainly of evaluating the effectiveness of Health Promotion through intervention programs, thus demonstrating its effects on the health of the populations and by the same its social utility. In the framework of this thesis, we wonder if the program is the only modality of intervention in Health Promotion even though it responds to expectations of Public Health. We propose an alternative modality more in line with the Promotion of Health, namely the concept of device whose central figure is the subject. But because the interventions of professionals within a device can differ according to their perception of the term of health, it requires a time of explanation to determine their intentions. We rely on theories of interdisciplinary intervention and health conceptions to lay the foundation for a Health Promotion device. Interdisciplinary intervention is mainly conditioned by the commitment of professionals who will have previously identified a common problem. The health conceptions participate, as for them, to structure our actions in the daily situations relating to our health, they can also enlighten the situations which concern the professionals who have to decide and act in a perspective promoter of health of the subjects which they accompany. This allows us to feed an object of research in Health Promotion around the implementation of a device. By listing topics as a nodal point of a device, we question what would allow them to decide to participate in what constitutes our research question. To do this, we studied a device in Health Promotion, EST03, which aims to support territorial actors who intervene with children and adolescents. We focused on a key moment that is the beginnings of this device where professionals are in a position to determine their commitment. We conceived two protocols allowing the collection and the analysis of speeches of 63 subjects, by the method of the semi-directed interview, concerning their professional activity and the links with the term of health. We used the qualitative content analysis software Nvivo 11 © and developed two analysis steps. The first allowed the constitution of 812 references. The second stage of the analysis revealed 28 health conceptions mobilized by the subjects. Using a similarity measure, we observed the existence of a healthy collective design in an asynchronous situation and then confirmed the presence of a meta-system of healthy conceptions. We discuss a methodological limit on the very situation of the interview as a disruptive situation. The latter questions the commitment of the researcher in his posture with the research object but which allows to be in phase with the real temporality of the beginnings of a device. We return to the main hypothesis by indicating that the process of explaining conceptions in health is an indicator of mobilization of professionals by its triggering effect. The meta-system of conceptions in health observed makes it possible to establish a link with the notion of collective activity but also with the sociological concept of negotiation. This allows us to establish some prerequisites for a device in Health Promotion, namely the explanation of the health conceptions of the subjects upstream of the device, the collective activity as modality of organization of the device, recognition and valorization of the collective activity of professionals by the institutions and the coordination of tasks
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Cédric Kempf. L’étude des conceptions en santé comme préalable à un dispositif de promotion de la santé. Gestion et management. Université de Lyon, 2019. Français. ⟨NNT : 2019LYSE1355⟩. ⟨tel-02465544⟩

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