Nicole Beaudet

Advancing population-based health-promotion and prevention practice in community-health nursing: key conditions for change.

Community-health nursing practice is a pivotal aspect of present-day health reforms. In Quebec, Canada, the recent introduction of a population-based approach has entailed increasing the resources allocated to health promotion and disease prevention. Semistructured interviews were conducted with nurses and managers (N = 69) in an effort to understand how these new resources are reflected in nursing practice. Three classes of factors emerged as key conditions for change: contextual and historical, training and professional-development, and work-organization factors. The authors propose courses of action respecting these conditions to provide support for community-health nursing practices that incorporate a contemporary population-based approach.

Defining, illustrating and reflecting on logic analysis with an example from a professional development program

Program designers and evaluators should make a point of testing the validity of a programs intervention theory before investing either in implementation or in any type of evaluation. In this context, logic analysis can be a particularly useful option, since it can be used to test the plausibility of a programs intervention theory using scientific knowledge. Professional development in public health is one field among several that would truly benefit from logic analysis, as it appears to be generally lacking in theorization and evaluation. This article presents the application of this analysis method to an innovative public health professional development program, the Health Promotion Laboratory. More specifically, this paper aims to (1) define the logic analysis approach and differentiate it from similar evaluative methods; (2) illustrate the application of this method by a concrete example (logic analysis of a professional development program); and (3) reflect on the requirements of each phase of logic analysis, as well as on the advantages and disadvantages of such an evaluation method. Using logic analysis to evaluate the Health Promotion Laboratory showed that, generally speaking, the programs intervention theory appeared to have been well designed. By testing and critically discussing logic analysis, this article also contributes to further improving and clarifying the method.

How Can Both the Intervention and Its Evaluation Fulfill Health Promotion Principles? An Example From a Professional Development Program

The emergence over the past 20 years of health promotion discourse poses a specific challenge to public health professionals, who must come to terms with new roles and new intervention strategies. Professional development is, among other things, a lever for action to be emphasized in order to meet these challenges. To respond to the specific training needs of public health professionals, a team from the Direction de santé publique de Montréal (Montreal Public Health Department) in Quebec, Canada, established in 2009 the Health Promotion Laboratory, an innovative professional development project. An evaluative component, which supports the project’s implementation by providing feedback, is also integrated into the project. This article seeks to demonstrate that it is possible to integrate the basic principles of health promotion into a professional development program and its evaluation. To this end, it presents an analytical reading of both the intervention and its evaluation component in light of the cardinal principles in this field. Initiatives such as the Health Promotion Laboratory and its evaluation are essential to consolidate the foundations of professional development and its assessment by concretely integrating health promotion discourse into these practices.

An analysis of the adaptability of a professional development program in public health: results from the ALPS Study

BackgroundProfessional development is a key component of effective public health infrastructures. To be successful, professional development programs in public health and health promotion must adapt to practitioners’ complex real-world practice settings while preserving the core components of those programs’ models and theoretical bases. An appropriate balance must be struck between implementation fidelity, defined as respecting the core nature of the program that underlies its effects, and adaptability to context to maximize benefit in specific situations. This article presents a professional development pilot program, the Health Promotion Laboratory (HPL), and analyzes how it was adapted to three different settings while preserving its core components. An exploratory analysis was also conducted to identify team and contextual factors that might have been at play in the emergence of implementation profiles in each site.MethodsThis paper describes the program, its core components and adaptive features, along with three implementation experiences in local public health teams in Quebec, Canada. For each setting, documentary sources were analyzed to trace the implementation of activities, including temporal patterns throughout the project for each program component. Information about teams and their contexts/settings was obtained through documentary analysis and semi-structured interviews with HPL participants, colleagues and managers from each organization.ResultsWhile each team developed a unique pattern of implementing the activities, all the program’s core components were implemented. Differences of implementation were observed in terms of numbers and percentages of activities related to different components of the program as well as in the patterns of activities across time. It is plausible that organizational characteristics influencing, for example, work schedule flexibility or learning culture might have played a role in the HPL implementation process.ConclusionsThis paper shows how a professional development program model can be adapted to different contexts while preserving its core components. Capturing the heterogeneity of the intervention’s exposure, as was done here, will make possible in-depth impact analyses involving, for example, the testing of program–context interactions to identify program outcomes predictors. Such work is essential to advance knowledge on the action mechanisms of professional development programs.

Organizational Knowledge Creation in the Context of a Professional Development Program: Mixed-Methods Longitudinal Results From the ALPS Study:

In Quebec (Canada), the 2004 health system reform brought new challenges for organizations and professionals. To support the reform, the Regional Public Health Directorate of Montreal designed a professional development pilot program, the Health Promotion Laboratory, a strategy to develop and improve health promotion practices and competencies in local health and social services centers. This article reports the results of an analysis of two laboratory sites using a mixed-methods approach and a multiple case study design; the aim was to describe the creation of knowledge through the laboratory and its dissemination in the organization, as well as to identify influencing factors. In-depth semistructured interviews were conducted to collect data on the knowledge creation process and organizational context. Self-administered questionnaires were used four times over the course of each laboratory to measure active participation, commitment, psychological safety, innovation, and satisfaction. Our findings showed that knowledge acquired through participation in the laboratory was disseminated in the host organizations, both through externalization, combination, and, to a lesser extent, internalization. It is highly plausible that team processes and outcomes such as commitment, satisfaction, and innovation influenced this process, as well as contextual factors such as participant turnover, university affiliation, and internal team dynamics. These results show the potential of the laboratory for improving professional practices. They also suggest useful avenues for managers and decision makers interested in implementing such an initiative. Future work should consider the inclusion of other constructs derived from the literature on team effectiveness such as group learning, communication, and skill development.

Collaborative learning processes in the context of a public health professional development program: a case study

ABSTRACT The health promotion laboratory (HPL – Canada) is a public health professional development program building on a collaborative learning approach in order to support long-term practice change in local health services teams. This study aims to analyse the collaborative learning processes of two teams involved in the program during the first year of implementation. Based on a multiple case study design involving observations, interviews, and documentary sources, the study: (1) describes the learning process by which each team built a common understanding of the problem at hand and developed an intervention to address it; (2) identifies factors that facilitated or hindered these processes; and (3) proposes a cross-case explanation of the collaborative learning process in the HPL. The results demonstrate that the two teams learned by expanding their repertoire of actions, albeit experiencing different processes. Results point to the central role of shared mental models and key influencing factors, such as commitment and participation (team cohesion), team climate (psychological safety), and leadership style. Unlike previous studies on team learning that concentrated on existing teams in organisations, the current research studied purposely created teams working at transforming their practices and showed that they can successfully learn if specific conditions are achieved.