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Master thesis

Evaluation du projet pilote Paris Santé Réussite

Abstract : CONTEXT - The specific learning disabilities affect 6 to 8% of children. In low socioeconomic background, those children have great difficulty in accessing a therapeutic care either by a delay or lack of diagnosis or either by the complexity of care pathways. The “Direction de l’action social et sanitaire” of Paris city has funded for an initial period of 3 years, a pilot project called "Paris Santé Réussite" (PSR). Its aims are threefold: to ensure early detection of children, assess their needs for their needs to provide a personalized treatment plan and follow up. Conducted on school children in first and second grade from 20 volunteers’ schools located in the 11th and 20th Parisian arrondissement. “Paris Santé Réussite” began on 2011/2012 school year. Summative and formative evaluation of the project have been completed. METHOD - The primary endpoint was defined as improvement or stagnation results in reading and dictation of 95% of children who have benefited from the entire PSR program compared to themselves and their school level, between second and third grade. The summative evaluation was conducted using data results to systematic assessments of children and data management. A difference in standard deviation of 0.5 or greater was considered as improvement, between ] -0.5;0.5 [ as stagnation and -0.5 or less as an aggravation. For formative assessment, 4 questionnaires were created to examine the various public and project stakeholders, including teachers, school doctors, local health professionals and families. Quantitative and formative analyzes were conducted on the answers. RESULTS - Of the 2521 children who had at least one evaluation during the last 3 years, 165 have benefited from the entire program on first and second grade with a follow-up assessment in third grade. Whether it be in reading or dictation, almost 80% of children followed by PSR improved or stabilized their competence compared to themselves and to their grade level. Our results are statistically significant, which means that we can not conclude that we reached our goals. We also observed that nearly 60% of children suffering from learning disabilities were not diagnosed using conventional mean. Furthermore, schools with teaching support for struggling students have statistically different second grade mean level compared to other schools. About the formative evolution, sixty five percent of the 43 teachers interviewed have responded. The great majority has expressed their wish to see PSR maintained. Ten school doctors have responded. Seven doctors have expressed their wish to see PSR maintained in their schools. Reservations regarding the organizational arrangements and autonomy of school doctors were mentioned by half of them. Nearly 60% of the 98 local professional health interviewed have responded. Among them, PSR is recognized as useful in its expertise role and care coordination. Seventy-seven % of respondents are in favor of maintaining PSR. The perspective of families is not yet known since the survey was not over yet. However, initial trends are quite favorable to the project, finding it mostly useful in its coordination work. DISCUSSION - Despite our primary endpoint has not been reached, it seems that “Paris Santé Réussite” meets a real need for graduate and concerted response in the treatment of learning disabilities in direction of children from low socioeconomic background. This is, to our knowledge, the only multidisciplinary center project closely associated with a school action. Our results show that the identification by conventional mean works less efficiently than in the rest of the population. They also show that the need for care and coordination are quite important. However, organizational improvements seem essential. We suggest clarification of stakeholders’ roles with empowerment and recognition of the school doctor as a primary care physician. These changes would allow PSR health professionals to enhance efforts in coordinating care and research activities.
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  • HAL Id : hal-02097974, version 1


Marie Husson. Evaluation du projet pilote Paris Santé Réussite. Santé publique et épidémiologie. 2014. ⟨hal-02097974⟩



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