Place de l’accompagnement par les pairs dans les programmes de prévention du surpoids visant à réduire les inégalités de santé à l’adolescence

Abstract : Introduction: Universal prevention programs for reducing overweight can potentially contribute to widening health inequalities. The main objective of this thesis was to design, implement and evaluate peer interventions targeting adolescents matched on socioeconomic status. Methodology: The relevance of peer education was analysed, both in general and more specifically regarding its potential to reduce health inequalities. Two interventions were developed based on two different modes of delivery. The first intervention consisted in the selection, training and regular follow-up of peer facilitators whose mission was to carry out nutritional activities with peer receivers. The second intervention was developed on Facebook and encouraged the virtual sharing of experiences relating to nutritional activities. Results: The analysis of the relevance of peer education led to two strategic choices: the first was to base the interventions on socio cognitive theory, as opposed to the more traditional didactic approach, and the second was to select and train peer facilitators from less advantaged backgrounds. The facilitator-receiver intervention led to the successful recruitment of several dyads and nutritional activities were implemented outside of school premises. A detailed evaluation led to recommendations for improving implementation. Using Facebook does not seem likely to widen health inequalities since over 80% of adolescents had access to Facebook. However, there was no sharing of experience between participants on the nutritional challenges group, which puts into question the initial logic model of this intervention. Discussion: The delivery and implementation of the online peer intervention must be modified in order to increase its range and impact. In contrast, the facilitator-receiver intervention in its current form with only minor adjustments is feasible and complements a health intervention well. This intervention has a double target: the reduction of overweight through the behaviour change of the receivers and the reduction of social inequalities not only for the receivers but also by empowering facilitators from disadvantaged backgrounds
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Theses
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http://docnum.univ-lorraine.fr/ulprive/DDOC_T_2017_0377_SAEZ.pdf
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https://hal.univ-lorraine.fr/tel-01917432
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Submitted on : Friday, November 9, 2018 - 2:00:51 PM
Last modification on : Thursday, April 11, 2019 - 4:02:23 PM

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  • HAL Id : tel-01917432, version 1

Citation

Laura Saez. Place de l’accompagnement par les pairs dans les programmes de prévention du surpoids visant à réduire les inégalités de santé à l’adolescence. Santé publique et épidémiologie. Université de Lorraine, 2017. Français. ⟨NNT : 2017LORR0377⟩. ⟨tel-01917432⟩

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