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Background The objective of this study was to assess the effectiveness of a Patient Navigation Intervention targeting deprived patients for Colo-Rectal Cancer (CRC) screening participation. Methods A cluster randomized controlled trial was conducted in 5 districts. Peer Lay Patient Navigators were recruited to operate in deprived areas. Eligible participants had to be between 50 and 74 years old, live in these deprived areas and receive an invitation to the nationally organized Colo-Rectal Cancer (CRC) screening during the study period. The theory-driven navigation intervention was deployed for 18 months. A population Health Intervention Research assessment method was used to assess effectiveness and context interaction. The primary criterion was screening participation at 12 months. Results Twenty-four thousand two hundred eighty-one individuals were included inside 40 clusters. The increase in participation in the intervention group was estimated at 23%, (ORa = 1.23, CI95% [1.07–1.41], p  = 0.003). For the subgroup of individuals who participated, the time delay to participating was reduced by 26% (ORa = 0.74, CI95% [0.57–0.96], p  = 0.021). Main factors modulating the effect of the intervention were: closeness of navigator profiles to the targeted population, navigators’ abilities to adapt their modus operandi, and facilitating attachment structure. Conclusion The ColoNav Intervention succeeded in demonstrating its effectiveness, for CRC screening. Patient Navigation should be disseminate with broader health promotion goals in order to achieve equity in health care. Trial registration clinicaltrials.gov NCT02369757 24/02/2015.

Background The mass colorectal cancer screening program was implemented in 2008 in France, targeting 16 million French people aged between 50 and 74. The current adhesion is insufficient and the participation rate is even lower among the underserved population, increasing health inequalities within our health care system. Patient Navigation programs have proved their efficiency to promote the access to cancer screening and diagnosis. Methods/Design The purpose of the study is to assess the implementation of a patient navigation intervention that has been described in another cultural environment and another health care system. The main objective of the program is to increase the colorectal cancer screening participation rate among the deprived population through the intervention of a navigator to promote the Fecal Occult Blood Test (FOBT) and complementary exams. We performed a multisite cluster randomized controlled trial, with three groups (one experimental group and two control groups) for 18 months. Discussion The study attempts to give a better understanding of the adhesion barriers to colorectal cancer screening among underserved populations. If this project is cost-effective, it could create a dynamic based on peer approaches that could be developed for other cancer screening programs and other chronic diseases. Trial registration NCT02369757

Acceptance of the Human Papillomavirus (HPV) vaccine by targeted populations will depend to a large extent on its acceptability among physicians. We examined the perceptions, attitudes and practices of general practitioners (GPs) in relation to HPV vaccination. From November 2007 to April 2008, a cross-sectional survey was carried out among a representative 5% sample of GPs in the large Rhône-Alpes region of France. Both quantitative (self-administered questionnaire) and qualitative (interview) approaches were used. During the month preceding the survey, 75.6% of the 279 GPs who responded had given at least one HPV vaccination and 47.6% had given a vaccination at the routine target age of 14 years. Overall, 80.8% of GPs reported a favourable opinion about HPV vaccination, 17.4% were uncertain and 1.8% were opposed. The main justification for a favourable opinion related to the public health benefits of the HPV vaccination (cited by 60% of those favouring vaccination). The main justification for an “opposed or uncertain” opinion was the too recent introduction of the vaccine (cited by 43.4%). The major difficulties in providing HPV vaccination were patients’ concerns about potential side effects (cited by 37% of the respondents) and the target age of 14 years (28.9%). Interviews suggested that the concern about age may relate to the need, as perceived by GPs, to discuss sexually transmitted infections with adolescent patients. A favourable opinion about HPV vaccination was associated with seeing more female patients per week, younger age, and GPs’ intention to recommend hepatitis B vaccination. This representative survey of GPs in a major region of France finds a favourable opinion about the HPV vaccine and widespread use of it, despite some concerns that the recent introduction of the vaccine means that we do not yet fully understand the potential for side effects and about the recommended target age of recipients.

Background The management of many chronic diseases requires a multidisciplinary and holistic approach. Long Covid is a recent, poorly understood disease with several symptoms. Most recommendations suggest a multidisciplinary approach. While there are a few programs aimed to the management of Long Covid, to our knowledge very few were assessed. The SPACO + study therefore aims to evaluate an innovative program which combines the methods used in therapeutic education and in personalized multifactorial intervention for management of Long Covid. Here, we present the protocol of our study, which aims to evaluate the effectiveness of an educational intervention in terms of changes in quality of life at 6 months in comparison with standard clinical practice in patients suffering from Long Covid. Methods To achieve our objectives, we have planned to carry out a prospective, multicentre, two-arm randomized controlled trial with a convergent parallel mixed methods design. Two countries are involved in this study: France and Cameroon. The study concerns patients aged 18 and over, who have been infected with Covid-19. They must also be diagnosed as having Long Covid in accordance with the WHO definition. The number of subjects required for the study is 400 individuals. Participants will be randomly assigned to either the intervention or control group using a dynamic randomization process to ensure balanced group characteristics. The SPACO + program is an educative intervention with individual follow-up by a nurse dedicated to the program. The SPACO + program offers five workshops, two of which are compulsories. Patients take part in the other workshops according to their needs. The program includes an 8 – 10 weeks intervention period. Each session lasts two hours and includes breaks (pacing). The main outcome measure will be quality of life, evaluated through the SF-36. Primary and secondary outcomes, with few exceptions, are assessed before the intervention (“T0”), at 8 weeks (“T1” corresponding to the end of SPACO + program’s session period) and then 3 months later (“T2”). Discussion If the SPACO + program is effective and accepted by professionals and patients, it could be disseminated in other regions to assess its transferability. The medico-economic evaluation will also make it possible to assess the benefits provided. Trial registration This trial is registered under the number NCT05787366 (March 24, 2023). Protocol Version N°3.0 (May 31, 2024)

ObjectivesTo examine knowledge about HPV vaccination and behaviour towards STD among 14–23-year-old (yo) girls and determine the correlation with HPV vaccination status.MethodsFrom 11/2008 to 04/2009, 316 girls were recruited by general practitioners in a cross-sectional study and filled a self-administered questionnaire. Twenty-eight were interviewed by a sociologist.ResultsOf the 316 girls, HPV vaccination was reported by 135 (42.7%). Parents were involved in the decision of vaccination for 62.4% of the 14–20 yo. Majority of unvaccinated girls preferred to wait (34.2%), did not feel concerned (27.3%) or intended to get the vaccine soon (25.5%). During the interviews, the 10 vaccinated girls declared having the same opinion as their parents and uncertain girls thought they were not yet concerned. Knowledge of HPV and pap-smear, need of pap-smear despite HPV vaccination was higher in vaccinated girls (13.3% vs 5.5%; 60.6% vs 34.9% in 14–16 yo girls and 60% vs 25.6% in 21–23 yo girls respectively). Overall, 87.2% cited condom for STD prevention and 88% of sexually active girls used it, irrespective of HPV vaccine status. Conditions for stopping condom use were more often reported by vaccinated 14–16 yo girls (24.2% vs 11.1%).ConclusionKnowledge about CC prevention was poor but seemed higher among vaccinated girls. Knowledge and behaviours about STD prevention seemed appropriate, whatever the HPV vaccination status. HPV vaccination should be widely proposed to adolescents and their parents and information on it and on CC prevention should be reinforced.

Le tabac est un facteur de risque majeur du cancer des voies aérodigestives supérieures. Le sevrage tabagique permet d’améliorer l’état de santé du patient, son taux de survie, et de diminuer les comorbidités et le risque d’autres cancers. La recommandation du sevrage tabagique est donc importante. Cependant, le taux d’arrêt du tabac après l’annonce de ce cancer reste faible. Il est donc nécessaire de comprendre les raisons d’une poursuite ou de l’arrêt de la pratique tabagique après l’annonce de la maladie. Dans cet objectif nous avons réalisé une enquête qualitative au sein d’un centre de lutte contre le cancer. Après des observations de consultation, nous avons rencontré des patients afin de recueillir leur expérience, leurs usages et pratiques, et ainsi leurs représentations du tabac malgré la maladie. Ces données qualitatives nous ont permis de mieux comprendre les différentes raisons qui permettent à certains patients d’envisager ou bien de débuter un processus de sevrage, et ceux pour qui l’arrêt définitif du tabac est difficile à envisager même à la suite de l’annonce du cancer. Tobacco is a major risk factor for patients with head and neck cancer. Smoking cessation improves a patient’s health, his survival, and reduces co-morbidities and the risk of other cancers. The recommendation of smoking cessation is therefore important. However, the rate of smoking cessation after the announcement of this cancer remains low. It is therefore necessary to understand the reasons for continuing or quitting smoking after the announcement of the disease. To this end, we conducted a qualitative survey at a Cancer Control Centre (CLCC). After consultation observations, we met patients in order to collect their experience, uses and practices, and thus their representations of smoking despite the disease. The qualitative data allowed us to better understand the different reasons why some patients consider or begin a withdrawal process, and those for whom permanent cessation of smoking cannot be considered even after the cancer announcement.

Background The objective of this study was to assess the effectiveness of a Patient Navigation Intervention targeting deprived patients for Colo-Rectal Cancer (CRC) screening participation. Methods A cluster randomized controlled trial was conducted in 5 districts. Peer Lay Patient Navigators were recruited to operate in deprived areas. Eligible participants had to be between 50 and 74 years old, live in these deprived areas and receive an invitation to the nationally organized Colo-Rectal Cancer (CRC) screening during the study period. The theory-driven navigation intervention was deployed for 18 months. A population Health Intervention Research assessment method was used to assess effectiveness and context interaction. The primary criterion was screening participation at 12 months. Results Twenty-four thousand two hundred eighty-one individuals were included inside 40 clusters. The increase in participation in the intervention group was estimated at 23%, (ORa = 1.23, CI95% [1.07-1.41], p = 0.003). For the subgroup of individuals who participated, the time delay to participating was reduced by 26% (ORa = 0.74, CI95% [0.57-0.96], p = 0.021). Main factors modulating the effect of the intervention were: closeness of navigator profiles to the targeted population, navigators' abilities to adapt their modus operandi, and facilitating attachment structure. Conclusion The ColoNav Intervention succeeded in demonstrating its effectiveness, for CRC screening. Patient Navigation should be disseminate with broader health promotion goals in order to achieve equity in health care. Trial registration clinicaltrials.gov NCT02369757 24/02/2015.

Abstract Background A health-promoting school (HPS) approach was introduced over 25 years ago and has been promoted globally since; however, the aspiration of a fully embedded, sustainable HPS system has not yet been achieved, and very few countries have implemented and sustained the approach at scale. The Alliance for health aims to enact and assess the impact of a comprehensive approach to health promotion at the school and community levels. This is an intersectoral project involving regional education authorities, regional public health agency, local policy makers, researchers, and local health promotion operators. The question arises as to how to identify factors influencing teachers’ activity in wellness (WB), health education (HE), life skills (LS) and health literacy (HL)? Methods This project involves 101 French primary schools and 97 associated municipalities in the AURA region randomly selected in an intervention and control groups. Primary school teachers were provided training, support, and resources to develop a health-promoting environment in school according to the Health-Promoting Schools framework. Primary school teachers were provided training, support, and resources to develop a health-promoting environment in school according to the Health-Promoting Schools framework. Each year, a questionnaire is distributed to teachers in order to monitor the development of their activity in the areas of WB, HE, LS and HL. 243 questionnaires are analyzed, collected from october 19 to March 20, 12 opening questions were analyzed (1591 items) in order to characterize their practices in the areas aboved. Based on this classification, factors contributing to activities were seeked by doing univariate, multivariate and exploratory factor analysis. Results: The descriptive analysis showed that factors are linked to institutional, contextual, individual and collective dimensions. The results are preliminary and the complex analysis are actually in process. Key messages • A better understanding linked to their practices in health education, health literacy, like skills and well-being is needed to develop appropriate training and support. • To develop adequate training and support in health promoting school, it's necessary to identify factors most linked to primary teacher practices in health education, like skills and health literacy.

Background: The mass colorectal cancer screening program was implemented in 2008 in France, targeting 16million French people aged between 50 and 74. The current adhesion is insufficient and the participation rate iseven lower among the underserved population, increasing health inequalities within our health care system. PatientNavigation programs have proved their efficiency to promote the access to cancer screening and diagnosis.Methods/Design: The purpose of the study is to assess the implementation of a patient navigation interventionthat has been described in another cultural environment and another health care system. The main objective ofthe program is to increase the colorectal cancer screening participation rate among the deprived populationthrough the intervention of a navigator to promote the Fecal Occult Blood Test (FOBT) and complementary exams.We performed a multisite cluster randomized controlled trial, with three groups (one experimental group and twocontrol groups) for 18 months.Discussion: The study attempts to give a better understanding of the adhesion barriers to colorectal cancerscreening among underserved populations. If this project is cost-effective, it could create a dynamic based on peerapproaches that could be developed for other cancer screening programs and other chronic diseases.

CENP‐H has recently been discovered as a constitutive component of the centromere that co‐localizes with CENP‐A and CENP‐C throughout the cell cycle. The precise function, however, remains poorly understood. We examined the role of CENP‐H in centromere function and assembly by generating a conditional loss‐of‐function mutant in the chicken DT40 cell line. In the absence of CENP‐H, cell cycle arrest at metaphase, consistent with loss of centromere function, was observed. Immunocytochemical analysis of the CENP‐H‐deficient cells demonstrated that CENP‐H is necessary for CENP‐C, but not CENP‐A, localization to the centromere. These findings indicate that centromere assembly in vertebrate cells proceeds in a hierarchical manner in which localization of the centromere‐specific histone CENP‐A is an early event that occurs independently of CENP‐C and CENP‐H.