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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.

A patient education program has been developed in the field of cancer for supporting cancer patients undergoing oral anticancer therapies. Its implementation was tested in 3 different settings. The objectives of this study were to 1) identify barriers and facilitators for implementing the patient education program, 2) identify practices encouraging or hindering implementation and 3) produce recommendations for its dissemination. Twenty semi-structured interviews were conducted with caregivers from all three establishments. The main factors associated with successful implementation were as follows: prescribers' representations on patient education, considered of low value; on oral anticancer therapies, considered too dangerous to be handled by the patient him/herself, the indefinite legitimacy of certain professions in charge of patient education programs; patients' engagement in their care pathway and provision of caregivers. Recommendations include developing patient education culture within the environment of the medical doctors' curriculum, to consider contextual, pre-existing cooperative units for implementing patient education, to systematically send patients to patient education programs without practicing triage. Successful implementation of patient education critically depends on the prescribing physicians' perceived value of patient education. Patient education should become mandatory, integrated as part of the cancer care pathway. Physicians lack the necessary time and/or means to assess patients' capacity for engagement, without adequate strategies for their support. Therefore, physicians should systematically refer all patients to patient education, where nurses can tailor their coaching of cancer patients. The study protocol was approved by the IRB SUD EST I (N° EudraCT: 2016-A00113-48). All participants were given written and verbal information about the study and gave informed consent to participate.

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.