Three studies were conducted to examine the role of psychosocial factors in the prediction of health innovation uptake. A health innovation is a device, treatment or altered food product intended to improve the health of an individual or group and considered new by the population of interest. Health innovations may be used to address current health problems in individuals but also play a key role in preventative health efforts. Encouraging individuals to adopt appropriate health innovations is often an important strategy in improving the general health and minimising the social cost of illness of a population. The current program of research examined the influence of predictors from the Theory of Planned Behaviour (TPB; Ajzen, 1991), the Technology Acceptance Model (TAM; Davis, 1989; Davis, Bagozzi, & Warshaw, 1989), and risk technology literature (Fischhoff, Slovic, Lichtenstein, Read, & Combs, 1978; Slovic, 1987; Slovic, Fischhoff, & Lichtenstein, 1980) on health innovation decision-making. Additionally, the study examined the background factors of previous experience with the innovation, age, and gender. Guided by the overall conceptualisations of change presented in the Stages of Change Model (Prochaska & DiClemente, 1984; Prochaska & Velicer, 1997) and the Innovation Decision Model (Rogers, 1958, 2003), the three studies aimed to examine the role of the proposed predictors for a number of different innovations at various stages of diffusion. Study 1 (N = 358) employed a correlational design to predict people's intentions and willingness to use the four health innovations of functional foods, vitamin supplements, alternative therapies and pedometers. Participants completed questionnaires based on the TPB examining attitude (favourability towards the innovation), subjective norms (pressure from others for innovation uptake) and perceived behavioural control (PBC; sense of control over adopting the innovation). In addition, participants completed items assessing the constructs of usefulness of the innovation and ease of use of the innovation from the TAM and familiarity of risks and dread of risks associated with the innovation, adapted from the risk literature. Background factors, such as previous innovation use and age and gender of the participants, were also examined. The underlying behavioural, normative, and control belief constructs of the TPB were examined to differentiate between those participants who reported that they were intending to or willing to adopt the health innovation and those who were not intending to or willing to adopt the health innovation. Overall, the results of Study 1 supported the TPB constructs, perceived usefulness from the TAM, and risk familiarity. Study 2 (N = 102) utilized an experimental design where usefulness of the four innovations examined in Study 1 and the familiarity of risks associated with them were manipulated in a 2 x 2 scenario based study. As in Study 1, participants completed measures of the TPB factors, an assessment of the dread of risk and reported background factors such as previous innovation use, and their age and gender. Participants read reports of 'recent research' that contained information about the innovations' usefulness in relation to health benefit and familiarity of risk in comparison to traditional health products. As in Study 1, people's intentions and willingness to use the health innovations were examined, as was a third outcome measure; participant predicted future use of each innovation. The results of Study 2 provided support for the TPB constructs of attitude and subjective norms. The study also provided limited support for the TAM factor of usefulness, as well as for the risk dimensions of familiarity of risks and dread of risks. The TPB construct of PBC and the background factors of age and gender were not supported. Study 3 (N = 116) employed a 2 x 2 between-subjects design where usefulness and dread of risks were manipulated for a previously unavailable health innovation, calcium enriched mints. Study 3 also involved a within-subjects measurement of two behaviour measures (estimated consumption, and a diary recorded measure of consumption) over three time periods. Intention was retained as a third uptake measure of innovation uptake. Participants were presented with manipulated information about the usefulness and dread of risks associated with calcium enriched mints. Study 3 examined the role of the manipulated constructs, the TPB factors, familiarity of risk, and demographics in the prediction of the enriched mints uptake. The design of this study addressed limitations identified in the literature and mirrored a number of authentic health innovation uptake situations. The results of Study 3 strongly supported the role of attitude and subjective norms as influential predictors of intention to consume the calcium enriched mints, and intention as a predictor of estimated and diary recorded measures of consumption. The study offered limited support for the risk factors of familiarity of risks and dread of risks and did not support the TAM construct of usefulness as a predictor of calcium enriched mint uptake. Taken together, the results of this research provided strong support for the role of the TPB factors of attitude and subjective norms, but not PBC, as predictors of health innovation intentions and willingness. The results also supported the role of intention as a predictor of health innovation adoption behaviour. Limited support was found for the risk dimensions of familiarity of risks and dread of risks, suggesting that another conceptualisation of risk may be more appropriate for health innovation decision-making. The results found little support for the TAM variables of usefulness and ease of use, or the influence of demographic characteristics of age and gender. These findings indicate that the general decision-making model of the TPB, with the exception of the role of PBC, provides a useful framework to understand people's health innovation decision-making. Given the limited support for PBC in the prediction of intentions and behaviour in this context, the Theory of Reasoned Action (Fishbein & Ajzen, 1975), with some consideration of risk factors, may be an appropriate approach to adopt to facilitate an understanding the factors underlying people's decision to use innovations designed to improve their health.

Innovation in healthcare is a central way of coping with the changes affecting the healthcare system through the megatrends of demographic change, digitalization as well as the opportunities in the life-sciences sector and the “-omics” subjects. Due to the multiple facets of the topic, research on innovation in healthcare is diverse and draws insights from systems theory, management theory, human resources, innovation and change management. While the literature on innovation in healthcare has grown steadily in the last 20 years and publications on pharmaceutical and medical device innovation, health technology assessment strategies, or digital innovations have increased significantly, other areas such as sectoral health innovation systems, the creation and implementation of innovation in hospitals still remain fairly uncharted. Applying established concepts such as systems of innovation theory, mass customization theory or management of employee involvement in innovation activities to the healthcare sector provides new insights into a field that is often considered a “blackbox”. This thesis adds to the topic in three essays, each focusing on a different aspect and depth level ranging from a macro perspective on healthcare innovation on a global scale to a meso level perspective on the implementation of personalized medicine in one country and putting a micro lens on innovation activities of hospital staff. The aim of this thesis is to provide an overview for researchers, policy makers and healthcare stakeholders about current developments, propose tools for measuring innovation and allow for benchmarking the current status quo in healthcare in order to foster new and innovative developments.

A área da saúde é considerada um dos setores econômicos mais dinâmico em termos de inovação e de acumulação de capital. Desta forma, a compreensão de sua estrutura e funcionamento é indispensável para a construção de políticas efetivas de promoção do bem-estar e do desenvolvimento dos países no âmbito dos Sistemas de Inovação em Saúde (SIS). O progresso tecnológico do setor de saúde vincula-se fortemente à ciência, tendo o advento da biotecnologia moderna acentuado a relação entre ciência e tecnologia para a pesquisa e a inovação médica, sendo que a inovação na área da saúde depende de pesquisas interdisciplinares e das interações entre indústrias e universidades, especialmente centros médicos acadêmicos, que atuam como centros de convergência de fluxos de informação científica e tecnológica. As pesquisas médica e biomédica no Brasil, a despeito de seu progresso em publicações científicas, apresentam caráter predominantemente acadêmico devido, em parte, ao fato de não existir suporte adequado à proteção à propriedade intelectual e ao reconhecimento de patentes no país. Neste sentido, a presente pesquisa tem como objetivo verificar como um empreendimento de base biotecnológica do segmento de fármacos é influenciado pelo SIS onde está inserido, tomando-se como objeto de estudo uma empresa desenvolvedora de produtos para oncologia, identificada aqui com o nome fictício de BIOTEC. Para tanto, foi realizado um estudo qualitativo e exploratório de caso único em duas etapas, a primeira envolvendo pesquisas em fontes de dados secundários e a segunda composta por entrevistas em profundidade com uma das empreendedoras da empresa BIOTEC e com a Gerente da Incubadora Empresarial do Centro de Biotecnologia da UFRGS (IECBiot), um dos parceiros da empresa e um importante ator dentro do Sistema Regional de Inovação em Saúde do Rio Grande do Sul (SRIS-RS). A partir das respostas obtidas, foi possível compreender como se dá a interação da empresa com outros atores do SIS brasileiro, em nível nacional e regional. Verificou-se também que,devido à existência de obstáculos associados ao excesso de burocracia e à dificuldade de ao acesso a fomento e incentivos no estado do RS, este não apresenta um ambiente propício ao desenvolvimento de empresas com o perfil da BIOTEC e que, apesar de existirem esforços do governo estadual em melhorar a situação do SRIS-RS, estas ainda se encontram aquém do necessário, fazendo com que, muitas vezes, as empresas optem por buscar ambientes mais favoráveis aos negócios. / The healthcare sector is one of the most dynamic sectors of the economy in terms of innovation and capital accumulation. Thus, understanding its structure and operation is essential for building effective policies to promote the welfare and development of countries under the health innovation systems (SIS). Technological progress in the healthcare sector binds strongly to science, with the advent of modern biotechnology marking the relationship between science and technology for research and medical innovation. Innovation in healthcare depends on interdisciplinary research and interactions between industries and universities, especially academic medical centers, which act as convergence centers of scientific and technological information flows. The medical and biomedical research in Brazil, despite its progress in scientific publications, have predominantly academic character, in part due to the fact that there isn’t adequate support for intellectual property protection and recognition of patents in the country. This way, this research aims to check how a biotechnology-based enterprise, focused on the production of drugs, is influenced by the HIS where it’s localized, taking as object of study a company that develops products for oncology, here identified with the fictitious name of BIOTEC. Therefore, it was conducted a qualitative and exploratory study of a single case in two stages, the first involving research on secondary data sources, and the second consisting of interviews with the entrepreneurs of BIOTEC company and the manager of the Business Incubator of the Biotechnology Center from UFRGS (IECBiot), one of the company partners and a major player within the health regional innovation system in the Rio Grande do Sul (SRIS-RS). From the answers obtained, it was possible to understand how is the company's interaction with the other actors of SIS, at the national and regional level. It was also found that, due to barriers associated with excessive bureaucracy and the difficulty to access finance promotion and incentives, the Rio Grande do Sul state doesn’t provide an appropriate environment to the development of companies with the BIOTEC’s profile. Although there are government efforts to improve the situation of SRIS-RS, they are still insufficient, which often make the companies choose to seek more favorable environments for business.

A área da saúde é considerada um dos setores econômicos mais dinâmico em termos de inovação e de acumulação de capital. Desta forma, a compreensão de sua estrutura e funcionamento é indispensável para a construção de políticas efetivas de promoção do bem-estar e do desenvolvimento dos países no âmbito dos Sistemas de Inovação em Saúde (SIS). O progresso tecnológico do setor de saúde vincula-se fortemente à ciência, tendo o advento da biotecnologia moderna acentuado a relação entre ciência e tecnologia para a pesquisa e a inovação médica, sendo que a inovação na área da saúde depende de pesquisas interdisciplinares e das interações entre indústrias e universidades, especialmente centros médicos acadêmicos, que atuam como centros de convergência de fluxos de informação científica e tecnológica. As pesquisas médica e biomédica no Brasil, a despeito de seu progresso em publicações científicas, apresentam caráter predominantemente acadêmico devido, em parte, ao fato de não existir suporte adequado à proteção à propriedade intelectual e ao reconhecimento de patentes no país. Neste sentido, a presente pesquisa tem como objetivo verificar como um empreendimento de base biotecnológica do segmento de fármacos é influenciado pelo SIS onde está inserido, tomando-se como objeto de estudo uma empresa desenvolvedora de produtos para oncologia, identificada aqui com o nome fictício de BIOTEC. Para tanto, foi realizado um estudo qualitativo e exploratório de caso único em duas etapas, a primeira envolvendo pesquisas em fontes de dados secundários e a segunda composta por entrevistas em profundidade com uma das empreendedoras da empresa BIOTEC e com a Gerente da Incubadora Empresarial do Centro de Biotecnologia da UFRGS (IECBiot), um dos parceiros da empresa e um importante ator dentro do Sistema Regional de Inovação em Saúde do Rio Grande do Sul (SRIS-RS). A partir das respostas obtidas, foi possível compreender como se dá a interação da empresa com outros atores do SIS brasileiro, em nível nacional e regional. Verificou-se também que,devido à existência de obstáculos associados ao excesso de burocracia e à dificuldade de ao acesso a fomento e incentivos no estado do RS, este não apresenta um ambiente propício ao desenvolvimento de empresas com o perfil da BIOTEC e que, apesar de existirem esforços do governo estadual em melhorar a situação do SRIS-RS, estas ainda se encontram aquém do necessário, fazendo com que, muitas vezes, as empresas optem por buscar ambientes mais favoráveis aos negócios. / The healthcare sector is one of the most dynamic sectors of the economy in terms of innovation and capital accumulation. Thus, understanding its structure and operation is essential for building effective policies to promote the welfare and development of countries under the health innovation systems (SIS). Technological progress in the healthcare sector binds strongly to science, with the advent of modern biotechnology marking the relationship between science and technology for research and medical innovation. Innovation in healthcare depends on interdisciplinary research and interactions between industries and universities, especially academic medical centers, which act as convergence centers of scientific and technological information flows. The medical and biomedical research in Brazil, despite its progress in scientific publications, have predominantly academic character, in part due to the fact that there isn’t adequate support for intellectual property protection and recognition of patents in the country. This way, this research aims to check how a biotechnology-based enterprise, focused on the production of drugs, is influenced by the HIS where it’s localized, taking as object of study a company that develops products for oncology, here identified with the fictitious name of BIOTEC. Therefore, it was conducted a qualitative and exploratory study of a single case in two stages, the first involving research on secondary data sources, and the second consisting of interviews with the entrepreneurs of BIOTEC company and the manager of the Business Incubator of the Biotechnology Center from UFRGS (IECBiot), one of the company partners and a major player within the health regional innovation system in the Rio Grande do Sul (SRIS-RS). From the answers obtained, it was possible to understand how is the company's interaction with the other actors of SIS, at the national and regional level. It was also found that, due to barriers associated with excessive bureaucracy and the difficulty to access finance promotion and incentives, the Rio Grande do Sul state doesn’t provide an appropriate environment to the development of companies with the BIOTEC’s profile. Although there are government efforts to improve the situation of SRIS-RS, they are still insufficient, which often make the companies choose to seek more favorable environments for business.

A área da saúde é considerada um dos setores econômicos mais dinâmico em termos de inovação e de acumulação de capital. Desta forma, a compreensão de sua estrutura e funcionamento é indispensável para a construção de políticas efetivas de promoção do bem-estar e do desenvolvimento dos países no âmbito dos Sistemas de Inovação em Saúde (SIS). O progresso tecnológico do setor de saúde vincula-se fortemente à ciência, tendo o advento da biotecnologia moderna acentuado a relação entre ciência e tecnologia para a pesquisa e a inovação médica, sendo que a inovação na área da saúde depende de pesquisas interdisciplinares e das interações entre indústrias e universidades, especialmente centros médicos acadêmicos, que atuam como centros de convergência de fluxos de informação científica e tecnológica. As pesquisas médica e biomédica no Brasil, a despeito de seu progresso em publicações científicas, apresentam caráter predominantemente acadêmico devido, em parte, ao fato de não existir suporte adequado à proteção à propriedade intelectual e ao reconhecimento de patentes no país. Neste sentido, a presente pesquisa tem como objetivo verificar como um empreendimento de base biotecnológica do segmento de fármacos é influenciado pelo SIS onde está inserido, tomando-se como objeto de estudo uma empresa desenvolvedora de produtos para oncologia, identificada aqui com o nome fictício de BIOTEC. Para tanto, foi realizado um estudo qualitativo e exploratório de caso único em duas etapas, a primeira envolvendo pesquisas em fontes de dados secundários e a segunda composta por entrevistas em profundidade com uma das empreendedoras da empresa BIOTEC e com a Gerente da Incubadora Empresarial do Centro de Biotecnologia da UFRGS (IECBiot), um dos parceiros da empresa e um importante ator dentro do Sistema Regional de Inovação em Saúde do Rio Grande do Sul (SRIS-RS). A partir das respostas obtidas, foi possível compreender como se dá a interação da empresa com outros atores do SIS brasileiro, em nível nacional e regional. Verificou-se também que,devido à existência de obstáculos associados ao excesso de burocracia e à dificuldade de ao acesso a fomento e incentivos no estado do RS, este não apresenta um ambiente propício ao desenvolvimento de empresas com o perfil da BIOTEC e que, apesar de existirem esforços do governo estadual em melhorar a situação do SRIS-RS, estas ainda se encontram aquém do necessário, fazendo com que, muitas vezes, as empresas optem por buscar ambientes mais favoráveis aos negócios. / The healthcare sector is one of the most dynamic sectors of the economy in terms of innovation and capital accumulation. Thus, understanding its structure and operation is essential for building effective policies to promote the welfare and development of countries under the health innovation systems (SIS). Technological progress in the healthcare sector binds strongly to science, with the advent of modern biotechnology marking the relationship between science and technology for research and medical innovation. Innovation in healthcare depends on interdisciplinary research and interactions between industries and universities, especially academic medical centers, which act as convergence centers of scientific and technological information flows. The medical and biomedical research in Brazil, despite its progress in scientific publications, have predominantly academic character, in part due to the fact that there isn’t adequate support for intellectual property protection and recognition of patents in the country. This way, this research aims to check how a biotechnology-based enterprise, focused on the production of drugs, is influenced by the HIS where it’s localized, taking as object of study a company that develops products for oncology, here identified with the fictitious name of BIOTEC. Therefore, it was conducted a qualitative and exploratory study of a single case in two stages, the first involving research on secondary data sources, and the second consisting of interviews with the entrepreneurs of BIOTEC company and the manager of the Business Incubator of the Biotechnology Center from UFRGS (IECBiot), one of the company partners and a major player within the health regional innovation system in the Rio Grande do Sul (SRIS-RS). From the answers obtained, it was possible to understand how is the company's interaction with the other actors of SIS, at the national and regional level. It was also found that, due to barriers associated with excessive bureaucracy and the difficulty to access finance promotion and incentives, the Rio Grande do Sul state doesn’t provide an appropriate environment to the development of companies with the BIOTEC’s profile. Although there are government efforts to improve the situation of SRIS-RS, they are still insufficient, which often make the companies choose to seek more favorable environments for business.

[pt] A teleconsulta, como ferramenta tecnológica, pode gerar maior acessibilidade a serviços de saúde de qualidade, além de servir para lidar com os desafios de recursos na indústria da saúde. Pode também ser particularmente relevante durante a pandemia de COVID-19, com o distanciamento social que demanda novas soluções tecnológicas para a oferta de serviços de qualidade com contato pessoal reduzido. Este trabalho propõe um modelo integrativo de aceitação de tecnologia para avaliar os fatores determinantes da adoção de teleconsulta pelos pacientes, alinhando construtos de caráter cognitivo e comportamental, oriundos do modelo de aceitação de tecnologia, com outros construtos de natureza distintas: (i) prontidão tecnológica, representando o fator de natureza tecnológica do modelo; e (ii) confiança e autoeficácia, representando construtos relacionados com aspectos específicos e relevantes na adoção de tecnologias em serviços de saúde. Para testar e validar o modelo conceitual proposto, foi utilizada a modelagem de equações estruturais com dados dos questionários de 415 consumidores. Os resultados obtidos indicam relações significativas entre os construtos avaliados, com particular relevância nos efeitos da utilidade percebida, antecedida pela confiança e prontidão tecnológica, sobre atitude e intenção de uso da teleconsulta. O uso deste modelo integrativo, com seis potenciais antecedentes, possibilitou explicar 67,7 por cento da variância da intenção comportamental de uso dos respondentes. Os achados também sugerem que o contexto pandêmico associado com o Covid-19 possa influenciar o comportamento dos pacientes quanto à intenção de uso da teleconsulta. Desta forma, os resultados obtidos fornecem avanços no debate da aceitação de tecnologia nos serviços de saúde, ao propor um modelo integrativo e potencialmente inédito de avaliação das intenções de uso, sobre a ótica dos pacientes. Também servem como potenciais fontes orientadoras para organizações de saúde e reguladores públicos, na formatação de estratégias para o futuro da teleconsulta no Brasil no período posterior à pandemia de COVID-19. / [en] Teleconsultation can be a strategic technological tool for patients to access quality healthcare while dealing with resource challenges within health industry. It can be particularly relevant during and after the COVID-19 pandemic, when the social distancing world had to scramble for new technological solutions to offer quality healthcare services with reduced personal contact. Our research proposes an integrative technology acceptance model to evaluate the drivers of teleconsultation adoption by patients, aligning cognitive and behavioral constructs from the technology acceptance model with other drivers associated with distinct natures, such as: (i) technology readiness, a factor with technological characteristics; and (ii) trust, and self-efficacy, constructs strongly associated and relevant to the acceptance of technologies in health-related services. To test and validate the proposed conceptual model, this study applied structural equations modeling based on survey’s data from a sample of 415 consumers. Results indicate significant relationships between the assessed constructs, with particular relevance on the effects of perceived usefulness, anteceded by trust and technology readiness, on attitude and intention to use teleconsultation. The model was able to explain 67.7 percent of respondents behavioral intention in adopting teleconsultation. Our findings also suggested the potential impact of the pandemic context (Covid-19) on the respondents answers and behaviors. Our findings support the debate on technology acceptance by providing an integrative and potentially new model for assessing patients intention of adopting new health-related technologies. In addition, results provide helpful insights for health organizations and regulators in their future strategies and debates on the teleconsultation introduction in Brazil in the period post-Covid-19 pandemic.

Les innovations médicales ont un impact considérable sur les pratiques cliniques, sur la formulation des politiques et sur les attentes du public envers le système de santé. Dans un contexte de système de santé public, les conséquences économiques importantes des innovations médicales freinent grandement leur adoption alors qu’elles sont souvent représentées dans les médias comme étant hautement désirables. Une telle définition de la problématique limite le débat sur ce qui rend les innovations sociales et technologiques en santé pertinentes d’un point de vue de santé des populations. Il apparaît donc intéressant de tirer profit d’une pratique communicationnelle innovante, le Café scientifique. Ce projet de recherche analyse un Café scientifique ayant mis en scène en mars 2007 un échange entre quatre experts et environ 80 membres du public autour des enjeux relatifs aux innovations en santé. Les objectifs sont : 1) analyser l’application d’une intervention de type Café scientifique; et 2) analyser ses retombées sur les participants. Cette étude de cas unique s’appuie sur des données qualitatives et quantitatives: 1) observation semi-participative; 2) enregistrement audiovisuel de l’activité; 3) questionnaires distribués à la fin de l’activité; et 4) entrevues semi-dirigées (n=11) avec des participants. L’analyse intégrée de ces données permet de mieux comprendre comment le contexte est structurant pour le débat, décrit les principaux rôles adoptés par les participants lors des échanges, identifie les principaux enjeux relatifs aux innovations médicales qui ont été débattus et dégage les dynamiques qui favorisent ou nuisent à un dialogue entre des scientifiques et le public. Le Café scientifique est une pratique encore peu répandue, mais qui suscite un intérêt à la fois chez les chercheurs et les participants. / Medical innovations have significant influence on clinical practice, policy-making and public expectation towards the health care system. In the context of public health care systems, the cost of health innovation is a major barrier to its adoption even if they are often portrayed in the media as inherently desirable. Such a framing of the problem impedes the debate on what makes social and technological health innovations relevant from a population health perspective. Thus it is interesting to take advantage of an innovative communicational process, the Café scientifique. This research project analyzes a Café scientifique that took place in March 2007 which established a dialogue between four experts and around 80 members of the public on health innovation issues. The objectives are: 1) to analyze the application of the Café scientifique, and 2) to analyze its impact on participants. This single case study uses qualitative and quantitative data: 1) semi-participative observation; 2) audiovisual recording of the activity; 3) surveys distributed at the end of the activity; 4) semi-directed interviews (n=11) with participants. Integrated analysis of all data gives a better understanding of how the context is structuring for the debate, describes the main roles adopted by participants, identifies key health innovation issues that were discussed and highlights which features have facilitated or hindered a dialogue between scientists and the public. The Café scientifique is an unusual practice which stirs up interest of both researchers and participants.

Introduction. Les programmes de vélos en libre-service (PVLS) représentent une innovation en transport actif. À ce jour, la sensibilisation à cette innovation en tant que prérequis à l’accessibilité n’a jamais été étudiée. Objectif. Identifier les facteurs liés à l’absence de sensibilisation à l’existence du PVLS à Montréal. Méthode. 7011 Montréalais âgés de 18 ans et plus ont été interrogés au cours de 3 sondages téléphoniques sur une période couvrant deux saisons : avant la première saison (n=2000), après la première saison (n=2502) et après la deuxième saison (n=2509). Des analyses de régression logistique ont été réalisées sur 93,6 % (n=6562) de l’échantillon pour examiner l’effet du temps, de la proximité des stations de vélos et du niveau d’éducation sur l’absence de sensibilisation à l’existence du PVLS. Résultats. Nous constatons que, après la première saison d’implantation du PVLS, la probabilité d’absence de sensibilisation au PVLS est plus élevée chez les individus dont le niveau d’éducation est faible que chez ceux dont le niveau d’éducation est élevé (RC = 1,60; 95 % IC : 1,18; 2,19). Aussi, nous observons que, après la deuxième saison d’implantation, la probabilité d’absence de sensibilisation au PVLS est plus élevée chez les individus dont le niveau d’éducation est faible et qui vivent dans un voisinage pourvu d’un PVLS, que chez ceux dont le niveau d’éducation est élevé et qui vivent dans un voisinage dépourvu d’un PVLS (RC = 1,63, 95 % IC : 1,01; 2,64). Conclusion. Malgré l’accessibilité au PVLS dans un voisinage, des inégalités sociales persistent. / Background. Public bicycle share programs (PBSP) are an active transportation innovation. No study has examined lack of awareness of PBSP as a factor limiting accessibility. Objective. Identify factors associated with lack of awareness of a PBSP across time in Montreal. Methods. Within the context of a larger study, a sample of 7,011 Montrealiers aged 18 years and over were recruited to participate in one of three telephone surveys occurring prior to implementation (n=2,000), after season 1 (n=2,502), and after season 2 (n=2,509). Multivariable logistic regression analyses were used to investigate associations between survey period, proximity to docking stations, and education with lack of PBSP awareness. Results. There was a greater likelihood of being PBSP-unaware among those with lower education after season 1 implementation in comparison to those with higher education (OR = 1.60, 95 %CI: 1.18, 2.19). There was also greater likelihood of being PBSP-unaware among those with lower education after season 2 implementation in neighbourhoods where the PBSP was available in comparison to those with higher education in neighbourhoods without PBSP docking stations (OR = 1.63, 95 %CI: 1.01, 2.64). Although lack of awareness decreased over time, greater likelihood of being PBSP-unaware was observed among those with lower education. Conclusion. Despite the physical presence of PBSP docking stations in neighbourhoods, socioeconomic inequalities persist.

Submitted by William Justo Figueiro (williamjf) on 2015-07-17T22:45:38Z No. of bitstreams: 1 33c.pdf: 1647534 bytes, checksum: d38839966d3f5f1486568ea3394baf47 (MD5) / Made available in DSpace on 2015-07-17T22:45:38Z (GMT). No. of bitstreams: 1 33c.pdf: 1647534 bytes, checksum: d38839966d3f5f1486568ea3394baf47 (MD5) Previous issue date: 2014-07-29 / UNISINOS - Universidade do Vale do Rio dos Sinos / Este estudo teve por objetivo compreender as caraterísticas das empresas industriais do segmento de equipamentos médicos, hospitalares e odontológicos localizadas no RS quanto aos seus processos inovativos. Para isto realizou-se uma pesquisa de caráter teórico-empírica. Utilizaram-se dados de fontes secundárias de informação, especialmente do Relatório Anual de Informações Sociais (RAIS) e do Diretório dos Grupos de Pesquisa do CNPq e fontes primárias de informação. Optou-se por uma pesquisa de campo, com uma amostra de dezessete empresas, em que se buscou, por meio da aplicação de um instrumento de pesquisa, de forma presencial, coletar informações a cerca dos processos inovativos, interação universidade-empresa e avaliação das empresas sobre as ações de promoção existentes para o setor. O desenvolvimento da pesquisa foi alicerçado numa abordagem teórica sobre sistemas nacionais de inovação, sistema de inovação em saúde e interação universidade-empresa. Os resultados mostraram que as empresas estão num processo crescente de desenvolvimento e inovação em produto, em processo e organizacional. Para inovar buscam informações de diversas fontes de conhecimento. Com relação às fontes internas, a área de vendas/marketing e serviços de atendimento ao cliente foi indicada pelas empresas como a principal fonte de informação para inovar. No que tange às fontes externas à empresa, os clientes, profissionais da saúde e os hospitais foram considerados como fontes muito relevantes para o processo de inovação das empresas. Quanto às parcerias estabelecidas, os clientes foram considerados o principal agente para se estabelecer parcerias. Empresas buscam estabelecer parceria com as universidades e o objetivo principal é o desenvolvimento de projetos de P&D em conjunto e a obtenção de validação de produtos por meio de ensaios laboratoriais; fica evidente que este relacionamento lhes confere credibilidade frente ao mercado. O fortalecimento das relações entre os diversos atores do sistema de inovação em saúde é fundamental para o desenvolvimento e fortalecimento do setor de EMHO no RS. / This study aimed to understand the characteristics of the industrial companies of the segment of medical, hospital and dental equipments, located in RS, about their innovative processes. For this, a theoretical and empirical survey was applied. Secondary data information, from Annual Report of Social Information (ARSI) and from CNPq Directory of Research Groups, and primary data were used. A field survey, with a sample of seventeen companies, was personally applied in order to collect information about the innovative processes, university-industry interaction and the assessment of companies about the existent actions for the sector promotion. The development of the research was grounded in a theoretical approach about national innovation systems, health innovation system and university-industry interactions. The results showed that the companies are in growing process of development and of innovation in product and process and organizational. To innovate, they use information from different sources of knowledge. About the internal sources, the area of sales and marketing and customer service was indicated by companies as the main source of information for innovation. Regarding the external sources, clients, health professionals and hospitals were considered highly relevant sources for the innovation process of companies. Considering the partnerships, customers were considered the main agent to establish partnerships. Companies interact with universities with the main purpose of developing R&D projects together and get the product validation by laboratory tests; it is evident that this relationship gives them credibility in the market. Strengthening relations between the various actors in the health innovation system is critical to the development and strengthening of EMHO sector in RS.

Les innovations médicales ont un impact considérable sur les pratiques cliniques, sur la formulation des politiques et sur les attentes du public envers le système de santé. Dans un contexte de système de santé public, les conséquences économiques importantes des innovations médicales freinent grandement leur adoption alors qu’elles sont souvent représentées dans les médias comme étant hautement désirables. Une telle définition de la problématique limite le débat sur ce qui rend les innovations sociales et technologiques en santé pertinentes d’un point de vue de santé des populations. Il apparaît donc intéressant de tirer profit d’une pratique communicationnelle innovante, le Café scientifique. Ce projet de recherche analyse un Café scientifique ayant mis en scène en mars 2007 un échange entre quatre experts et environ 80 membres du public autour des enjeux relatifs aux innovations en santé. Les objectifs sont : 1) analyser l’application d’une intervention de type Café scientifique; et 2) analyser ses retombées sur les participants. Cette étude de cas unique s’appuie sur des données qualitatives et quantitatives: 1) observation semi-participative; 2) enregistrement audiovisuel de l’activité; 3) questionnaires distribués à la fin de l’activité; et 4) entrevues semi-dirigées (n=11) avec des participants. L’analyse intégrée de ces données permet de mieux comprendre comment le contexte est structurant pour le débat, décrit les principaux rôles adoptés par les participants lors des échanges, identifie les principaux enjeux relatifs aux innovations médicales qui ont été débattus et dégage les dynamiques qui favorisent ou nuisent à un dialogue entre des scientifiques et le public. Le Café scientifique est une pratique encore peu répandue, mais qui suscite un intérêt à la fois chez les chercheurs et les participants. / Medical innovations have significant influence on clinical practice, policy-making and public expectation towards the health care system. In the context of public health care systems, the cost of health innovation is a major barrier to its adoption even if they are often portrayed in the media as inherently desirable. Such a framing of the problem impedes the debate on what makes social and technological health innovations relevant from a population health perspective. Thus it is interesting to take advantage of an innovative communicational process, the Café scientifique. This research project analyzes a Café scientifique that took place in March 2007 which established a dialogue between four experts and around 80 members of the public on health innovation issues. The objectives are: 1) to analyze the application of the Café scientifique, and 2) to analyze its impact on participants. This single case study uses qualitative and quantitative data: 1) semi-participative observation; 2) audiovisual recording of the activity; 3) surveys distributed at the end of the activity; 4) semi-directed interviews (n=11) with participants. Integrated analysis of all data gives a better understanding of how the context is structuring for the debate, describes the main roles adopted by participants, identifies key health innovation issues that were discussed and highlights which features have facilitated or hindered a dialogue between scientists and the public. The Café scientifique is an unusual practice which stirs up interest of both researchers and participants.