The purpose of this study was to test the premise that feedabck intervention cues differentially direct attention to a level of a processing hierarcy proposed by Kluger and DeNisi (1996). The hierarchy consists of task details, task motivation (general task), or meta-task processes (attention to "self"). Feedback designed to initiate different level of processing was manipulated and performance on a typing task was measured. The relationship between the feedback manipulation and performance was analyzed through analysis of covariance and repeated measures analysis of variance. For the analysis of covariance, the assumption of equality of slopes was violated, so data were analyzed through an ATI design. The feedback manipulation was associated with changes in performance, and these changes depended on ability. / Master of Science

The study's purpose was to determine if participants reported that booster sessions following a stepfamily education course were effective. Agencies in northern Utah that provide services to low-income (including minorities) families were used to recruit a sample of 487 males and 560 females. Participants were required to be in a relationship that formed a remarriage or to have children from a previous relationship, forming a stepfamily. Booster sessions were educational meetings that occurred four to six weeks after the completion of the stepfamily education course. Intervention theory states that as protective factors are implemented through prevention education they lessen the effects of risk factors in participants' lives. Booster sessions were focused on reiterating protective factors taught in the stepfamily course material and served as a protective factor through offering continued support to participants. A self-report measure was used at the completion of the booster session. Participants were asked if the booster session was worthwhile (fun, educational, and worth their time), if they learned something, and if they recognized a change in their knowledge base concerning healthy stepfamily skills through attending the booster session. Participants consistently reported that they did find the booster session worthwhile, that they learned something, and that they increased in knowledge concerning healthy stepfamily skills. Although all participants reported that booster sessions were effective, Latino participants reported higher averages than Caucasian participants in research questions two and three. Study findings suggest that booster sessions can serve as a means of increasing educational gains of participants after the conclusion of course material. Also, discussion is provided concerning the implications of providing family life education for the Latino population.

<p>The perspective on health among school pupils needs to be extended. School is animportant arena for the promoting of health among youth, primarily from a healthpromoting perspective and a proactive perspective. A holistic approach has gatheredsome ground in the policy documents for the nine year compulsory school in Sweden, butin what way, and what effect does it have on the governing authorities and on schoollevel?The aim of the study is to investigate the coherence between national, municipal andlocal levels regarding the view on health among pupils. In order to do this, the guidelinesfor pupil health in the municipality of Örebro and operational plans for seven F9 schoolsin the municipality of Örebro will be studied and compared to the government bill”Health, learning and sense of security”. In order to obtain a theoretical understanding ofthe course of events between the different organizational levels, intervention theory hasbeen used as an explanatory model.Through analysis of the municipal guidelines for youth and pupil health, shows that thedocument very much resembles the government bill, which becomes apparent through thesame abstract formulations used. The content of the operational plans, particularly thequestion of preventing ill-health, therefore generally stays on an abstract level as well.Consequently, no concrete measures are taken on school level.From what the government bill emphasizes, the strongest reflection in the operationalplans is the point of quality control in the pupil health work and the participation ofparents. The operational plans are influenced by documents that describe how the pupilhealth work is to be organized, but there is still no policy document available for pupilhealth on local school level that includes health promoting and preventive measures. Thusthe schools lack the tools needed to tackle ill-health from a holistic point of view.However, several measures are available when it comes to reactive measures such asbullying and abusive behaviour.</p> / <p>Det finns ett behov av en utvidgad syn på elevhälsa som uppmärksammar fler aspekter avhälsa. Skolan är en viktig arena för arbetet med barn och ungdomars hälsa, inte minstutifrån ett hälsofrämjande och förebyggande perspektiv. I de dokument som styr skolanhar ett helhetsperspektiv på elevers hälsa fått ett allt större utrymme men på vilket sättoch vad innebär det, från de styrande organen för skolan och ner till personalen som skabemöta eleverna?Syftet med studien är att undersöka överensstämmelsen mellan en nationell och enkommunal och en lokal nivå vad gäller elevhälsa. Konkret innebär det att granska Örebrokommuns riktlinjer för barn- och elevhälsa och sju verksamhetsplaner för F9-skolor iÖrebro kommun utifrån regeringspropositionen ”Hälsa, lärande och trygghet”. För att fåen sammanhängande teoretisk beskrivning av skeendet mellan de olika organisatoriskanivåerna har en interventionsteori används som förklaringsmodell.Det som framkommit genom analys av det kommunala dokumentet är att det i stort ärväldigt likt propositionen, vilket bland annat innebär att det som formulerats i abstraktaordalag i propositionen sällan formuleras mer konkret i kommunens riktlinjer. Det somblir skrivet i verksamhetsplanerna, i synnerhet det som rör att förebygga psykisk ohälsa,blir därför också i vissa fall bara till abstrakta målformuleringar som aldrig tar form ikonkreta åtgärder eller insatser.Det som starkast avspeglas i verksamhetsplanerna utifrån det som framhålls ipropositionen är vikten av att kvalitetssäkra elevhälsoarbetet och att arbeta med eleversoch föräldrars delaktighet. Till stor del formas verksamhetsplanerna utifrån dokumentsom konkret beskriver hur arbetet med elevhälsa ska bedrivas, dock finns det inte någotelevhälsodokument på lokal nivå som generellt beskriver ett förebyggande ochhälsofrämjande arbete. Således har skolorna få verktyg för att angripa ohälsa ur etthelhetsperspektiv. Däremot finns det ett flertal specifika åtgärder till redan befintligproblematik, likt mobbning och kränkande behandling.</p>

The perspective on health among school pupils needs to be extended. School is animportant arena for the promoting of health among youth, primarily from a healthpromoting perspective and a proactive perspective. A holistic approach has gatheredsome ground in the policy documents for the nine year compulsory school in Sweden, butin what way, and what effect does it have on the governing authorities and on schoollevel?The aim of the study is to investigate the coherence between national, municipal andlocal levels regarding the view on health among pupils. In order to do this, the guidelinesfor pupil health in the municipality of Örebro and operational plans for seven F9 schoolsin the municipality of Örebro will be studied and compared to the government bill”Health, learning and sense of security”. In order to obtain a theoretical understanding ofthe course of events between the different organizational levels, intervention theory hasbeen used as an explanatory model.Through analysis of the municipal guidelines for youth and pupil health, shows that thedocument very much resembles the government bill, which becomes apparent through thesame abstract formulations used. The content of the operational plans, particularly thequestion of preventing ill-health, therefore generally stays on an abstract level as well.Consequently, no concrete measures are taken on school level.From what the government bill emphasizes, the strongest reflection in the operationalplans is the point of quality control in the pupil health work and the participation ofparents. The operational plans are influenced by documents that describe how the pupilhealth work is to be organized, but there is still no policy document available for pupilhealth on local school level that includes health promoting and preventive measures. Thusthe schools lack the tools needed to tackle ill-health from a holistic point of view.However, several measures are available when it comes to reactive measures such asbullying and abusive behaviour. / Det finns ett behov av en utvidgad syn på elevhälsa som uppmärksammar fler aspekter avhälsa. Skolan är en viktig arena för arbetet med barn och ungdomars hälsa, inte minstutifrån ett hälsofrämjande och förebyggande perspektiv. I de dokument som styr skolanhar ett helhetsperspektiv på elevers hälsa fått ett allt större utrymme men på vilket sättoch vad innebär det, från de styrande organen för skolan och ner till personalen som skabemöta eleverna?Syftet med studien är att undersöka överensstämmelsen mellan en nationell och enkommunal och en lokal nivå vad gäller elevhälsa. Konkret innebär det att granska Örebrokommuns riktlinjer för barn- och elevhälsa och sju verksamhetsplaner för F9-skolor iÖrebro kommun utifrån regeringspropositionen ”Hälsa, lärande och trygghet”. För att fåen sammanhängande teoretisk beskrivning av skeendet mellan de olika organisatoriskanivåerna har en interventionsteori används som förklaringsmodell.Det som framkommit genom analys av det kommunala dokumentet är att det i stort ärväldigt likt propositionen, vilket bland annat innebär att det som formulerats i abstraktaordalag i propositionen sällan formuleras mer konkret i kommunens riktlinjer. Det somblir skrivet i verksamhetsplanerna, i synnerhet det som rör att förebygga psykisk ohälsa,blir därför också i vissa fall bara till abstrakta målformuleringar som aldrig tar form ikonkreta åtgärder eller insatser.Det som starkast avspeglas i verksamhetsplanerna utifrån det som framhålls ipropositionen är vikten av att kvalitetssäkra elevhälsoarbetet och att arbeta med eleversoch föräldrars delaktighet. Till stor del formas verksamhetsplanerna utifrån dokumentsom konkret beskriver hur arbetet med elevhälsa ska bedrivas, dock finns det inte någotelevhälsodokument på lokal nivå som generellt beskriver ett förebyggande ochhälsofrämjande arbete. Således har skolorna få verktyg för att angripa ohälsa ur etthelhetsperspektiv. Däremot finns det ett flertal specifika åtgärder till redan befintligproblematik, likt mobbning och kränkande behandling.

Sweden is home to five recognized national minorities, namely the Jews, the Roma, the Torne Valley Descendants (Tornedalians), the Swedish Finns, and the Sami population which also are an indigenous group. The Government`s Minority Policy aims at protecting and supporting the national minorities and the historical minority languages (Yiddish, Romani chib, Sami, Finnish, Meänkieli). The policy also promotes the right of youth, belonging to national minority groups in order to develop and streng then their cultural identity. This paper seeks to address the lack of involvement of Swedish Finnish youth in the so called Finnish Administrative Areas (Finskt förvaltningsområde, FFO), and how the Norrköping and Haninge municipalities tackle the issue.   In this paper, a reconstruction of the intervention theory is presented with inspiration sought from the ideas of Evert Vedung, in order to see if the intentions of the legislation are implemented. In accordance to the research on how the policy is designed, the democratic theory, the theory of participation, as well as the theory of identity will be linked together to the opinions of officials. This will be done in accordance to the reconstructed intervention theory, which will be used as a tool in order to show how the selected mechanisms relate in order to describe how the policy will receive an expected result. The intervention theory is a method which is meant to be in use during the evaluation of measures done by the public organization. I have conducted audits on how each FFO approaches the problem at hand using municipality documents relating to the Swedish Finnish youth. In addition, I have interviewed municipal officials in the FFO:s of Norrköping and Haninge with the aim to get an impartial over view on how they are perceived by the Swedish Finnish youth within FFO.   The result of my research indicates that local government activities in many cases can be linked to democracy theory, identity theory as well as participation theory. The mechanisms which were chosen used the recently named theories, are used to measure the municipalities offer of activities are language, interventions, activities and also the media. These theories have been used to select the mechanisms considered to be the most important deemed by the Law on the Protection of National Minorities (SFS 2009: 724[1]). [1] Lag (2009:724) om nationella minoriteter och minoritetsspråk

Problématique : Le concept d’« Hôpital promoteur de santé » (HPS) a émergé dans le sillon de la Charte d’Ottawa (1986) qui plaide notamment pour une réorientation des services de santé vers des services plus promoteurs de santé. Il cible la santé des patients, du personnel, de la communauté et de l’organisation elle-même. Dans le cadre de la réforme du système de santé au Québec qui vise à rapprocher les services de la population et à faciliter le cheminement de toute personne au sein d’un réseau local de services de santé et de services sociaux (RLS), l’adoption du concept HPS semble constituer une fenêtre d’opportunité pour les CHU, désormais inclus dans des réseaux universitaires intégrés de soins de santé et rattachés aux RLS, pour opérer des changements organisationnels majeurs. Face au peu de données scientifiques sur l’implantation des dimensions des projets HPS, les établissements de santé ont besoin d’être accompagnés dans ce processus par le développement de stratégies claires et d’outils concrets pour soutenir l’implantation. Notre étude porte sur le premier CHU à Montréal qui a décidé d’adopter le concept et d’implanter notamment un projet pilote HPS au sein de son centre périnatal. Objectifs : Les objectifs de la thèse sont 1) d’analyser la théorie d’intervention du projet HPS au sein du centre périnatal; 2) d’analyser l’implantation du projet HPS et; 3) d’explorer l’intérêt de l’évaluation développementale pour appuyer le processus d’implantation. Méthodologie : Pour mieux comprendre l’implantation du projet HPS, nous avons opté pour une étude de cas qualitative. Nous avons d’abord analysé la théorie d’intervention, en procédant à une revue de la littérature dans le but d’identifier les caractéristiques du projet HPS ainsi que les conditions nécessaires à son implantation. En ce qui concerne l’analyse d’implantation, notre étude de cas unique a intégré deux démarches méthodologiques : l’une visant à apprécier le niveau d’implantation et l’autre, à analyser les facteurs facilitants et les contraintes. Enfin, nous avons exploré l’intérêt d’une évaluation développementale pour appuyer le processus d’implantation. À partir d’un échantillonnage par choix raisonnés, les données de l’étude de cas ont été collectées auprès d’informateurs clés, des promoteurs du projet HPS, des gestionnaires, des professionnels et de couples de patients directement concernés par l’implantation du projet HPS au centre périnatal. Une analyse des documents de projet a été effectuée et nous avons procédé à une observation participante dans le milieu. Résultats : Le premier article sur l’analyse logique présente les forces et les faiblesses de la mise en oeuvre du projet HPS au centre périnatal et offre une meilleure compréhension des facteurs susceptibles d’influencer l’implantation. Le second article apprécie le niveau d’implantation des quatre dimensions du projet HPS. Grâce à la complémentarité des différentes sources utilisées, nous avons réussi à cerner les réussites globales, les activités partiellement implantées ou en cours d’implantation et les activités reposant sur une théorie d’intervention inadéquate. Le troisième article met en évidence l’influence des caractéristiques de l’intervention, des contextes externe et interne, des caractéristiques individuelles sur le processus d’implantation à partir du cadre d’analyse de l’implantation développé par Damschroder et al. (2009). Enfin, le dernier article présente les défis rencontrés par la chercheure dans sa tentative d’utilisation de l’évaluation développementale et propose des solutions permettant d’anticiper les difficultés liées à l’intégration des exigences de recherche et d’utilisation. Conclusion : Cette thèse contribue à enrichir la compréhension de l’implantation du projet HPS dans les établissements de santé et, particulièrement, en contexte périnatal. Les résultats obtenus sont intéressants pour les chercheurs et les gestionnaires d’hôpitaux ou d’établissements de santé qui souhaitent implanter ou évaluer les projets HPS dans leurs milieux. / Problem: The concept of health promoting hospitals (HPH) emerged in the wake of the 1986 Ottawa Charter, which notably calls for the reorientation of health services toward more health promoting services. The concept targets the health of patients, staff, the community and the organization itself. In the context of Quebec’s health system reform that aims to bring services closer to the population and facilitates the journey of any person within a local network of health and social services (RLS), the adoption of the HPH concept appears to be a window of opportunity for teaching hospitals, now included in integrated university health care networks (RUIS) and linked to RLS, to carry out major organizational changes. Given the paucity of evidence regarding implementation of the different dimensions of HPH projects, there is a need for health care facilities to be accompanied in this process through the development of clear-cut strategies and practical tools in order to support implementation. Our study will focus on the first university hospital in Montreal that decided to adopt the concept and implement a HPH pilot project within its perinatal centre. Objectives: The objectives of this thesis are 1) to analyse the intervention theory underlying the HPH project; 2) to analyse the implementation of the HPH project; and 3) to explore the potential of developmental evaluation as a means of supporting the implementation process. Methods: To better understand the implementation of the HPS project, we opted for a qualitative case study. We first analyzed the theory of intervention by conducting a literature review in order to identify the characteristics of an HPS project as well as the conditions necessary for its implementation. Then, as regards the implementation analysis, our single case study had two methodological approaches: one to assess the level of implementation and the other to analyze facilitators and barriers to implementation. Finally, we explored the interest of using developmental evaluation to support the implementation process. Based on purposeful sampling, data of the case study were collected from key informants, HPH project promoters, managers, professionals and couples of patients directly concerned by the HPH project implementation in the perinatal centre. A documentary analysis of project documents has been done and participant observation was conducted in the setting. Results: The first article is about a logical analysis that presents the strengths and weaknesses of the implementation of the HPH project within the birthing centre, and offers a deeper comprehension of the factors likely to influence implementation. The second article assesses the level of implementation of the four dimensions of the HPH project. The complementarity of the different sources used allowed us to identify global successes, activities that were implemented only partially or still in the process of implementation, and activities that were based on an inadequate intervention theory. The third article shows the influence of intervention characteristics, outer and inner settings, and individual characteristics upon the implementation process, using the consolidated framework for implementation research developed by Damschroder et al. (2009). The fourth and final article highlights the challenges encountered by the researcher in attempting to use developmental evaluation, and puts forth solutions that will enable researchers to anticipate the difficulties that can emerge from integrating the demands of research and of utilization. Conclusion: This thesis contributes to the understanding of HPH project implementation in health care facilities, particularly within a perinatal care context. The results we have obtained are of interest to researchers as well as hospital or health care facility administrators who wish to implement or evaluate HPH projects.

Problématique : Le concept d’« Hôpital promoteur de santé » (HPS) a émergé dans le sillon de la Charte d’Ottawa (1986) qui plaide notamment pour une réorientation des services de santé vers des services plus promoteurs de santé. Il cible la santé des patients, du personnel, de la communauté et de l’organisation elle-même. Dans le cadre de la réforme du système de santé au Québec qui vise à rapprocher les services de la population et à faciliter le cheminement de toute personne au sein d’un réseau local de services de santé et de services sociaux (RLS), l’adoption du concept HPS semble constituer une fenêtre d’opportunité pour les CHU, désormais inclus dans des réseaux universitaires intégrés de soins de santé et rattachés aux RLS, pour opérer des changements organisationnels majeurs. Face au peu de données scientifiques sur l’implantation des dimensions des projets HPS, les établissements de santé ont besoin d’être accompagnés dans ce processus par le développement de stratégies claires et d’outils concrets pour soutenir l’implantation. Notre étude porte sur le premier CHU à Montréal qui a décidé d’adopter le concept et d’implanter notamment un projet pilote HPS au sein de son centre périnatal. Objectifs : Les objectifs de la thèse sont 1) d’analyser la théorie d’intervention du projet HPS au sein du centre périnatal; 2) d’analyser l’implantation du projet HPS et; 3) d’explorer l’intérêt de l’évaluation développementale pour appuyer le processus d’implantation. Méthodologie : Pour mieux comprendre l’implantation du projet HPS, nous avons opté pour une étude de cas qualitative. Nous avons d’abord analysé la théorie d’intervention, en procédant à une revue de la littérature dans le but d’identifier les caractéristiques du projet HPS ainsi que les conditions nécessaires à son implantation. En ce qui concerne l’analyse d’implantation, notre étude de cas unique a intégré deux démarches méthodologiques : l’une visant à apprécier le niveau d’implantation et l’autre, à analyser les facteurs facilitants et les contraintes. Enfin, nous avons exploré l’intérêt d’une évaluation développementale pour appuyer le processus d’implantation. À partir d’un échantillonnage par choix raisonnés, les données de l’étude de cas ont été collectées auprès d’informateurs clés, des promoteurs du projet HPS, des gestionnaires, des professionnels et de couples de patients directement concernés par l’implantation du projet HPS au centre périnatal. Une analyse des documents de projet a été effectuée et nous avons procédé à une observation participante dans le milieu. Résultats : Le premier article sur l’analyse logique présente les forces et les faiblesses de la mise en oeuvre du projet HPS au centre périnatal et offre une meilleure compréhension des facteurs susceptibles d’influencer l’implantation. Le second article apprécie le niveau d’implantation des quatre dimensions du projet HPS. Grâce à la complémentarité des différentes sources utilisées, nous avons réussi à cerner les réussites globales, les activités partiellement implantées ou en cours d’implantation et les activités reposant sur une théorie d’intervention inadéquate. Le troisième article met en évidence l’influence des caractéristiques de l’intervention, des contextes externe et interne, des caractéristiques individuelles sur le processus d’implantation à partir du cadre d’analyse de l’implantation développé par Damschroder et al. (2009). Enfin, le dernier article présente les défis rencontrés par la chercheure dans sa tentative d’utilisation de l’évaluation développementale et propose des solutions permettant d’anticiper les difficultés liées à l’intégration des exigences de recherche et d’utilisation. Conclusion : Cette thèse contribue à enrichir la compréhension de l’implantation du projet HPS dans les établissements de santé et, particulièrement, en contexte périnatal. Les résultats obtenus sont intéressants pour les chercheurs et les gestionnaires d’hôpitaux ou d’établissements de santé qui souhaitent implanter ou évaluer les projets HPS dans leurs milieux. / Problem: The concept of health promoting hospitals (HPH) emerged in the wake of the 1986 Ottawa Charter, which notably calls for the reorientation of health services toward more health promoting services. The concept targets the health of patients, staff, the community and the organization itself. In the context of Quebec’s health system reform that aims to bring services closer to the population and facilitates the journey of any person within a local network of health and social services (RLS), the adoption of the HPH concept appears to be a window of opportunity for teaching hospitals, now included in integrated university health care networks (RUIS) and linked to RLS, to carry out major organizational changes. Given the paucity of evidence regarding implementation of the different dimensions of HPH projects, there is a need for health care facilities to be accompanied in this process through the development of clear-cut strategies and practical tools in order to support implementation. Our study will focus on the first university hospital in Montreal that decided to adopt the concept and implement a HPH pilot project within its perinatal centre. Objectives: The objectives of this thesis are 1) to analyse the intervention theory underlying the HPH project; 2) to analyse the implementation of the HPH project; and 3) to explore the potential of developmental evaluation as a means of supporting the implementation process. Methods: To better understand the implementation of the HPS project, we opted for a qualitative case study. We first analyzed the theory of intervention by conducting a literature review in order to identify the characteristics of an HPS project as well as the conditions necessary for its implementation. Then, as regards the implementation analysis, our single case study had two methodological approaches: one to assess the level of implementation and the other to analyze facilitators and barriers to implementation. Finally, we explored the interest of using developmental evaluation to support the implementation process. Based on purposeful sampling, data of the case study were collected from key informants, HPH project promoters, managers, professionals and couples of patients directly concerned by the HPH project implementation in the perinatal centre. A documentary analysis of project documents has been done and participant observation was conducted in the setting. Results: The first article is about a logical analysis that presents the strengths and weaknesses of the implementation of the HPH project within the birthing centre, and offers a deeper comprehension of the factors likely to influence implementation. The second article assesses the level of implementation of the four dimensions of the HPH project. The complementarity of the different sources used allowed us to identify global successes, activities that were implemented only partially or still in the process of implementation, and activities that were based on an inadequate intervention theory. The third article shows the influence of intervention characteristics, outer and inner settings, and individual characteristics upon the implementation process, using the consolidated framework for implementation research developed by Damschroder et al. (2009). The fourth and final article highlights the challenges encountered by the researcher in attempting to use developmental evaluation, and puts forth solutions that will enable researchers to anticipate the difficulties that can emerge from integrating the demands of research and of utilization. Conclusion: This thesis contributes to the understanding of HPH project implementation in health care facilities, particularly within a perinatal care context. The results we have obtained are of interest to researchers as well as hospital or health care facility administrators who wish to implement or evaluate HPH projects.

La vaccination qui est le sujet sur lequel porte cette recherche est une des questions de santé publique les plus importantes; elle fait néanmoins l’objet de nombreuses controverses. Dans le contexte de cette thèse, c’est plutôt l’accès à la vaccination qui est mis en question. La présente recherche vise à analyser une stratégie d’amélioration de la couverture vaccinale à l’aide d’une évaluation de processus extensive en trois étapes faisant suite à une documentation approfondie du contexte. En effet, la recherche analyse les perceptions et les facteurs d’influence de la couverture vaccinale avant l’intervention, les assises conceptuelles et théoriques de cette intervention, l’implantation et la réception de l’intervention et enfin les résultats et les mécanismes mis en œuvre pour les atteindre. Les résultats indiquent que la vaccination s’insère dans l’ensemble des stratégies locales de protection fondées sur des notions endogènes du risque. Ces éléments culturels associés à des facteurs socioéconomiques et aux rapports entre parents et services de santé concourent à expliquer un niveau relativement bas de couverture vaccinale complète de 50% avant l’intervention. L’analyse exploratoire de l’intervention indique que celle-ci intègre une théorie initiale implicite et une philosophie. L’intervention finale était évaluable; cependant, la validation de sa théorie a été compromise par des écarts dans l’implantation. L’approche descriptive montre des taux de réalisation d’activités assez élevés, une atteinte de plus de 95% des cibles et un niveau de réception acceptable, ce qui indique que l’intervention est une stratégie réalisable mais à améliorer. La couverture vaccinale après l’intervention est de 87%; elle est influencée positivement par les niveaux de connaissance élevés des parents et le fait pour les enfants d’être nés dans un centre de santé, et négativement par l’éloignement par rapport au site de vaccination. L’atteinte des résultats suit la procédure principale d’amélioration du niveau de connaissance des parents. Celle-ci est basée sur un mécanisme latent qui est la perception des « opportunités » que fournit la vaccination pour prévenir divers risques sanitaires, sociaux et économiques. Cependant, des approches complémentaires tentent de maximiser les effets de l’intervention en utilisant les pouvoirs conférés aux relais communautaires féminins et la coercition sociale. Cette recherche contribue à éclairer la relation entre l’évaluation du processus et l’analyse de l’évaluabilité, à conceptualiser et opérationnaliser autrement les notions de doses d’intervention administrées et de doses reçues. Sur le plan de la pratique, la recherche contribue à proposer l’amélioration des profils de personnel pour les activités de vaccination et la vulgarisation de la stratégie. Des propositions sont faites pour l’amélioration de l’intervention et l’information des institutions de financement des interventions. / Immunization is one of the most important subjects in public health despite constant on-going controversies. In the context of this research it is more its accessibility that is at issue. This particular research is situated in the perspective of the comprehensive approaches to evaluation and analyses an immunization improvement strategy using a three steps process evaluation after documenting its context. The perceptions and factors influencing immunization coverage before the intervention are assessed, as well as the conceptual and theoretical foundations of the intervention, the implementation and reception of the intervention and mechanisms used to attain the results. The results indicate that immunization is integrated into the local strategies used for protection and grounded in the local concept of risk. Results show also that the context associated with socioeconomic factors and the relations between parents and health services contribute to explain the relatively low complete immunization coverage rate (50.3%) before the intervention. The exploratory analysis indicates that the intervention had an implicit theory and a philosophy. Although the intervention was adequate for an evaluation, discrepancies in the implantation compromised the possibilities of validating its initial theory and philosophy. The descriptive analysis showed that more than 95% of the recipients were reached by the intervention and the received dose of intervention was acceptable indicating that the intervention is a workable strategy that needs to be improved. The complete immunization coverage after the intervention was 87.3%; it was influenced positively by factors including parents’ level of knowledge and the fact that the child was born in a health center, and negatively by the long distances from household to immunization place. The strategies involved in the attainment of the results used parents’ knowledge improvement as a principal procedure. This contains an underlying mechanism mainly related to the perception of the opportunities that immunization permits for preventing various health, social and economic risks. However, complementary approaches tend to maximize intervention outcome by using the power given to female community immunization facilitators and social coercion. The research contributes to highlight the relationship between evaluability assessment and process evaluation, to propose a new conceptual and operational understanding of dose of intervention administered and dose of intervention received. On practical grounds, this research recommended the improvement of the immunization activities staff profile and the widespread adoption of the strategy after it improvement. Indications are provided to improve the intervention and to inform founding agencies.

No description available.