Évaluation d'une formation de développement professionnel continu portant sur l'intégration des notions de sexe et de genre : une approche de méthodes mixtes

Authors: Deom Tardif, Alèxe
Advisor: Légaré, France
Abstract: Health inequalities between men and women persist in Canada. This study assessed the impact of a continuing professional development (CPD) training program that incorporates notions of sex and gender on the intention of healthcare professionals' intention to adapt pharmacological and non-pharmacological strategies in cases of diabetes and depression, considering the differences between men and women. We also explored barriers and facilitators to healthcare professionals' integration of sex and gender considerations into their clinical practice. Using an integrated convergent mixed-methods research design, including a non-randomized controlled trial, we conducted the study at six sites in Quebec (n = 4), Ontario (n = 1) and New Brunswick (n = 1). We recruited 127 healthcare professionals who were enrolled in one of the two CPD training courses on pharmacological and non-pharmacological strategies for managing diabetes and depression. The two courses were offered simultaneously but differed in content: one integrated cosiderations of sex and gender (intervention group) and the other did not (control group). At the end of the CPD training, we used the CPD-Reactionquestionnaire to measure healthcare professionals' intention to adapt pharmacological and non-pharmacological strategies in cases of diabetes and depression, considering the differences between men and women. Then, in semi-structured group discussions, we explored barriers and facilitators to participants' integration of sex and gender considerations into their clinical practice. Discussions were recorded and transcribed verbatim. We performed an analysis of covariance to compare the mean intention scores of the intervention and control groups using the Wilcoxon non-parametric test. Informed by the Theoretical Domains Framework, we carried out a thematic analysis of the verbatim. Inspired by the COM-B model of behavior, we triangulated the quantitative and qualitative results to produce recommendations. After training, mean intention scores for the intervention (n=49 participants) and control group (n=78 participants) were 5.65 ± 0.19 and 5.19 ± 0.15, respectively. Meandifference was -0.47 (CI -0.95 to 0.01; p=0.06). Adjusted for age, sex, and practice settings, mean difference was -0.57 (CI -1.09 to 0.05; p=0.03). Using the Theoretical Domains Framework, we identified ten barriers to integration of sex and gender considerations into clinical practice related to eight domains, and seven facilitators related to six domains. Recommendations included the addition of group discussions and clinical case vignettes showing the consequences of omitting sex and gender considerations in clinical practice. Our findings will inform future CPD initiatives to help reduce sex and gender inequalities in health care in Canada
Document Type: Mémoire de maîtrise
Issue Date: 2021
Open Access Date: 28 June 2021
Permalink: http://hdl.handle.net/20.500.11794/69486
Grantor: Université Laval
Collection:Thèses et mémoires

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