In the Rennes North/West Multi-Professional Health Center (MSP), whose specificity is multi-site, working in partnership with all medical-social actors in the neighborhood and integrating as closely as possible to the needs of the users including those in the upstream of all projects is obvious and commitment from the beginning of your adventure.
The application to participate in the SECPA experiment, the structure of a coordinated participatory exercise, was therefore obvious. Let the Rennes MSP team know what has changed since March 2022, the date of its integration into the SECPA program.
In MSP Rennes Nord/Ouest, the notion of user participation has been a principle grounded in the functioning of the association that manages it since its foundation in 1979. In fact, several users are members of the association’s office and/or board of directors. Furthermore, “patients-users-citizens” are widely encouraged to implement actions and projects on the topic of health and well-being. Isabelle Jusselin, a nurse in charge of participatory health actions in MSP, adds that there was talk of establishing a committee for users, but that so far too few candidates have come forward to formalize it. ” This does not mean that we will not succeed because we must be able to take into account those who are at the heart of the care and neighborhood. Residents know better what is useful and suitable for them. In general, we always ensure that our actions are directed towards their needs and expectations. “, she specifies.
However, he notes that the users who are most involved in the association and SMEs are not necessarily representatives of the surrounding population. In the neighborhoods of Beauregard and Villejean, in the heart of which MSP is located, there is a multicultural richness that the association would like to find in its bodies. In the meantime, MSP teams allocate time to go to the field to get to know the entire population of the mentioned settlements, in order to fully understand their needs.
Therefore, one of the first areas of improvement in the participatory approach, which the SECPA funding enabled MSP, was to send a pair into the field for three months with a mission to survey residents as well as key health and social stakeholders in the neighborhood to better understand their problems. Such work was all the more important because MSP Rennes North/West is a multi-locality and gathers as many as 115 health professionals for 22,000 inhabitants in its territory.
Contribution of the SECPA experiment
First, 115 health workers and 22,000 residents were supported by an expanded team of health coordinators, mediators and receptionists, which now has 10 employees. ” As we have long sought to make it easier for our patients to access therapies that are not normally reimbursed by health insurance, such as occupational therapy or psychomotor therapy, we have mobilized coordination time to seek external funding, at the expense of actions or support closest to the beneficiaries », emphasizes Johanna Abolgassemi, director of MSP.
Furthermore, the information that the couple sent to the field made it possible to highlight the main topics regarding which the respondents had expectations, such as nutrition, physical activity, mental health, respiratory health or even the isolation of the elderly, for which the MSP teams and its partners gave are a priority in their efforts. This better understanding of the population, which includes many people who do not speak, is also enriched by the SECPA’s allocation specifically devoted to professional health interpretation ( read our article on urban interpretation).
These working bases resulted in actions in which the participation of users was encouraged, as well as healthcare professionals from SMEs who were asked to come and meet them during various collective workshops, many of which saw the light of day or became sustainable through experimentation. Thus, Béatrice, a user who gladly participates in numerous SME actions, says that she was particularly moved by the intervention of the doctor who came during the workshop on respiratory health: ” We felt he was worried. He was discreet and spoke like everyone else. He told us that he learned things and expressed his desire to return. This surprised me a lot “. Among the meetings that Béatrice regularly attends are the weekly health cafes. Born after Isabelle Jusselin’s permanent stay in the community center, linked to the “compass” psychological support system established thanks to the SECPA, the meetings gradually took the form of a friendly meeting, which in completely constructed with the participation of users, guided by Isabelle, and sometimes prepared in advance with the help of health professionals when users have to process a certain topic. Béatrice specifies: ” The concept of participatory health scared me a little at first. I wondered what I could contribute. In reality it happens by itself. I got my confidence back thanks to the health cafes because this summer I gave up all the treatments I take for diabetes. I didn’t understand why they were prescribing me this or that, it annoyed me and I ended up in the hospital. I need support, because I’m exhausting myself and health cafes help me a lot “.
Goal, prevention and promotion of health
As stated in the specifications of the experiment, the grants received by MSP Rennes North/West enabled the implementation or stabilization of several individual or collective support systems and activities for the prevention or promotion of health. Simultaneously with the increase in health interpretation, from June 2022 to the end of 2023, more than 200 user requests for health mediation were recorded. These requirements relate in particular to health rights, support in care, as well as social or administrative issues. At the same time, the “Boussole” system, thanks to medical-psycho-social coordination at the local level, along with collective meetings in health cafes and health walks, gave birth to 884 psychological support consultations, according to data from the end of 2023. Finally, thanks to SECPA, activities in the benefits of prevention and health promotion have multiplied, often implemented in a “going towards” approach and in collaboration with users and neighborhood partners. The success of these diverse activities aimed at all audiences shows how popular the collective formats are, especially as teams realize that they are a stepping stone towards social bonding, as users who participate in them often meet again outside of these meetings. Reiterating among the ten offered workshops the most original ones, hoping that they will be a source of inspiration, such as the “papotes et tinkering” workshops (led by an occupational therapist and a speech therapist), the accompaniment of a passage from 6e (4 workshops and a sample meeting for a dozen children and parents with the aim of preventing school phobias) or “adapted circus” workshops, which are sessions for children with psycho-physical disorders, led by an occupational therapist, a speech therapist and a circus artist.