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REFLEX-ISS: a tool for teams to observe, understand, and analyze an intervention with regard to social inequalities in health

This discussion tool is provided to your team so that members can think collectively about how to better take into account social inequalities in health (SIH) in their project, with the aim of reducing them, or at least not aggravating them. This discussion tool is not intended to measure the impact or the effectiveness of an intervention in reducing SIH; rather, its main objective is to open up dialogue on SIH. It complements other tools that you are likely to use to ensure the quality of your project. It will support your team in the process of identifying and analyzing strengths and elements to improve with respect to reducing social inequalities in health. It incorporates key strategies such as participation, action on social determinants of health, collaboration, intersectorality, and empowerment.

For whom?

  • Managers, professionals, volunteers, elected officials, etc.
  • Any persons planning, implementing, evaluating, or ensuring sustainability of an intervention

Why?

  • To adjust and improve a planned or existing intervention at different stages of its life cycle
  • To support collaboration and consultation processes for greater empowerment
  • To develop advocacy and mobilize partners to fight SIH together

How?

  • A reflexive approach with team members and stakeholders, including target subgroups
  • Supported by a facilitator with a good understanding of ISS and related concepts

Available resources:

  • Reflex-ISS – online web version (French and English)
  • Reflex-ISS – interactive PDF version (French, Spanish and English)
  • User guide and glossary (French and English)
  • Case study examples (French and English)

Summary of key discussion elements to take better account of SIH at different stages of an intervention’s life cycle

 

Areas

 

 

Key discussion elements

Planning 

 

·         Identifying SIH issues, the target subgroups, the problems faced, the context, and social determinants of health(SDH) involved

·         Searching for sources of information

·         Framing the intervention objectives in terms of an action plan to address SDH

·         Involving  target subgroups and stakeholders

Implementation ·         Adopting work methods that encourage participation of target subgroups and stakeholders

·         Defining roles, tasks, and responsibilities

·         Sharing leadership

·         Supporting the acquisition of knowledge and competencies

·         Adapting the intervention and making it accessible according to the different levels of literacy of target subgroups

Evaluation

 

·         Integrating the evaluation plan into all phases of the intervention

·         Ensuring participation at all stages of the evaluation

·         Establishing a process to assess long-term effects and undesirable outcomes

Sustainability  ·         Activities to ensure the intervention results are sustainable

·         Putting in place human, organizational, and financial resources to support the intervention in the long term

Empowerment  ·         Activities aimed at developing self-esteem, critical awareness, competencies, and participation of target subgroups and stakeholders

 

Download the interactive grid – REFLEX-ISS Tool:

Guichard, A., Ridde, V., Nour, K., & Lafontaine, G. (2015). REFLEX-ISS Tool - Taking better account of social inequalities in health. Longueuil : CISSS de la Montérégie‐Centre, Direction de santé publique de la Montérégie. Download

 

Two examples of the tool in use:

Contact us:

Linda François, coordinator

+1 – 514­ – 995 – 2403