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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
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
In recent years, Valéry Ridde and his team have developed or participated in the development of several evaluation tools in Public Health. To make these tools accessible and usable by as many this page presents and makes them available to different audiences. Details on the applicability of tools, analysis grids, related articles and examples of practice are available for each tool. Click on the tool that interests you for more details:
Authors are responsible for the scientific quality of their research. The role of the editorial board is to assess the overall quality of the manuscript submitted, and in particular, the clarity of the objective, the logical coherence, the quality of language, and the adherence to ethical procedures. Members of the board may call upon one or more external reviewers.
When reading the manuscripts, reviewers should respond to the following questions:
For all manuscripts:
Is the message of the proposed publication clear and explicit? YES / NO
Are the arguments coherent? YES / NO
Is the manuscript intelligibly written and does it respect the standards of the language used? YES / NO
In addition to the preceding questions, for manuscripts on scientific research:
Is there a specific/explicit objective or research question? YES / NO
Do the data presented satisfy the objective? YES / NO
Was the study approved by an ethics committee? YES / NO
Recommendations:
Do you recommend publication of the manuscrit? YES without modifications / YES with modifications / NO
If YES with modifications: what points should the author(s) improve, given the above-mentioned evaluation questions?
Manuscripts will be accepted or rejected based on the reviewers’ feedback.
Word limit: There is no limit, but authors are encouraged to keep their manuscript within a reasonable word count and to be concise.
Reference format: Authors should use reference management software (e.g. Zotero) and organize their references according to the American Psychological Association (6th Edition).
Open review process: Authors are encouraged to thank reviewers in the final manuscript.
Publication process: Authors are responsible for formatting their manuscript according to the collection’s template.
The following statement must appear in every manuscript: “The authors are entirely responsible for the scientific quality of the research presented in this publication.”
Submission process:
Pre-evaluation: Authors seeking publication in the collection must first submit an abstract. The editorial board will review the abstract within one week. Authors whose abstracts are positively reviewed will then be invited to submit their manuscript.
Abstract preparation: 500 words maximum, 5 key words, 3 key citations, format unstructured.
Pre-evaluation criteria: relevance, language quality, logical coherence, adherence to abstract preparation instructions.
Abstracts should be sent to Émilie Robert ().
Manuscript review time frame: The committee will review the manuscript within a maximum of one month after it is received.
Manuscript formatting time frame: The final formatted version will be made available on the Papers website as soon as the final manuscript is submitted.