Scaling up integrated care programs for individuals with complex needs requires adaptability across contexts and a strong commitment to engaging diverse communities. Meaningful involvement of patient partners from different backgrounds and identities is crucial for promoting health equity and expanding opportunities to actively engage in research. However, strategies to effectively engage these partners require more detailed description.To provide a comprehensive description of the engagement strategies for 2SLGBTQIA+, Indigenous, and migrant patients partners during the scale-up and evaluation of an integrated care program.The study uses a participatory approach embedded within a larger mixed-method, multiple-case design. From fall 2024 to Spring 2026, monthly meetings allowed patient partners to share care experiences, provide program feedback, and contribute to research decisions. A senior patient partner offered specific mentoring and teachings. The team documented engagement in a logbook, wrote reports after each meeting summarizing discussions, and gathered ongoing feedback throughout. Final insights were reviewed and refined by patient partners.The committee demonstrated relative stability in its composition, although it occasionally struggled to maintain engagement. Cultural safety measures were deemed necessary, such as smudging with sage during meetings. Pluralism and equity were promoted by ensuring balanced representation of communities within the committee. Members received training sessions on the integrated care program and patient engagement in research. They also co-drafted the Terms of Reference and advised the team on adaptations to intervention tools and a semi-structured interview guide. Some patient partners shared experiences within a community of practice for case managers.Involving patient partners with diverse identities in the same committee is feasible and beneficial for enriching both the content and conduct of research but requires careful implementation and attention to fostering interpersonal bonds.The engagement process offers actionable insights for research teams aiming to include patient partners from diverse communities, highlighting strategies to promote equity and meaningful participation.

People living with chronic diseases often experience cognitive, social, and emotional vulnerabilities that limit their understanding of health information. These difficulties negatively affect health literacy, treatment adherence, and the quality of care pathways.This study aimed to analyse the influence of health literacy on the management of chronic diseases by comparing patients’ and healthcare professionals’ perceptions. It also explored how healthcare professionals adapt their communication, the barriers to understanding, and their impact on health literacy and care pathways.A mixed-methods study with a predominantly qualitative design was conducted. The quantitative phase consisted of an exploratory survey carried out over eight weeks among patients with chronic diseases (n = 107) and healthcare professionals (n = 111). Descriptive analyses focused on clarity of language, educational materials, and time devoted to explanations. The qualitative phase followed a phenomenological approach, with semi-structured interviews conducted with 15 patients, including two expert patients, and 18 healthcare professionals. Data were analysed using interpretative phenomenological analysis.A discrepancy was identified between patients’ perceived understanding and the information that healthcare professionals believed they provided: 53% of patients considered the information clear, compared with 69% of healthcare professionals. Regarding educational materials, 31% of patients expressed a need for them, but only 27% reported having received them, whereas 65% of healthcare professionals stated that they provide such materials. Qualitative findings highlighted five main themes: time constraints, patient vulnerabilities, educational materials, the healthcare professional–patient relationship, and the organisation of care pathways.The results confirm that health literacy plays a key role in patient autonomy and treatment adherence. The intention to inform alone is insufficient. Plain language, reformulation, adequate time for explanation, and appropriate educational materials are essential.Integrating health literacy into clinical practice is therefore necessary to improve understanding, strengthen patient autonomy, and secure care pathways, particularly through adapted and easy-to-understand educational resources.

The 2021 Bioethics Law profoundly transformed the legal framework governing medically assisted reproduction (MAR) in France by opening access to assisted reproductive technologies (ART) to single women and female same-sex couples. Healthcare professionals are thus confronted with new family configurations that challenge their professional frames of reference, their support practices, and their representations of “ideal” parenthood.The aim is, on the one hand, to gain a better understanding of the social, emotional, and material motivations that lead to this reproductive choice in a context marked by persistent conjugal inequalities and by a growing questioning of the heterosexual couple as a prerequisite for parenthood, and, on the other hand, to reflect on the medical support provided for these specific reproductive trajectories.This research is based on a multi-sited qualitative study and draws on three types of empirical material: the analysis of autobiographical narratives from around ten books written by women who have undergone solo ART; the study of exchanges and discussions on social media, which provide access to contemporary forms of collective storytelling; and in-depth interviews conducted both with women engaged in a solo ART process and with healthcare professionals involved in their care.This methodological combination makes it possible to jointly capture the situated experiences of patients and the professional, ethical, and normative logics that structure medical support. Solo ART trajectories are marked by a wide diversity of social situations, but also by recurring motivations related to the search for emotional security, material stability, and reproductive autonomy.Preliminary analyses suggest the existence of tensions between women’s expectations and medical support practices, particularly when implicit forms of judgment, conjugal normalization, or the infantilization of patients persist.By jointly analyzing women’s narratives, online exchanges, and professional practices, this research contributes to a better understanding of the social and medical issues surrounding solo ART in post–2021 Bioethics Law France.

Low literacy level has a negative impact on health and is a lever to promote individual health and autonomy. Patients with very low literacy level have difficulty making appointments (appts) and attending general practice (GP) consults.Identify and understand the barriers and levers to making and attending GP appts among patients with very low literacy level in order to facilitate and improve their access to healthcare.Qualitative study of 13 semi-structured individual interviews, from June 2024 to April 2025, recruited by general practitioners (GPs) via Single-Item Literacy Screener (SILS). Analysis inspired by grounded theory and data triangulation.Patients struggled with communicating, managing schedules, social and administrative procedures, digital tools, and finding their way around. They could call, go to the medical offices to make an appt but they almost never did it online. Overwhelmed, they were dependent on caregivers in particular. Some were resilient and sought to become autonomous in order to communicate : personalized directories, voice messages, spellcheckers ; to memorize better : memory aid, visual identification, gesture repetitions. They found the reminder messages useful and suggested using a file number to make it easier to make appts. The quality of the physician-patient relationship promoted communication and patient engagement. The GPs facilitated access to care by directly making appts, by directing patients to secretariats, colleagues, and healthcare facilities.The study's limitations include : the SILS was modified but not tested or validated before use ; patients had difficulty understanding the purpose of the interview ; interviews were conducted only with patients who had managed to book appts ; and recruitment was carried out by GPs who were more familiar with the topic. Strengths include triangulation of analyses, logbook. Missed appts are a marker of vulnerability and a warning sign for healthcare professionals. Digital literacy, the quality of the physician-patient relationship, and the role of caregivers all influence patient attendance.Recognizing these difficulties is a challenge in promoting the gradual empowerment of patients.

A new paradigm is emerging between primary care and public health, shifting from an individual-focused model to a more population- and community-oriented approach. Prevention must become a shared mission among professionals, supported by clarified roles and appropriate training. In this perspective, EUROPREV recently highlighted key priorities: evidence-based interventions, structural integration of prevention, prioritization of high-risk patients, and proportionate universalism. However, many primary care teams still lack methodological and organizational skills to structure territorial prevention actions. The development of coordinated care—within multidisciplinary group practices, primary care teams, and territorial professional health communities—strengthens the need for specific public health competencies. Preliminary studies identified two major barriers: the absence of dedicated training tailored to primary care, and insufficient resources to design structured prevention projects.Between 2018 and 2024, a progressive process led to the development of a dedicated training pathway. A first study confirmed the need for such training. The DU CSP2 (University Diploma in Coordination of Public Health Actions in Primary Care) was created to introduce primary care teams to project methodology and territorial public health. After three student cohorts and significant regional impact, the need for further professionalization became evident. This resulted in the creation of the M2 PPS – AOSP (Master’s in Prevention and Health Promotion – Specialization in Actions and Organisations in Primary Care). This program deepens competencies in primary-care health policy, interprofessional research, and territorial public health communication. It combines e-learning, on-site sessions, and a practicum focused on a territorial prevention intervention.Participants report significant improvements in coordination, territorial diagnosis, evaluation, and communication. The program supports new roles, such as primary care public health project officers, and strengthens population-centred primary care.This experience shows that dedicated training can strengthen territorial public health capacity and support interprofessional collaboration.The M2 PPS – AOSP provides an innovative and timely response to transformations in primary care by integrating prevention, project methodology, and population-health responsibility into daily practice.

General practice consultations bring together the GP and patient around the latter's health issues. Research has focused on the mental problem-solving activity of the GP, referred to as clinical reasoning. However, decision-making in consultations is increasingly conceptualized not only as the outcome of the GP's reasoning but also of the patient's problematization activity.The purpose of this work is to explore the experience a patient has and makes of their health problems during a general practice consultation.Data were collected through video-stimulated recall interviews with patients after their consultations. Consultations were filmed from the patient’s perspective using wearable camera glasses. Each interview comprised two parts: (a) an explicitation interview exploring the patient’s experience and reasoning before the consultation, and (b) a video-based stimulated recall to analyze their experience during the consultation. John Dewey’s theory of inquiry provided our analytical framework.Twelve in-depth interviews were conducted. Our analysis allows us to describe the patient's approach to the consultation according to three themes: - the experience prior to the consultation - the decisions to share information with the GP - the reception of the GP's messages.  When identifying health problems, patients develop and examine hypotheses related to the possibilities for action and resolution that they offer. Among these possibilities is making an appointment with a GP. During the consultation, patients decide to share certain information with the GP based on their perception of the latter, and receive messages based on how well they fit with their inquiry.The GP's activity appears to be decisive in terms of the messages they convey to the patient and the positions that these messages imply for the patient's inquiry. One limitation is that we explored patients' experiences after a single consultation. Future studies could explore the experience of follow-up care.This work has made it possible to analyze the patient's experience during consultations. It provides insights into understanding the transformative potential of consultations on patient activity and the concepts of adherence or, conversely, non-adherence. It thus opens up new perspectives for GP education.