Participation et contribution des médecins généralistes aux contrats locaux de santé de La Réunion. Étude transversale descriptive auprès des coordinateurs locaux
Bibliographic record
Abstract
Background :,Réunion Island are experiencing an increase in social and territorial health inequalities (STHI), despite an overall improvement in health status In 2009, public health policies saw the advent of a tool advocating as one of its main missions the reduction of these STHI: the local health contract (LHC). Co-developed by local health stakeholders, territorial authorities, and health institutions, these contracts aim to address the health determinants of a population within a specific area, based on a locally relevant diagnosis at the territorial level. The primary objective of this study was to determine the participation of general practitioners in LHCs on Réunion Island. Secondary objectives were to assess the deployment of LHCs across the territory and to identify factors influencing the engagement of general practitioners within these contracts.Method : This is a descriptive cross-sectional study conducted using responses to a survey targeting LHC coordinators. The study surveyed all active LHC coordinators on Réunion Island, a quarter of the respondents not completing the survey.Results : 12 coordinators of CLS out of the 16 identified responded. In 2024, 58% reported working in collaboration with one or more doctors, totaling 21 doctors, including 12 general practitioners, out of the 1,229 general practitioners on the island, collaborating with 6 CLS. The main reasons cited for this low proportion include the lack of recognition for doctors participating in the programs, the organizational incompatibility of private practice with this tool, and the lack of visibility of CLS among primary care professionals. Although half of the CLS have at least one participating doctor focused on a public health issue within their structure, all programs collaborate with coordinated care organizations. The main public health topics addressed by the CLS, in descending order, are: promotion of physical activity and the fight against obesity and malnutrition for 100% of CLS; combating addictions for 92% of CLS; autonomy and social inclusion for 75% of CLS; mental health for 75% of CLS; and sexual health for 50% of CLS.Conclusion : This study highlighted the low participation of general practitioners in CLS in Réunion and provides insights into the factors influencing their involvement. It also sheds light on the distribution of CLS and their public health focus areas. The study offers perspectives on improving the participation of general practitioners as well as amplifying the citizen's voice in these public health tools.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".