title: A health equity impact assessment umbrella program (AAPRISS) to tackle social inequalities in health: program description.
abstract: BACKGROUND
  The failure to simultaneously address two objectives (increasing the average health of the population and reducing health inequalities) may have led to what has been observed in France so far: an overall decrease in mortality and increase in inequality.
  
  
  OBJECTIVE
  The Apprendre et Agir pour Réduire les Inégalités Sociales de Santé (AAPRISS) methodology is to analyze and modify interventions that are already underway in terms of their potential impact on health inequalities. It relies on partnership between researchers and actors in the health field, as well as policy makers. In this paper, we describe the program and discuss its feasibility and acceptability.
  
  
  METHODS
  This program is not a single intervention, but a process aiming at assessing and reshaping existing health programs, therefore acting as a kind of meta-intervention. The program develops scientific and methodological support stemming from co-construction methods aimed at increasing equity within the programs. Stakeholders from prevention policy-making and the health care system, as well as researchers, collaborate in defining interventions, monitoring their progress, and choosing indicators, methods and evaluation procedures. The target population is mainly the population of the greater Toulouse area. The steps of the process are described: (1) establishment of AAPRISS governance and partnerships; (2) inclusion of projects; and (3) the projects' process.
  
  
  CONCLUSIONS
  Many partners have rallied around this program, which has been shown to be feasible and acceptable by partners and health actors. A major challenge is understanding each partner's expectations in terms of temporality of interventions, expected outcomes, assessment methods and indicators. Analyzing the projects has been quite feasible, and some modifications have been implemented in them in order to take inequalities in health into account.
authors: UMR 1027 Inserm - Université Paul Sabatier, Toulouse, France Institut Fédératif d'Etudes et de Recherches Interdisciplinaires Santé Société, Toulouse, France Centre Hospitalo-Universitaire de Toulouse, France thierry.lang@univ-tlse3.fr.
authors: Thierry
authors: T
authors: Lang
authors: UMR 1027 Inserm - Université Paul Sabatier, Toulouse, France Institut Fédératif d'Etudes et de Recherches Interdisciplinaires Santé Société, Toulouse, France.
authors: Elsa
authors: E
authors: Bidault
authors: UMR 1027 Inserm - Université Paul Sabatier, Toulouse, France Institut Fédératif d'Etudes et de Recherches Interdisciplinaires Santé Société, Toulouse, France.
authors: Mélanie
authors: M
authors: Villeval
authors: Instance Régionale d'Education et de Promotion de la Santé, Toulouse, France.
authors: François
authors: F
authors: Alias
authors: Oncopole de Toulouse, France.
authors: Benjamin
authors: B
authors: Gandouet
authors: Centre Hospitalo-Universitaire de Toulouse, France.
authors: Martine
authors: M
authors: Servat
authors: Mairie de Toulouse, France.
authors: Ivan
authors: I
authors: Theis
authors: Ecole des Hautes Etudes en Santé Publique, Rennes, France.
authors: Eric
authors: E
authors: Breton
authors: Institut Fédératif d'Etudes et de Recherches Interdisciplinaires Santé Société, Toulouse, France EA 4561 Prissmh-Soi, Toulouse III, Toulouse, France.
authors: Nadine
authors: N
authors: Haschar-Noé
authors: UMR 1027 Inserm - Université Paul Sabatier, Toulouse, France Institut Fédératif d'Etudes et de Recherches Interdisciplinaires Santé Société, Toulouse, France Institut Claudius Régaud, Toulouse, France.
authors: Pascale
authors: P
authors: Grosclaude
mesh_terms: D005260:Female; D005602:France; D000069576:Health Equity; D006291:Health Policy; D006293:Health Promotion; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D016730:Program Development; D015397:Program Evaluation / Q000379:methods*; D012959:Socioeconomic Factors
keywords: community-based research/participatory research; determinants of health; equity/social justice; evaluation; health impact assessment; qualitative; quantitative