Laurène Houtin

Cette thèse a pour objectif l’examen des conséquences de la stigmatisation du surpoids chez les jeunes femmes qui se perçoivent en surpoids (que cette perception soit justifiée ou non) via le phénomène de menace du stéréotype (Steele & Aronson, 1995). Nous proposons que des contextes menaçants, en lien avec les stéréotypes négatifs qui portent sur les comportements alimentaires des personnes en surpoids, peuvent biaiser l’estimation que ces femmes font des aliments et augmenter leur consommation d’aliments réconfortants. Les études expérimentales de ce travail doctoral confirment ces hypothèses : leurs résultats indiquent que plus les femmes pensent avoir un excès de poids, (i) moins elles réussissent à estimer la teneur calorique des aliments et à sélectionner les plats en fonction de leurs valeurs nutritionnelles, et (ii) plus elles consomment d’aliments gras et sucrés. Nous investiguons également le rôle médiateur des émotions (et notamment celui de l’anxiété) ainsi que sur celui de la réduction des ressources disponibles en mémoire de travail dans ces effets. Si nos études ne permettent pas d’affirmer l’implication de mécanismes émotionnels, une de nos études met en cause la diminution des ressources en mémoire de travail.Bien que d’autres études ont déjà fait état des conséquences de la menace du stéréotype lié au surpoids chez les personnes objectivement en surpoids (e.g., Brochu & Dovidio, 2014), les études de cette thèse sont les premières à mettre en évidence les conséquences de ce phénomène chez les femmes qui se perçoivent en surpoids, et à confirmer qu’il est nécessaire de prendre en compte cette variable dans l’étude des conséquences de la stigmatisation du surpoids.

Background: Despite its proven efficacy in preventing HPV-related cancers, HPV vaccine uptake remains suboptimal in France (i.e., coverage reached 54.6% for girls and 15.8% for boys in 2023). Understanding stakeholder perspectives across key dimensions related to vaccination perceptions, HPV-related representations, barriers, facilitators, and communication dynamics is essential. This study investigates the knowledge, attitudes, barriers, and facilitators related to HPV vaccination among four stakeholder groups: adolescents, parents, school staff, and pharmacists. Methods: A total of 63 semi-structured interviews were conducted with middle school students ( n = 15), parents ( n = 18), school staff ( n = 15), and pharmacists ( n = 15) in France. Thematic analysis was used to identify common and group-specific representations, emotional responses, and social dynamics influencing HPV vaccine acceptance. Results: Participants generally supported HPV vaccination as a cancer-prevention tool but highlighted barriers such as limited HPV knowledge, gender-based misconceptions, unease discussing sexuality, concerns about side effects, and logistical hurdles. Facilitators included trust in healthcare professionals, pharmacies’ accessibility, and the school’s potential as an information platform. While adolescents expressed injection anxiety and a need for age-appropriate, anonymous formats, parents emphasized clear, data-driven communication. Overall, teachers felt underprepared, and pharmacists showed willingness to engage but required better informational tools. All groups called for targeted, emotionally resonant, multi-channel communication. Conclusions: Increasing HPV vaccination requires coordinated efforts that support schools, mobilize trusted healthcare professionals, and deliver clear, stigma-free information. Practical tools and targeted training could further strengthen stakeholder engagement.

Background: There is a growing interest in the influence of variables that may negatively influence the reasoning of health care professionals, namely intolerance of uncertainty, defined as health care professionals’ difficulty tolerating ambiguous situations that often trigger discomfort, overtesting, and suboptimal treatment choices, and resource consumption, defined as the ordering of unnecessary diagnostic tests that can waste resources and compromise decision‐making. Objective: Our purpose was to assess the influence of intolerance of uncertainty and resource consumption on the chosen therapeutic strategy. Methods: A total of 127 physiotherapists were challenged to play a simulation game and choose a therapeutic strategy for 3 cases of low back pain of increasing difficulty (easy, medium, and difficult). Their intolerance of uncertainty level and their resource consumption were measured (ie, requests for test results for each case). Results: Results showed that 87.4% (111/127) of participants chose the most appropriate strategy (ie, the one in line with the strategy recommended by experts) for the easy case, 46.5% (59/127) for the medium, and 29.1% (37/127) for the difficult. For the easy case, intolerance of uncertainty and resource consumption had a negative influence on the chosen therapeutic strategy, which was less appropriate (β=–4.03, t121=–3.92, P<.001). Moreover, resource consumption among highly intolerant individuals had a more adverse influence on the chosen strategy (β=–3.42, t121=–5.09, P<.001). Such results were not found for the medium and difficult cases. Conclusions: Resource consumption may have a negative influence in some cases on the treatment strategies chosen by the physiotherapists who are most intolerant of uncertainty. Future research avenues are suggested to ensure the quality of patient care concerning physiotherapists’ level of intolerance of uncertainty.

Background: People with disabilities face persistent employment difficulties, mainly because of a lack of recognition of their competencies, especially people with intellectual disabilities. As employment counsellors need to identify the competencies of beneficiaries, a public competencies identification service has been developed and funded by the French Ministry of Labour, Diagoriente.Method: We compared the impact of a competencies identification session using Diagoriente (N = 48) to a more classic session using a text document (N = 47), with a sample composed mainly of people with intellectual disabilities (75.5%).Results: Participants who used Diagoriente felt better able to identify and explain their competencies and to create a relevant career plan than those who had followed a classic session.Conclusions: Our results suggest that Diagoriente, and as we suggest, employment support digital tools, when adapted to the specific needs of people with intellectual disabilities, can provide additional keys to help them build their career plans.

Because of a lack of performance or their age, top-level athletes often have to rebuild their professional future outside the sports sector and without any substantial diploma. The experiences and activities of this population may differ greatly from those of regular career transition-seeking people. Therefore, understanding these specificities and identifying the transversal competencies of top-level athletes is a challenge if we are to provide efficient career guidance for their transition. To do this, 43 top-level athletes underwent semistructured interviews. A content analysis highlighted 15 themes and 240 transversal activities of the interviewed top-level athletes, showing that it is possible to identify transversal activities in the daily lives of top-level athletes that match other careers. This allowed us to create a matrix able to join the activities and regular occupations listed in the ROME job directory of France Labor. We discuss the implications of these results for initiatives such as digital career guidance tools.

BACKGROUND There is a growing interest in the influence of variables that may negatively influence the reasoning of health care professionals, namely intolerance of uncertainty, defined as health care professionals’ difficulty tolerating ambiguous situations that often trigger discomfort, overtesting, and suboptimal treatment choices, and resource consumption, defined as the ordering of unnecessary diagnostic tests that can waste resources and compromise decision‐making. OBJECTIVE Our purpose was to assess the influence of intolerance of uncertainty and resource consumption on the chosen therapeutic strategy. METHODS A total of 127 physiotherapists were challenged to play a simulation game and choose a therapeutic strategy for 3 cases of low back pain of increasing difficulty (easy, medium, and difficult). Their intolerance of uncertainty level and their resource consumption were measured (ie, requests for test results for each case). RESULTS Results showed that 87.4% (111/127) of participants chose the most appropriate strategy (ie, the one in line with the strategy recommended by experts) for the easy case, 46.5% (59/127) for the medium, and 29.1% (37/127) for the difficult. For the easy case, intolerance of uncertainty and resource consumption had a negative influence on the chosen therapeutic strategy, which was less appropriate (β=–4.03, t121=–3.92, P<.001). Moreover, resource consumption among highly intolerant individuals had a more adverse influence on the chosen strategy (β=–3.42, t121=–5.09, P<.001). Such results were not found for the medium and difficult cases. CONCLUSIONS Resource consumption may have a negative influence in some cases on the treatment strategies chosen by the physiotherapists who are most intolerant of uncertainty. Future research avenues are suggested to ensure the quality of patient care concerning physiotherapists’ level of intolerance of uncertainty.

L’orientation professionnelle des élèves de collèges et lycées, qui plus est des publics à besoins éducatifs spécifiques (i.e., SEGPA, ULIS), demeure un problème récurrent en France. La présente étude a évalué dans quelle mesure un outil numérique facilitant l’identification des expériences personnelles et professionnelles ayant permis le développement de compétences transversales (Diagoriente) s’avérait pertinent pour l’accompagnement à l’orientation scolaire et professionnelle d’élèves de collèges et lycées, dont ceux dans des filières spécialisées. D’après les entretiens menés auprès de 19 professionnels de l’orientation scolaire, l’outil et la démarche Diagoriente seraient pertinents pour accompagner la construction du projet professionnel des élèves y compris des élèves à besoins spécifiques. Il apparaît que la principale force de Diagoriente réside dans sa démarche unique d’identification des compétences via les expériences professionnelles et personnelles qui favorisent la valorisation des jeunes. La démarche permet également de transformer les élèves en véritables actrices et acteurs de leur orientation. Les outils numériques accessibles et polyvalents tels que Diagoriente représentent une des opportunités que les professionnels scolaires peuvent saisir afin de lutter contre les inégalités sociales qui, encore aujourd’hui, déterminent grandement les choix d’orientation.

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L’orientation professionnelle des élèves de collèges et lycées, notamment des publics à besoins éducatifs spécifiques (i.e., SEGPA, ULIS), demeure un problème récurrent en France. Nous avons évalué dans quelle mesure un outil numérique facilitant l’identification des expériences personnelles et professionnelles ayant permis le développement de compétences transversales (Diagoriente) s’avérait pertinent pour l’accompagnement à l’orientation scolaire et professionnelle d’élèves de collèges et lycées, notamment de filières spécialisées. D’après 19 entretiens auprès de professionnels de l’orientation scolaire, Diagoriente serait pertinent pour accompagner la construction du projet professionnel des élèves, y compris ceux à besoins spécifiques. La principale force de Diagoriente résiderait dans sa démarche unique d’identification des compétences via les expériences professionnelles et personnelles qui favorisent la valorisation des jeunes. Les outils numériques accessibles et polyvalents comme Diagoriente représentent une des opportunités que les professionnels scolaires peuvent saisir pour lutter contre les inégalités sociales qui, encore aujourd’hui, déterminent grandement les choix d’orientation.

Background: Distrust of COVID-19 vaccines may hamper vaccination campaigns. We focused on the cognitive determinants of intentions to get vaccinated against COVID-19. We were interested in (i) the effects of stress, and (ii) the effects of self-protection systems on attitudes and intentions to get vaccinated with a COVID-19 vaccine. Methods: We conducted an online observational study with 203 French students (MAge = 19, SDAge = 2.52, Women = 173), in which we measured, through self-reported questionnaires, their perceived stress and vulnerability to disease, belief in a dangerous world, pandemic-related stressors living conditions, attitudes and intentions to get vaccinated, and confidence in the government's management of COVID-19. We conducted two multiple linear mediation analyses.Results: Participants who reported higher trust in the government and who reported higher stress levels were more likely to have positive attitudes toward the COVID-19 vaccine, although both these influences seem to be –at least partially - independent. Conclusions: The factor that most robustly predicted both attitudes and intentions to vaccinate was confidence in the information provided by the government and its ability to manage the pandemic in general. Our analyses suggest the existence of two profiles of people likely to have positive attitudes toward vaccination: those who trust the government and are not stressed by vaccination, and those who do not trust the government but would get vaccinated to reduce their stress. We discuss how to improve the effectiveness of COVID-19 vaccine policies through communication.