Clémence Brun

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.

Thèse de doctorat en Sciences cognitives, psychologie et neuro-cognition.Soutenue le 6 novembre 2023. Université Grenoble Alpes. École doctorale : École doctorale ingénierie pour la santé, la cognition, l’environnement. Université Grenoble Alpes. Laboratoire : Techniques de l’Ingénierie Médicale et de la Complexité – Informatique, Mathématiques, Applications, Grenoble. Thèse dirigée par— Nicolas PINSAULT, Professeur des Universités, Université Grenoble Alpes (directeur)— Richard MONVOISIN, In...

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The medical environment is prone to diagnostic errors, which can have serious consequences for patients' health status. However, healthcare professionals (HCPs) are often overconfident in their choices. In this context, there is a growing interest in the influence of variables that may negatively influence the reasoning of HCPs, namely intolerance of uncertainty (IU) and resource consumption. We challenged 127 physiotherapists to play a simulation game and choose a therapeutic strategy for three cases of low back pain of increasing difficulty (easy, medium, difficult). We measured their IU level and their resource consumption (i.e., requests for test results for each case). Our results showed that 87.4% of participants chose the most appropriate strategy for the easy case, 46.5% for the medium and 29.1% for the difficult. For the easy case, IU and resource consumption had a negative influence on the chosen therapeutic strategy, which was less adapted. Moreover, resource consumption among highly intolerant individuals had a more adverse influence on the chosen strategy. However, we did not find the same results for the medium and difficult cases. We propose hypotheses to explain this difference (i.e., system 1/system 2, consideration of the physiotherapist's speciality, perception of uncertainty). We also outline potential improvements to our tool and suggest future research avenues.

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Literature shows that intolerance of uncertainty can negatively affect health professionals' medical decision-making process. However, there is no intolerance of uncertainty measurement tools in French, so this study aimed at validating the Intolerance of Uncertainty Scale-12 (IUS-12) in French, and a version of the IUS-12 adapted for healthcare professionals (IUS-12-H). We asked health professionals to complete our two scales of interest, as well as several scales covering related constructs. Five hundred and sixteen health professionals completed French versions of the IUS-12 and the IUS-12-H, and our additional scales. Exploratory factor analyses showed that the IUS-12 and IUS-12-H scales had a two-factor structure as in the seminal article of Carleton et al. (2007). The IUS-12 and the IUS-11-H French versions show psychometric properties comparable to the original version indicating that they can be used as the seminal scales for French health professionals.