Analysis of complex public health interventions: The case of prevention of STIs in Montreal [L'analyse des interventions complexes en santé publique: Le cas de la prévention des ITSS à Montréal]

摘要

OBJECTIVES: Based on a theory of intervention as a complex action system, analyze collaboration among partners in Montréal's sexually transmitted and blood-borne infections (STBBI) prevention program to identify main operations problems and possible scenarios for change to achieve better outcomes. METHODS: A descriptive study was conducted using three data sources - public policies and programs, system management documents, and interviews with three types of partners. The results were validated with stakeholders. RESULTS: Five main operations problems affecting the capacity of the system to provide expected services were identified, as well as strategies the partners use to address these. CONCLUSION: Two scenarios for system change to increase its effectiveness in achieving program goals are discussed.