Evaluation of autonomy. From tools to uses (EVAUTO)
IRESP funding (2022-2024)
Coordinator: Philippe Le Moigne
In line with my previous work on the measurement of mental disorder, this project aims to examine the architecture and use of autonomy assessment tools (guides, grids, scales, etc.) employed in policies of the same name, i.e. essentially for the elderly and people with disabilities. The content and purpose of these tools are diverse, and their use is far from widespread when it does not contribute to an assessment conducted without the user's knowledge. In other words, the use of these instruments confronts the evaluation with two questions: 1) with regard to their content, to what definitions of autonomy do these tools refer; 2) in their use, and in the manner of a mise en abyme, to what extent do they succeed in encouraging the participation of the user in the evaluation of his/her situation, in other words, in mobilizing his/her autonomy in the measurement of the latter?
The hypothesis that we defend is that the criteria that organize these tools are strongly indexed to their purposes. In other words, we are dealing here with a "channel effect", with the definition of autonomy targeted by the grids varying according to their function and their destination, i.e. the sector of care. However, the concrete use of these grids cannot be fully appreciated if it is not integrated with all the more or less formal elements that the evaluators take into account (observations, interviews, testimonies, evidence of changes over time, etc.), hence the meaning of the protocol that we propose to develop here.
1) Initially, we intend to make an inventory of the available tools (AGGIR, GEVA, DESIR, MAP, EGS, SMAF, VQS, etc.), and to subject their content to a lexicographical analysis. This project will be accompanied by fieldwork involving the completion of a thesis. 2) This will aim to study the use of the tools in context. The first step will be to select the structures targeted by the evaluation (APA departmental team, MDPH, home help service, gerontological network, EHPAD, neurology and gerontology department in CHU, etc.). The type of investigation to be conducted will then be determined with the teams of the structures selected. As a proposal, we envisage devoting the study to the follow-up of around thirty evaluation situations (this figure being likely to evolve due to the time required to carry out this follow-up), through non-participant observation associated with (semi-directive) interviews of professionals. The project also aims to integrate the user and his relatives in order to establish what the "evaluation produces on them" and the way in which they intend to or can contribute to it.
Healing Encounters: Reinventing an indigenous medicine in the clinic and beyond
ERC funding (2018-2024)
Coordinator: Emilia Sanabria
This project aims to develop a symmetrical, ethnographically grounded theory of what healing entails from the perspective of those who give, receive or evaluate healing. It is designed to break with binary frames that contrast indigenous and biomedical healing, positioning them on a tradition–modernity continuum. To do this, it will study the striking expansion and prolific reinventions of healing practices that make use of the Amazonian herbal brew ayahuasca. The unprecedented globalization of this indigenous medicine provides a unique opportunity to study healing encounters ethnographically. The project will examine healing across three related sites: Healing in the City will examine the production of neo-traditional urban healing forms. Healing in the Laboratory will analyse how ayahuasca is reinvented as a psychiatric tool to treat mental health problems and Healing in the Forest will study the contemporary reconfigurations of indigenous shamanism in Amazonia. These practices are entangled in long histories of postcolonial encounters: they are all – neotraditional, biomedical and indigenous alike – thoroughly modern and mixed. The comparative analysis is structured around three transversal objectives: 1) Material Semiotics: will map the entanglement of biological and symbolic effects; 2) Encounters Beyond-the-Human: will push medical anthropology beyond the human by paying attention to the healing propitiated by more-than-human beings and 3) Radical Alterity in a Common World of Encounters.
Health mobility and support: medical evacuations of minors from Mayotte to Reunion Island (AccMinEV)
ARS Mayotte, Ilpem, MSH Paris Nord and UPCité funding (2023-2026)
Coordinator: Lynda Lotte Hoareau, Cermes3
Co-coordinator: Dolorès Pourette, Ceped
This project addresses the question of continuities and discontinuities of care, accompaniment and links (social, family and emotional) in the case of medical evacuations of minors from Mayotte to Reunion Island.
The subject of medical evacuations in the Overseas Territories of the Indian Ocean is part of a more general reflection on mobility and therapeutic circulation, and on the health and care experiences of migrant populations. In Mayotte, the complexity of patients' health care pathways can be explained as much by their precarious situation as by administrative insecurity and insufficient health care services. In this singular context, we have chosen to observe the support situation of people who are or have been evacuated from Mayotte to Reunion Island and their families - through the observation of the functioning of the EVASAN system. Our project aims to understand the effects of this context (social, geopolitical, legal and institutional) on the trajectories of minors in need of care and their relatives, as well as the effects of separation/early termination on the child and his/her family when the latter leaves alone for long-term care.
The project has two main objectives:
- To identify and describe the organization and types of support, official or spontaneous, and the actors involved: institutional actors, health professionals, family, entourage, association.
- To document the diversity of the trajectories of children and their relatives, at the interface between health situations, family configurations, inequalities of resources and administrative situations.
The chosen method is inductive and comprehensive, closely linking conceptual knowledge and ethnographic survey practices (interviews, observations).
Our research is built with a plurality of views due to our research trajectories inscribed in different disciplinary fields (anthropology, sociology, psychology, geography, law) and our previous experiences of interdisciplinary dialogues. This multidisciplinarity allows us to better understand the experiences and trajectories of children and their relatives, and the modalities of their accompaniment: we thus put into dialogue anthropological approaches of therapeutic circulations, sociological works on care trajectories, health organizations and care practices, the production of inequalities in childhood, as well as works in psychology on the prevention of early bonds in a context of separation.
Contrat ANRS-MIE (2022-)
Coordinateurs : Jeremy Ward, Cermes3 et Patrick Peretti-Watel, INSERM, UVE
The project has four main strands.
The first area of research in the ICOVAC project focuses on contemporary vaccine issues in the general population, by looking at the potential impact of the COVID-19 epidemic on the French public's relationship with vaccines. The aim is to study public attitudes and behaviour in relation to these issues, using a variety of approaches (questionnaire surveys, in-depth interviews, grey literature, etc.).
Because the emergence of public controversies about vaccines and the politicisation of these debates are among the main determinants of attitudes towards vaccines, a second theme looks at the evolution of mobilisation and debate around vaccines in France.
The influenza A(H1N1) vaccination campaign was a turning point in the evolution of critical mobilisation around vaccines in France. The event attracted a whole new range of critical players to the issue of vaccines. This reshaping of the landscape of vaccine criticism has resulted in a decade of controversy in the mainstream media over vaccine safety (use of aluminium adjuvants, HPV vaccine, multivalent vaccines, etc.). Will the COVID-19 epidemic, by putting vaccines at the heart of the media and political agenda as never before, constitute a similar or even more important turning point? The work in this area will involve tracking the evolution of vaccine-related debates and mobilisations in a number of ways (ethnography of anti-vaccine movements, monitoring debates on social networks, longitudinal analysis of media coverage).
Strand 3 of the project concerns healthcare workers in charge of vaccination in France and will develop three lines of research:
1. using quantitative data, the aim will be to study the role of trust “par défaut” (the concept of reluctant trust proposed by Giddens) in vaccines among general practitioners and to explain the mechanisms that influence the vaccination behaviour of these professionals in relation to the other determinants of this behaviour;
2. in the context of the expansion of the role of nurses in the vaccination of the population (April 2022) and their growing role in prevention (task-shifting), to study, using a quantitative approach, the determinants of this profession's hesitancy to vaccinate and the extent to which this hesitancy is a form of expression of working conditions that are less and less satisfactory;
3. using a qualitative approach (semi-directive interviews with various healthcare workers) to study the extent to which vaccine hesitancy among certain healthcare professionals is a form of expression of conflict with institutional players (health authorities, national health insurance fund, etc.) and would fall within the scope of the politicisation of vaccination, is indicative of their relationship with science and scientists, and, finally, the extent to which these various potential determinants have been affected by the Covid-19 pandemic.
Over the last four years, a great deal of research has been launched in France into the issues surrounding vaccines. The fourth theme of the ICOVAC project aims to give more visibility to this research, bring together the researchers behind it and encourage dialogue between them - in short, to contribute to the structuring of this field of research through scientific promotion.
The SHS-Vaccination-France network
The first action was to create the SHS-Vaccination-France network. This network is aimed at all those interested in research into the human and social aspects of vaccination. Its aim is to encourage contacts, exchanges and collaboration between its members. It distributes information and news (calls for projects, job offers, conferences, publications, etc.) via a newsletter (registration details below) and regularly organises scientific meetings.
For more information:
The report "Research on the human and social aspects of vaccination in France since COVID-19 - 1st edition".
The SHS Vaccination France network was set up to encourage interdisciplinary exchanges and the circulation of analyses of the human and social aspects of vaccination. In the same spirit, the ICOVAC-France project proposes to produce reports summarising the research carried out on this subject in France. The first report focuses on research produced since the start of the COVID-19 epidemic.
The report can be downloaded free of charge in French or English here:
Impact assessment and adaptation to the Covid-19 crisis (COVADAPT)
Coordinator for Cermes3: Xavier Briffault
The 2020 Covid-19 coronavirus global crisis is exceptional in world history for its scale and impact. We need to move beyond this crisis, but we also need to understand how best to help the people living with it, at all scales. We need to understand the social, mental health and crisis management impacts of such an event. How do we find the resources or, on the contrary, what are the signs of mental distress that it can cause? How can we concretely help the most fragile on a daily basis by better understanding the preventive alerts? How do our capacities to adapt evolve and develop over time? But also how will this help us to develop our tools in the event of new crises and to adapt our paradigm changes to reduce their occurrence as much as possible.
This is the aim of the Covadapt study that the Human Adaptation Institute, in collaboration with researchers from several laboratories and universities, including CERMES3, ICM, Univ. Grenoble Alpes - Univ. Savoie Mont Blanc, Université Paris 2 Panthéon-Assas (Largepa), has decided to launch immediately, through online questionnaires, designed with specialists in several complementary fields Your help, by agreeing to participate in this study, will be invaluable.
Longitudinal Tracking of Attitudes Toward a COvid-19 VAccin (SLAVACO)
ANR funding (2021-2023)
Coordinator: Jeremy Ward, Cermes3
The SLAVACO project is funded by the French National Research Agency and led by Jeremy Ward (Inserm, Cermes3). This project aims to study the evolution of public attitudes towards the different aspects of covid vaccination but also attitudes towards vaccines more generally; the attitudes of health professionals and the evolution of discussions about vaccines taking place on social networks. It mobilises a consortium of researchers from different teams and disciplines. We are particularly interested in the socio-economic factors behind vaccine hesitancy but also vaccine adherence. We are particularly interested in the way in which ordinary relationships with politics and science influence representations of vaccines. The project is mainly based on questionnaire surveys and on the analysis of content published on the social network twitter.
- Enquête Covireivac : les français et la vaccination
- Enquête Covireivac : attitudes des français face à l’obligation vaccinale Covid-19
- Premiers résultats de l’enquête Slavaco Vague 1 et approfondissement de l’analyse de l’enquête Covireivac - les français et la vaccination
- Enquête Slavaco Vague 2 : passe sanitaire, obligation vaccinale et rappels
- Enquête Slavaco Vague 3 - Sesstim : vaccination des enfants, intentions de vaccination contre le Covid et usage de l’application TousAntiCovid
People with disabilities in Jewish religious communities in France: An intersectionality perspective
Jerusalem College of Technology funding (2021-2023)
Coordinator: Zvika Orr (Jerusalem College of Technology)
Co-coordinator : Yaël Tibi-Lévy, Cermes3
This project explores the intersection between religious community life and disability, based on the case of Jewish religious communities in France, particularly those living in Paris. Based on thirty semi-structured in-depth interviews with people with disabilities and their families, as well as professionals in the fields of healthcare, social work, education, and religion, this study seeks to examine how religious and cultural identities, beliefs, values, and norms influence the perception and treatment of people with disabilities in these communities, the difficulties they encounter, and the strategies implemented to try to overcome them. This project illuminates the meaning and impact of the double minority status of Jewish religious people with disabilities: as persons with disabilities in an ableist society (where being able-bodied is the norm) and as a religious minority in a secular country (where services provided or funded by the state should not include religious considerations). Thus, this project highlights challenges, dilemmas, tensions, and successes related to the efforts of some Jewish organizations to ensure that people with disabilities in their community can reconcile their living environment with religious values, if they wish to do so.
Polyordinaries. Parents and children with multiple disabilities yesterday, today and tomorrow. Producing the ordinary, a daily political work
IReSP, CNSA and Université Paris Cité funding (2020-2024)
Coordinator: Myriam Winance, Cermes3
The objective of this research project is, by describing and analyzing the daily life of families in which one of the members is polyhandicapped, to shed light on what is "ordinary" for these families and how, on a daily and permanent basis, these families and their various members organize their daily life and define it as "ordinary" or not. From a scientific point of view, this research will shed light on this concept of "ordinary". From a practical and political point of view, it will make the concrete daily life of these families more visible and contribute to improving the services, establishments and assistance offered to them.
The authority of scientific medicine in the face of clinical research controversies (AMES)
ANR funding (2022-2025)
Coordinator: Jeremy Ward, Cermes3
Public debates on medical issues very often involve considerations on the scientific character of health knowledge or on the conduct of medical research. This relationship between science and medicine has been strengthened by the progressive development of Evidence-Based-Medicine (EBM), which promotes clinical research, in particular the conduct of clinical trials, as a necessary step towards medical proof. Such trials then find themselves discussed in the public arena, as was the case during the Covid-19 epidemic around the therapeutic benefits of treatments. In turn, the public controversies that develop around this clinical research are presented by some observers as reflecting a crisis of confidence in scientific medicine and in science in general, with potential consequences for public attitudes and health practices. This research aims to jointly analyse the public image of clinical research and public attitudes towards it, clarifying their relationship.
The main objective of this sociology project is to characterise the practical relationship to medical research, with a focus on clinical research, of the French population by studying the link between media treatment of these themes and individual perceptions.
The secondary objective of the project is to provide a better understanding of the relationship between the general perception of science and the perception of medicine.
Trajectories of Genomic Innovations in French Care Settings (TraGenInnov)
ANR funding (2022-2026)
Coordinator: Catherine Bourgain, Cermes3
- Laboratoire Cermes3 (Villejuif) : Catherine Bourgain, Claire Beaudevin, Lucile Ruault
- Laboratoire Pacte (Université Grenoble Alpes, Sciences Po Grenoble, CNRS - Grenoble) : Séverine Louvel, Héléna Revil
- Laboratoire CESP (Centre de recherche en épidémiologie et santé des populations, CNRS - Inserm - Institut Gustave Roussy - UVSQ - Université Paris Saclay - Villejuif) : Nathalie Pelletier-Fleury
- Centre de Recherche en Cancérologie de Lyon (Inserm, CNRS, Université Lyon 1, Centre Léon Bérard, Hospices Civils de Lyon) : Sylvain Besle
- Institut Gustave Roussy : Estelle Vallier
- Gemass (Groupe d'Etude des Méthodes de l’Analyse Sociologique de la Sorbonne, Sorbonne Université – CNRS, Paris) : Solenne Carof, Renaud Debailly
As a package machines and associated devices, genomic technologies are now widespread in health care contexts, where their use has become massive and routine. Social science studies have analyzed the conditions of their introduction in some clinical fields, but few have questioned the transversal effects of the development of a molecular level of analysis common to many conditions. Circulation between clinical fields, standardization logics or leverage effects could however be expected. We also lack global analyses on the conditions of production and recognition of the status of biomedical innovations that these technologies enjoy today.
The TraGenInnov multidisciplinary research team will investigate the conditions under which these technologies come to be considered as innovations for care. Following an approach inspired by socio-historical analyses of how history and social contexts matter in the fate of technologies, TraGenInnov reconstructs the trajectories of genetic innovations in France, in six clinical contexts from rare diseases, cardiovascular diseases and cancer.
The aim is to analyze (1) the forms and impact of professional work around these technologies, (2) the work of patients and families, and (3) the effects of state, market, professional and citizen regulations. We focus on the settings in which the innovative character of a technology is claimed, admitted or criticized by the actors. We seek to identify the specificities of clinical traditions and the possible transversal effects of technologies.
TraGenInnov reconstructs these trajectories using qualitative methods (interviews, ethnographic observations) rooted in the sociology and anthropology of science and health, complemented by quantitative processing of data from the National Health Data System (SNDS) following a health economics approach.