-Title: Towards the science of implementing evidence-based practices in Child and Adolescent Psychiatry
Date : December 5, 2023 at 2:00 p.m.
Location : Faculté de médecine Lyon Est, Bâtiment Principal Rockefeller, en salle des Thèses.
Jury :
M. BALEYTE Jean-Marc, Professeur des Universités Praticien Hospitalier, Université de Caen Normandie ;
M. COLIN Cyrille, Professeur des Universités Praticien Hospitalier, Université Lyon 1 ;
M. GEORGIEFF Nicolas, Professeur des Universités Praticien Hospitalier, Université Lyon 1 ;
Monsieur GICQUEL Ludovic, Professeur des Universités Praticien Hospitalier, Université de Poitiers ;
Monsieur MOTTRON Laurent, Professeur, Université de Montréal (Canada) ;
Madame PURPER-OUAKIL Diane, Professeure des Universités Praticien Hospitalier, Université de Montpellier ;
Madame SCHOTT-PETHELAZ Anne-Marie, Professeure des Universités Praticien Hospitalier, Université Lyon 1 ;
Monsieur SPERANZA Mario, Professeur des Universités Praticien Hospitalier, Université Paris Saclay.
Abstract :
For almost 10 years, I have been conducting research focused on etiology and action research in autism. Recently, this work has broadened to include the science of implementing evidence-based practices in the field of Child and Adolescent Psychiatry (CAP).
My first line of research focused on the biomarkers and neurocognitive processes involved in autism. In some young children with prototypical autism, prolonged observation of isomorphic elements such as letters or numbers is observed. My initial research work, carried out in inter-CHU collaboration with the HCL at the Centre Expert en Autisme de l'Hôpital de Rivière-de-Prairie affiliated to the Université de Montréal, was based on the hypothesis of atypia in the spatial processing of perception (Geoffray, Poster, IMFAR, Philadelphia, 2010). This hypothesis has recently evolved: in collaboration with J-R Hochmann's team (Baby lab, ISC, CNRS UMR 5229, Bron), we hypothesize that atypia in temporal processing could explain atypia in spatial processing in perception (Dochez, submitted). This work will continue with an evaluation of perceptual processing in at-risk babies in the Marianne national cohort (Pr. Amaria Baghdali), in which we are collaborating (Geoffray, 2023). During my mobility at the University of Manchester in the UK in 2019, I worked on the MAPK (Mitogen Activated Protein Kinase) signaling pathway, which plays a key role in regulating synaptic plasticity and memory, and is potentially involved in autism (Geoffray et al., 2020, 2021). All this work is aimed at improving the phenotyping of autism and developing precision medicine in the future.
My second line of research, which has been dominant over the last 10 years, concerns action research in the field of early intervention in autism (Geoffray et al., 2016). These studies focus on the effectiveness of certain models of early intervention in autism (Jurek et al., 2021; Touzet et al., 2017; Geoffray et al., submitted). My science thesis dealt with how to evaluate the effectiveness of therapies for autism. This work has evolved with Dr. J. Jurek's EDISS Science thesis (defense scheduled for December 2023) on the contribution of qualitative research in this field (Jurek et al., 2022; Geoffray et al., submitted). They will continue shortly with the supervision of a science thesis (Dr. Jay) on the efficiency of video-feedback parental guidance.
My third line of research, focused on "implementation science", aims to assess the various factors involved at all levels of implementing evidence-based practices (EBPs) in current practice, and to measure the impact of modifying some of these factors on implementation. In particular, implementation depends on the characteristics of the intervention, the individual characteristics of practitioners (e.g.: attitudevis-à-vis EBP of professionals, Piccolo, submitted, 2023), the internal context (structure, policy, culture of the organization), the external context (economic, political and social context, including patient resources), and implementation processes (strategies adopted to induce active practice change). We directed a colleague's master's thesis during our mobility in Manchester, on the importance of
the importance of including parents as an implementation factor in parent guidance techniques (Balanovska et al., Autism, under review). Another publication is in progress on the attitude of LEP health professionals towards evidence-based practices (Piccolo, submitted). This year, we're starting work with a medical intern on the feasibility of improving implementation through three leaders of three techniques, for which the teams in the neurodevelopment service I manage (80 agents) have been trained since September 2021. Another project is getting underway with a Master's 2 student in public health on the implementation of the referral platform for metropolitan France's first LEP requests, which I created and have also been in charge of since April 2021. This work is aimed at optimizing resource allocation, establishing an EBP-based PEA in synergy with all partners.
