Innovative process to support the sustainability and scale-up of anxiety prevention programs in schools in Quebec, Canada

Année :


Lane J, Therriault D, Lauzier-Jobin F, Paré-Beauchemin R, McSween-Cadieux E, Ziam S, Dagenais C, Gosselin P, Smith J, Houle A-A, Drapeau M, Roy M, Thibault I. (2022). Innovative process to support the sustainability and scale-up of anxiety prevention programs in schools in Quebec, Canada. International Journal of Integrated Care. 22(S3): 156.


Introduction: Anxiety disorders are among the most common mental health disorders affecting youth [1]. Several programs have been developed to prevent these disorders, but few have been implemented systematically, with the intention to sustainability and scaling up to all schools. The HORS-PISTE Program was developed based on the Knowledge to Action framework [2] derived from implementation science. We chose this framework because it is recognized to be clear and easy to use, to foster stakeholder engagement, to consider the local context, and to propose a cyclical and iterative process [3].

Objectives and method: The objective of the presentation is to describe the Program and how this framework was used to design, implement, sustain, evaluate, and scale up this program. An example of a student’s involvement in the design of the program will be highlighted. A multi-method (pre and post-test evaluation protocol, surveys, implementation review meetings, logbooks of facilitators) and multi-informant approach (students, parents, teachers, school stakeholders linked to the program logistics) was used.

Results: The HORS-PISTE Program aims to prevent anxiety among high school students (aged 12 to 17 years). In the short term, the program seeks to develop and promote various life skills that are determinants of mental health and well-being. The program was developed by involving more than a hundred stakeholders including students. The program offers a continuum with its two components: Exploration (universal prevention component) which is implemented with all students and Expedition (early intervention component) for students who remain vulnerable despite their participation in the Exploration component. The program invites professionals from the education and health networks to join forces in the deployment of the program.

The different development, implementation and evaluation cycles of the HORS-PISTE program will be presented through the phases of the Knowledge to Action framework, thus demonstrating how it is possible to maximize its sustainability and scaling up to all Quebec secondary schools.

Conclusion: About 100 schools are currently implementing the program. The Quebec Ministry of Health and Social Services is funding a team in order to support schools to make the program accessible to all schools.

Implications: Several strengths of the process held by the HORS-PISTE program shed light on how best practices can be capitalized to promote program sustainability and scale-up. The challenges of combining the scientific rigor associated with assessment with the reality in the reality of practice will also be raised.