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Created on 04 Aug 2026

Authors

Carine Bétrisey, François Bolduc, Nathalie Delli-Colli, Finn Makela, Anne Hudon, Marie-Ève Caty, Arnaud Duhoux, Annie Carrier

Published in

Sante publique (Vandoeuvre-les-Nancy, France). Volume 38. Issue 1. Pages 123-136.

Abstract

Under pressure, public social and health services systems call on professionals and clinical managers to take on the role of change agents to effectively meet population needs and promote equity in access to services. However, when faced with challenges in fulfilling their role, these field actors may hesitate to act, notably due to the fear of retaliation.
To assess the prevalence of this fear, this study aimed to develop a questionnaire encompassing three key concepts: the problematic situations that may prompt actions, the agentic actions themselves, and the fear of retaliation. We used the modified Delphi method to design this tool, first based on scientific literature and exploratory interviews, and then with input from domain experts. Once developed, the items were validated by a panel for relevance, comprehensiveness, and clarity.
Eight panelists participated in the process. All questionnaire components reached consensus after two rounds of consultation. The process led to modifications (e.g., wording, measurement scales) and additions (e.g., frequency of refraining from acting due to fear) to the questionnaire.
This measurement tool enables a better understanding of the complex process of fear of retaliation. Strategies can thus be implemented to encourage agentic actions among social and health services field actors.

PMID:
42547392
Bibliographic data and abstract were imported from PubMed on 04 Aug 2026.

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