Evidence Library

Title: What are the key ingredients for effective public involvement in health care improvement and policy decisions? A randomised trial process evaluation
Author: Boivin, A., Lehoux, P., Burgers, J. and Grol, R.
Date Published: 2014
Reference: Milbank Quarterly, 92, (2), 319–350
Are service users or carers authors: No/Not Known

Abstract: This article reports on an evaluation of a randomised trial of public involvement in health policy decision-making in Canada. The trial took place at six sites. At three sites, patients and the public attended a preparation meeting, were consulted about their preferences for long-term care for chronic conditions, and then attended a two-day debate with health professionals to agree priorities for health policy. At the other three sites, the health professionals debated the issue without any public involvement. The results showed that the patients’/ public’s priorities were very different from those of professionals. The involvement created greater consensus. The researchers evaluated the involvement process to identify which key ingredients influenced the patients’ / public's ability to engage in the debate successfully and to influence the final outcomes. They identified the following important factors: providing appropriate support and preparation to patients/ the public – this is not just about explaining technical terms but also about encouraging the development of a shared public expertise – so that patients/ public members can speak on behalf of a wider group not just themselves as individuals; placing less emphasis on obtaining ‘representative’ members, but thinking about who identifies the patient/public members, creating opportunities for them to interact and giving them access to population-based evidence – so they have legitimacy to speak on behalf of a wider group and credibility with health professionals; developing a process that combines information-giving, consultation and involvement as this contributes to the public’s credibility, legitimacy and power; having skilled facilitators to moderate groups rather than subject experts, as this helps to even out power imbalances.

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Categories: public health
reflecting on public involvement in research
journal article

Date Entered: 2015/04/27

Date Edited: 2015/04/27

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