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Effective Health Care Program

Knowledge Briefs: Public Deliberation

Research Report
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These reports (Knowledge Brief No. 1; Knowledge Brief No. 2) are available in PDF (178 kB) only. People using assistive technology may not be able to fully access information in this file. For additional assistance, please contact us.

Project Overview

These Knowledge Briefs describe public deliberation, a distinct consultation method used to obtain considered and informed public input on complex societal issues. They are based on findings from the Literature Review on Public Deliberation Methods for Eliciting Public Input on Health Topics.

Report Summaries

Knowledge Brief No. 1

The literature on public deliberation shows that health program and policy decisionmakers, researchers, and others increasingly are interested in having lay people learn about and consider complex issues affecting the broader community in order to contribute to unraveling controversy and identifying common ground. Standing deliberative bodies, such as NICE’s Citizens Council and Quebec’s Consultation Forum, weigh in on population health and health care issues and play an ongoing role in health decisionmaking processes. Others play a short-term role in shaping health decisions, such as Canada’s Romanow Commission that convened over the course of one and a half years to deliberate on the future of health care in Canada (von Lieres & Kahane, 2006). Still other deliberative gatherings identified in the literature were one-time engagements that were not explicitly tied to decisionmaking processes but that elucidated public views on certain social issues.

Few applications of deliberation in the literature document formal delivery of participants’ feedback to policymakers. Many conveners of public deliberation conducted deliberative processes in order to learn more about the public’s values and to explore the value of public deliberation. The literature includes a diverse range of health topics that have been addressed via public deliberation. The relevance of public deliberation to decisionmaking about health issues continues to grow, particularly in response to new mandates in the United States for patient and consumer engagement in health care research prioritization, care service delivery, and safety and quality improvement.

Knowledge Brief No. 2

The literature on public deliberation features distinct deliberative methods that have unique characteristics and purposes, implemented across a range of settings and fields. The literature also includes examples of hybrid approaches or innovative methods, such as the use of photovoice in deliberation and the Choosing Healthplans Altogether resource allocation game. The range of methods observed in the literature indicates that this public consultation approach is dynamic and adaptable to a variety of contexts.

Questions remain regarding the relative strengths and weaknesses of different deliberative approaches, since few comparisons of the various methods have been conducted. Implementation of deliberative methods can be time-consuming and costly; therefore, studies comparing various deliberative methods have an important role in helping sponsors select appropriate methods.

Important questions also remain regarding the outcomes of deliberation. Outcomes measured in the literature include process measures as well as measures of the effect of deliberation on individual participants and on decisionmaking. Substantial literature demonstrates the effectiveness of public deliberation in terms of changes in participants’ knowledge, beliefs, attitudes, perspectives, values, opinions, or policy preferences (as relevant). However, the effect of deliberative public input on public policy has not been thoroughly investigated.

Journal Publications

Siegel JE, Heeringa JW, Carman KL. Public deliberation in decisions about health research. Virtual Mentor. 2013 Jan 1;15(1):56-64. doi: 10.1001/virtualmentor.2013.15.1.pfor2-1301. PMID: 23356809.

Wang G, Gold MR, Siegel J, et al. Deliberation: obtaining informed input from a diverse public. J Health Care Poor Underserved. 2015 Feb; 26(1):223-42. PMID: 25702739.

Carman K, Mallery C, Maurer M, et al. Effectiveness of public deliberation methods for gathering input on issues in healthcare: results from a randomized trial. Soc Sci Med. 2015 May;133:11-20. PMID: 25828260.