Evaluating Public Participation in a Deliberative Dialogue: A Single Case Study

Document Type : Original Article

Authors

1 School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada

2 School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada

3 Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

4 Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

Abstract

Background 
Deliberative dialogues (DDs) are used in policy-making and healthcare research to enhance knowledge exchange and research implementation strategies. They allow organized dissemination and integration of relevant research, contextual considerations, and input from diverse stakeholder perspectives. Despite recent interest in involving patient and public perspectives in the design and development of healthcare services, DDs typically involve only professional stakeholders. A DD took place in May 2019 that aimed to improve the social environment (eg, safety, social inclusion) and decrease social isolation in a rent-geared-to-income housing complex in a large urban community. Tenants of the housing complex, public health, primary care, and social service providers participated. This study aimed to determine how including community tenants impacted the planning and execution of a DD, including adjustments made to the traditional DD model to improve accessibility.

Methods 
A Core Working Group (CWG) and Steering Committee coordinated with researchers to plan the DD, purposefully recruit participants, and determine appropriate accommodations for tenants. A single mixed-methods case study was used to evaluate the DD process. Meeting minutes, field notes, and researchers’ observations were collected throughout all stages. Stakeholders’ contributions to and perception of the DD were assessed using participant observation, survey responses, and focus groups (FGs).

Results 
34 participants attended the DD and 28 (82%) completed the survey. All stakeholder groups rated the overall DD experience positively and valued tenants’ involvement. The tenants heavily influenced the planning and DD process including decisions about key DD features. Suggestions to improve the experience for tenants were identified.

Conclusion 
These findings demonstrate the viability of and provide recommendations for DDs involving public participants. Like previous DDs, participants found the use of engaged facilitators, issue briefs, and off-the-record deliberations useful. Similarly, professional stakeholders did not highly value consensus as an output, although it was highly valued among tenants, as was actionability.

Keywords


  • epublished Author Accepted Version: February 5, 2022
  • epublished Final Version: February 28, 2022
  1. Boyko JA, Lavis JN, Abelson J, Dobbins M, Carter N. Deliberative dialogues as a mechanism for knowledge translation and exchange in health systems decision-making. Soc Sci Med. 2012;75(11):1938-1945. doi:1016/j.socscimed.2012.06.016
  2. Boyko JA. Deliberative Dialogues as a Mechanism for Knowledge Translation and Exchange [dissertation]. Hamilton, ON: McMaster University; 2010.
  3. Lavis JN, Boyko JA, Gauvin FP. Evaluating deliberative dialogues focussed on healthy public policy. BMC Public Health. 2014;14:1287. doi:1186/1471-2458-14-1287
  4. Boydell KM, Dew A, Hodgins M, et al. Deliberative dialogues between policy makers and researchers in Canada and Australia. J Disabil Policy Stud. 2017;28(1):13-22. doi:1177/1044207317694840
  5. Boyko JA, Kothari A, Wathen CN. Moving knowledge about family violence into public health policy and practice: a mixed method study of a deliberative dialogue. Health Res Policy Syst. 2016;14:31. doi:1186/s12961-016-0100-9
  6. Daya A. Using a Deliberative Dialogue to Facilitate the Uptake of Research Evidence in Rehabilitation for Children with Cerebral Palsy [thesis]. London, ON: Western University; 2017.
  7. Moat KA, Lavis JN, Clancy SJ, El-Jardali F, Pantoja T. Evidence briefs and deliberative dialogues: perceptions and intentions to act on what was learnt. Bull World Health Organ. 2014;92(1):20-28. doi:2471/blt.12.116806
  8. Boyko JA, Lavis JN, Dobbins M. Deliberative dialogues as a strategy for system-level knowledge translation and exchange. Healthc Policy. 2014;9(4):122-131.
  9. Plamondon K, Caxaj S. Toward relational practices for enabling knowledge-to-action in health systems: the example of deliberative dialogue. ANS Adv Nurs Sci. 2018;41(1):18-29. doi:1097/ans.0000000000000168
  10. Banner D, Bains M, Carroll S, et al. Patient and public engagement in integrated knowledge translation research: are we there yet? Res Involv Engagem. 2019;5:8. doi:1186/s40900-019-0139-1
  11. Boivin A, L'Espérance A, Gauvin FP, et al. Patient and public engagement in research and health system decision making: a systematic review of evaluation tools. Health Expect. 2018;21(6):1075-1084. doi:1111/hex.12804
  12. O'Brien N, Law S, Proulx-Boucher K, et al. Codesigning care improvements for women living with HIV: a patient-oriented deliberative dialogue workshop in Montréal, Quebec. CMAJ Open. 2020;8(2):E264-E272. doi:9778/cmajo.20190158
  13. Cope DG. Case study research methodology in nursing research. Oncol Nurs Forum. 2015;42(6):681-682. doi:1188/15.onf.681-682
  14. Polit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. Philadelphia, PA: Lippincott Williams & Wilkins; 2008.
  15. Stake RE. Qualitative case studies. In: Denzin NK, Lincoln YS, eds. The Sage Handbook of Qualitative Research. Sage Publications Ltd; 2005;443-466.
  16. Our home, our health, our future: A community health profile of Vanier Towers. https://www.hamilton.ca/sites/default/files/media/browser/2019-02-25/community-health-profile-vanier-towers-health-report.pdf. Accessed September 1, 2020. Published January 2019.
  17. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101. doi:1191/1478088706qp063oa
  18. Marshall G, Jonker L. An introduction to descriptive statistics: a review and practical guide. Radiography. 2010;16(4):e1-e7. doi:1016/j.radi.2010.01.001
  19. Brett J, Staniszewska S, Mockford C, et al. Mapping the impact of patient and public involvement on health and social care research: a systematic review. Health Expect. 2014;17(5):637-650. doi:1111/j.1369-7625.2012.00795.x
  20. Ong BN, Hooper H. Involving users in low back pain research. Health Expect. 2003;6(4):332-341. doi:1046/j.1369-7625.2003.00230.x
  21. Lavis JN, Boyko JA, Oxman AD, Lewin S, Fretheim A. SUPPORT Tools for evidence-informed health Policymaking (STP) 14: organising and using policy dialogues to support evidence-informed policymaking. Health Res Policy Syst. 2009;7 Suppl 1:S14. doi:1186/1478-4505-7-s1-s14
  22. Kovacs Burns K, Bellows M, Eigenseher C, Gallivan J. 'Practical' resources to support patient and family engagement in healthcare decisions: a scoping review. BMC Health Serv Res. 2014;14:175. doi:1186/1472-6963-14-175
  23. van Deventer C, McInerney P. Patients' involvement in their own care through quality improvement initiatives: a systematic review of qualitative and opinion evidence. JBI Evid Synth. 2012;10(57):3936-3948.
  24. Shaghaghi A, Bhopal RS, Sheikh A. Approaches to recruiting 'hard-to-reach' populations into re-search: a review of the literature. Health Promot Perspect. 2011;1(2):86-94. doi:5681/hpp.2011.009

Articles in Press, Corrected Proof
Available Online from 05 February 2022
  • Receive Date: 30 June 2021
  • Revise Date: 23 September 2021
  • Accept Date: 02 February 2022
  • First Publish Date: 05 February 2022