Effectiveness of Public Deliberation Methods for Gathering Input on Issues in Healthcare: Findings from a Randomized Trial

Social Science & Medicine 133:11-20, May 2015; DOI:10.1016/j.socscimed.2015.03.024

10 Pages Posted: 27 Feb 2018

See all articles by Kristin Carman

Kristin Carman

American Institutes for Research

Coretta Mallery

American Institutes for Research

Maureen Maurer

American Institutes for Research

Grace Wang

American Institutes for Research

Steven Garfinkel

American Institutes for Research

Manshu Yang

American Institutes for Research

Dierdre Gilmore

American Institutes for Research

Amy Windham

American Institutes for Research

Marge Ginsburg

Center for Healthcare Decisions

Shoshanna Sofaer

CUNY Baruch College

Marthe Gold

Sophie Davis School of Biomedical Education, City College of New York

Ela Pathak-Sen

Government of the United Kingdom - National Health Service (NHS)

Todd Davies

Stanford University - Symbolic Systems Program; Center for the Study of Language and Information

Joanna Siegel

Government of the United States of America - Center for Outcomes and Evidence

Rikki Mangrum

American Institutes for Research

Jessica Fernandez

University of Maryland

Jennifer Richmond

University of North Carolina (UNC) at Chapel Hill

James Fishkin

Stanford University

Alice Siu

Center for Deliberative Democracy

Date Written: March 14, 2015

Abstract

Public deliberation elicits informed perspectives on complex issues that are values-laden and lack technical solutions. This Deliberative Methods Demonstration examined the effectiveness of public deliberation for obtaining informed public input regarding the role of medical evidence in U.S. healthcare. We conducted a 5-arm randomized controlled trial, assigning participants to one of four deliberative methods or to a reading materials only (RMO) control group. The four deliberative methods reflected important differences in implementation, including length of the deliberative process and mode of interaction. The project convened 76 groups between August and November 2012 in four U.S. Chicago, IL; Sacramento, CA; Silver Spring, MD; and Durham, NC, capturing a sociodemographically diverse sample with specific attention to ensuring inclusion of Hispanic, African-American, and elderly participants. Of 1774 people recruited, 75% participated: 961 took part in a deliberative method and 377 participants comprised the RMO control group. To assess effectiveness of the deliberative methods overall and of individual methods, we evaluated whether mean pre-post changes on a knowledge and attitude survey were statistically different from the RMO control using ANCOVA. In addition, we calculated mean scores capturing participant views of the impact and value of deliberation. Participating in deliberation increased participants' knowledge of evidence and comparative effectiveness research and shifted participants' attitudes regarding the role of evidence in decision-making. When comparing each deliberative method to the RMO control group, all four deliberative methods resulted in statistically significant change on at least one knowledge or attitude measure. These findings were underscored by self-reports that the experience affected participants' opinions. Public deliberation offers unique potential for those seeking informed input on complex, values-laden topics affecting broad public constituencies.

Keywords: Public deliberation, Public engagement, Citizens' jury, Public opinion, Evidence-based medicine, Comparative effectiveness research, United States

JEL Classification: I18, D70

Suggested Citation

Carman, Kristin and Mallery, Coretta and Maurer, Maureen and Wang, Grace and Garfinkel, Steven and Yang, Manshu and Gilmore, Dierdre and Windham, Amy and Ginsburg, Marge and Sofaer, Shoshanna and Gold, Marthe and Pathak-Sen, Ela and Davies, Todd R. and Siegel, Joanna and Mangrum, Rikki and Fernandez, Jessica and Richmond, Jennifer and Fishkin, James and Siu, Alice, Effectiveness of Public Deliberation Methods for Gathering Input on Issues in Healthcare: Findings from a Randomized Trial (March 14, 2015). Social Science & Medicine 133:11-20, May 2015; DOI:10.1016/j.socscimed.2015.03.024. Available at SSRN: https://ssrn.com/abstract=3123537

Kristin Carman

American Institutes for Research ( email )

1990 K Street, NW
Washington, DC 20006-1107
United States

Coretta Mallery

American Institutes for Research ( email )

1990 K Street, NW
Washington, DC 20006-1107
United States

Maureen Maurer

American Institutes for Research ( email )

1990 K Street, NW
Washington, DC 20006-1107
United States

Grace Wang

American Institutes for Research ( email )

1990 K Street, NW
Washington, DC 20006-1107
United States

Steven Garfinkel

American Institutes for Research ( email )

1990 K Street, NW
Washington, DC 20006-1107
United States

Manshu Yang

American Institutes for Research ( email )

1990 K Street, NW
Washington, DC 20006-1107
United States

Dierdre Gilmore

American Institutes for Research ( email )

1990 K Street, NW
Washington, DC 20006-1107
United States

Amy Windham

American Institutes for Research ( email )

1990 K Street, NW
Washington, DC 20006-1107
United States

Marge Ginsburg

Center for Healthcare Decisions ( email )

Sacramento, CA
United States

Shoshanna Sofaer

CUNY Baruch College ( email )

17 Lexington Avenue
New York, NY 10021
United States

Marthe Gold

Sophie Davis School of Biomedical Education, City College of New York ( email )

Convert Avenue at 138th Street
New York, NY 10031
United States

Ela Pathak-Sen

Government of the United Kingdom - National Health Service (NHS) ( email )

London, SW1A 2NS
United Kingdom

Todd R. Davies (Contact Author)

Stanford University - Symbolic Systems Program ( email )

Stanford, CA 94305-2150
United States

HOME PAGE: http://www.stanford.edu/~davies

Center for the Study of Language and Information ( email )

Stanford, CA 94305-4115
United States

Joanna Siegel

Government of the United States of America - Center for Outcomes and Evidence ( email )

540 Gaither Road, Suite 2000
Rockville, MD 20850
United States

Rikki Mangrum

American Institutes for Research ( email )

1990 K Street, NW
Washington, DC 20006-1107
United States

Jessica Fernandez

University of Maryland ( email )

College Park
College Park, MD 20742
United States

Jennifer Richmond

University of North Carolina (UNC) at Chapel Hill ( email )

102 Ridge Road
Chapel Hill, NC NC 27514
United States

James Fishkin

Stanford University ( email )

Stanford, CA 94305
United States

Alice Siu

Center for Deliberative Democracy ( email )

Stanford, CA 94305-2050
United States

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