I've been spending time lately becoming more familiar with methods of public participation and the evidence behind participation.' When I first moved to British Columbia, the government was sponsoring 'Conversations on Health' which I initially found exciting and innovative.' That effort was designed to give the public a voice about health care in the province.' I sent in my comments via the website and read about the public meetings being held throughout the province. I became a skeptic when I compared the data and original reports from the conversations and the conclusions.' They didn't seem to match. I've recently learned the development of mistrust is a pitfall of public engagement:' if the effort is not sincere, cynicism can be created.
Since British Columbia values public engagement (with efforts in the past 5 years done much better than Conversations in Health), I've been working to inform myself about the evidence behind it and the methods used.' An amazing resource is the Picker Institute Europe which launched a website expressly for the purpose of reviewing what works and what doesn't in Patient and Public Engagement (PPE, a new TLA for me!)' www.investinengagement.info.' At this site you can read about best buys in PPE, view the evidence, measurement, and case studies.' Another great resource is the International Association for Public Participation, www.iap2.org .' Here you can find training, resources and tools.'
[caption id="attachment_553" align="alignright" width="342" caption="Spectrum of Public Participation from www.iap2.org"][/caption]
The patient part of PPE matches many of my interests and experiences: health literacy, shared decision-making, health promotion and self-management.' The evidence here is strong, useful and growing.' My so-far brief dip into the literature on the public part of PPE indicates that public involvement in health care system redesign and community health activities is rarely studied in a systematic way because for many it represents a fundamental value.' I was encouraged by the summary from Picker Institute Europe that describes effective methods to involve the public in priority-setting (so important in a publicly funded healthcare system where 'do everything for me' creates challenges for the pocketbook), reviews the benefit of public involvement in quality (stronger evidence for stimulating improvement than for actually changing quality at this point in time), and limited evidence for community development.' My conclusion is that the evidence-base for public participation is about where the evidence for patient involvement was 15 years ago.' I'm also trying to figure out how the activities in British Columbia, particularly of the Patient Voices Network
I was also pleased to see on the comprehensive www.peopleandparticipation.net website that I am already familiar with at least two public engagement techniques, patient journey mapping and open space technology.' The case studies (which I searched by key word) were useful to understand the techniques in context.
I still have a LOT to learn about PPE and I'm very happy to be living in a culture where engagement is sought.' I hope I can contribute to understanding what works and what doesn't in public engagement.