Effectiveness of public deliberation methods for gathering input on issues in healthcare: Results from a randomized trial
Effectiveness of public deliberation methods for gathering input on issues in healthcare: Results from a randomized trial
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DOI：
10.1016/j.socscimed.2015.03.024
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发表时间：
2015-05-01
影响因子：
5.4
通讯作者：
Chao, Alice Siu
中科院分区：
文献类型：
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作者：
Carman, Kristin L.;Mallery, Coretta;Chao, Alice Siu
公众审议有助于对充满价值观但缺乏技术解决办法的复杂问题提出知情的观点。本次审议方法演示考察了公众审议对于获取有关医学证据在美国医疗保健中的作用的知情公众意见的有效性。我们进行了一项5臂随机对照试验，将参与者分配到四种审议方法之一或仅阅读材料（RMO）对照组。这四种审议方法反映了在执行方面的重要差异，包括审议过程的长度和互动方式。该项目于2012年8月至11月在美国四个地点召集了76个小组：芝加哥，IL;萨克拉门托，CA;银泉，MD;和达勒姆，NC，捕获了一个社会人口统计学上多样化的样本，特别注意确保包括西班牙裔，非洲裔美国人和老年参与者。在招募的1774人中，75%的人参与了研究：961人参与了审议方法，377人组成了RMO对照组。为了评估审议方法的整体和个人的方法的有效性，我们评估是否平均前后变化的知识和态度的调查是有统计学差异的RMO控制使用ANCOVA。此外，我们还计算了参与者对审议的影响和价值的看法的平均得分。参与审议增加了参与者对证据和比较有效性研究的了解，并改变了参与者对证据在决策中的作用的态度。当比较每一个审议的方法RMO控制组，所有四个审议的方法导致至少一个知识或态度的措施在统计上显着的变化。自我报告强调了这些发现，即这次经历影响了参与者的意见。对于那些就影响广泛公众群体的复杂、充满价值观的话题寻求知情意见的人来说，公开审议提供了独特的潜力。(C)2015爱思唯尔有限公司版权所有。
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. locations: 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. (C) 2015 Elsevier Ltd. All rights reserved.