title: Public engagement in priority-setting: results from a pan-Canadian survey of decision-makers in cancer control.
abstract: Decision-makers are challenged to incorporate public input into priority-setting decisions. We conducted a pan-Canadian survey of decision-makers in cancer control to investigate the types of evidence, especially evidence supplied by the public, that are utilized in health care priority-setting. We further examined how normative attitudes and contextual factors influence the use of public engagement as evidence at the committee level. Administered between November and December 2012, 67 respondents from 117 invited individuals participated in the survey. The results indicated that public engagement was infrequently utilized compared to clinical effectiveness evidence or cost evidence. General positive agreement between normative attitudes towards the use of evidence and the frequency of evidence utilization was observed, but absence of correlative agreement was found for the types of evidence that are supplied by the general public and for cost-effectiveness inputs. Regression analyses suggested that public engagement was unevenly utilized between jurisdictions and that educational background and barriers to implementing public input may decrease the odds of using public engagement as evidence. We recommend that institutions establish a link between committee members' normative attitudes for using public engagement and its real-world utilization.
authors.affiliation: Canadian Centre for Applied Research in Cancer Control (ARCC), Canada; Cancer Control Research, British Columbia Cancer Agency, Canada; School of Population and Public Health, University of British Columbia, Canada.
authors.forename: Dean A
authors.initials: DA
authors.lastname: Regier
authors.affiliation: Canadian Centre for Applied Research in Cancer Control (ARCC), Canada; Cancer Control Research, British Columbia Cancer Agency, Canada.
authors.forename: Colene
authors.initials: C
authors.lastname: Bentley
authors.affiliation: School of Population and Public Health, University of British Columbia, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Canada.
authors.forename: Craig
authors.initials: C
authors.lastname: Mitton
authors.affiliation: School of Population and Public Health, University of British Columbia, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Canada.
authors.forename: Stirling
authors.initials: S
authors.lastname: Bryan
authors.affiliation: School of Population and Public Health, University of British Columbia, Canada; W. Maurice Young Centre for Applied Ethics, University of British Columbia, Canada.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Burgess
authors.affiliation: Provincial Health Services Authority, British Columbia, Canada.
authors.forename: Ellen
authors.initials: E
authors.lastname: Chesney
authors.affiliation: Population and Preventive Oncology, British Columbia Cancer Agency, Canada.
authors.forename: Andy
authors.initials: A
authors.lastname: Coldman
authors.affiliation: Joint Centre for Bioethics, University of Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gibson
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Canada; Pharmacoeconomics Research Unit, Cancer Care Ontario, Canada.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hoch
authors.affiliation: Department of Health Service Administration, University of Sharjah, United Arab Emirates.
authors.forename: Syed
authors.initials: S
authors.lastname: Rahman
authors.affiliation: Pan-Canadian Oncology Drug Review (pCODR), Canada.
authors.forename: Mona
authors.initials: M
authors.lastname: Sabharwal
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Canada.
authors.forename: Carol
authors.initials: C
authors.lastname: Sawka
authors.affiliation: Research, Knowledge Translation, and Library Services, BC Ministry of Health, Canada.
authors.forename: Victoria
authors.initials: V
authors.lastname: Schuckel
authors.affiliation: Canadian Centre for Applied Research in Cancer Control (ARCC), Canada; Cancer Control Research, British Columbia Cancer Agency, Canada; School of Population and Public Health, University of British Columbia, Canada. Electronic address: speacock@bccrc.ca.
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Peacock
mesh_terms: D002017:Budgets; D002170:Canada; D003256:Community Participation / Q000379:methods*; D003362:Cost-Benefit Analysis; D003657:Decision Making; D019317:Evidence-Based Medicine; D015276:Health Care Rationing / Q000458:organization & administration*; D006291:Health Policy; D006292:Health Priorities / Q000458:organization & administration*; D006801:Humans; D020380:Needs Assessment; D009369:Neoplasms / Q000191:economics / Q000628:therapy*; D012959:Socioeconomic Factors
keywords: Canada; Health care decision-making; Health policy; Priority setting; Public engagement