title: Effectiveness of public deliberation methods for gathering input on issues in healthcare: Results from a randomized trial.
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.
  
  
  METHODS
  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.
authors.affiliation: American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA. Electronic address: KCarman@air.org.
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Carman
authors.affiliation: American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA.
authors.forename: Coretta
authors.initials: C
authors.lastname: Mallery
authors.affiliation: American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA.
authors.forename: Maureen
authors.initials: M
authors.lastname: Maurer
authors.affiliation: American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA.
authors.forename: Grace
authors.initials: G
authors.lastname: Wang
authors.affiliation: American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Garfinkel
authors.affiliation: American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA.
authors.forename: Manshu
authors.initials: M
authors.lastname: Yang
authors.affiliation: American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA.
authors.forename: Dierdre
authors.initials: D
authors.lastname: Gilmore
authors.affiliation: American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Windham
authors.affiliation: Center for Healthcare Decisions, 955 University Avenue, Suite C, Sacramento, CA 95825, USA.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Ginsburg
authors.affiliation: American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA.
authors.forename: Shoshanna
authors.initials: S
authors.lastname: Sofaer
authors.affiliation: City College of New York, The Graduate Center, CUNY, 365 Fifth Avenue, New York, NY 10016, USA.
authors.forename: Marthe
authors.initials: M
authors.lastname: Gold
authors.affiliation: Commotion, Nishana Enterprises Ltd, Culvert Cottage, Kingsmill Lane, Painswick GL6 6RT, UK.
authors.forename: Ela
authors.initials: E
authors.lastname: Pathak-Sen
authors.affiliation: Center for the Study of Language and Information, Stanford University, CSLI, Cordura Hall, 210 Panama Street, Stanford, CA 94305, USA.
authors.forename: Todd
authors.initials: T
authors.lastname: Davies
authors.affiliation: Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, 540 Gaither Road, Suite 2000, Rockville, MD 20850, USA.
authors.forename: Joanna
authors.initials: J
authors.lastname: Siegel
authors.affiliation: American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA.
authors.forename: Rikki
authors.initials: R
authors.lastname: Mangrum
authors.affiliation: American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Fernandez
authors.affiliation: American Institutes for Research, 1000 Thomas Jefferson Street, NW, Washington, DC 20007, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Richmond
authors.affiliation: Center for Deliberative Democracy, Stanford University, Dept. of Communication, 450 Serra Mall, Bldg 120, Stanford, CA 94305, USA.
authors.forename: James
authors.initials: J
authors.lastname: Fishkin
authors.affiliation: Center for Deliberative Democracy, Stanford University, Dept. of Communication, 450 Serra Mall, Bldg 120, Stanford, CA 94305, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Siu Chao
mesh_terms: D000328:Adult; D000368:Aged; D003256:Community Participation / Q000379:methods*; D003657:Decision Making; D019317:Evidence-Based Medicine; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011639:Public Opinion; D014481:United States
keywords: Citizens' jury; Comparative effectiveness research; Evidence-based medicine; Public deliberation; Public engagement; Public opinion; United States