title: FRAMEWORK FOR USER INVOLVEMENT IN HEALTH TECHNOLOGY ASSESSMENT AT THE LOCAL LEVEL: VIEWS OF HEALTH MANAGERS, USER REPRESENTATIVES, AND CLINICIANS.
abstract: OBJECTIVE
  The aim of this study was to explore stakeholders' points of views regarding the applicability and relevance of a framework for user involvement in health technology assessment (HTA) at the local level. We tested this framework in the context of the assessment of alternative measures to restraint and seclusion among hospitalized adults and those living in long-term-care facilities.
  
  
  METHODS
  Twenty stakeholders (health managers, user representatives, and clinicians) from seven regions of Quebec participated in a semi-structured interview. A thematic analysis of the transcribed interviews was performed.
  
  
  RESULTS
  The findings highlighted the relevance and applicability of the framework to this specific HTA. According to interviewees, direct participation of users in the HTA process allows them to be part of the decision-making process. User consultation makes it possible to consider the views of a wide variety of people, such as marginalized and vulnerable groups, who do not necessarily meet the requirements for participating in HTA committees. However, some user representatives emphasized that user consultation should be integrated into a more holistic and participatory perspective. The most frequent barrier associated with user involvement in HTA was the top-down health system, which takes little account of the user's perspective.
  
  
  CONCLUSIONS
  The proposed framework was seen as a reference tool for making practitioners and health managers aware of the different mechanisms of user involvement in HTA and providing a structured way to classify and describe strategies. However, there is a need for more concrete instruments to guide practice and support decision making on specific strategies for user involvement in HTA at the local level.
authors.affiliation: Université Laval & CHU de Québec Research Centermarie-pierre.gagnon@fsi.ulaval.ca.
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Gagnon
authors.affiliation: CHU de Québec Research Center.
authors.forename: Marie
authors.initials: M
authors.lastname: Desmartis
authors.affiliation: Université Laval,Faculty of Nursing Sciences.
authors.forename: Johanne
authors.initials: J
authors.lastname: Gagnon
authors.affiliation: Université Laval,Department of Management.
authors.forename: Michèle
authors.initials: M
authors.lastname: St-Pierre
authors.affiliation: CHU de Québec.
authors.forename: Marc
authors.initials: M
authors.lastname: Rhainds
authors.affiliation: CHU de Québec.
authors.forename: Martin
authors.initials: M
authors.lastname: Coulombe
authors.affiliation: CHU de Québec Research Center.
authors.forename: Mylène Dipankui
authors.initials: MD
authors.lastname: Tantchou
authors.affiliation: Université Laval,Department of Family Medicine;CHU de Québec Research Center.
authors.forename: France
authors.initials: F
authors.lastname: Légaré
mesh_terms: D026683:Advisory Committees; D003142:Communication; D003657:Decision Making; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D010358:Patient Participation; D036301:Qualitative Research; D011792:Quebec; D012107:Research Design; D013673:Technology Assessment, Biomedical / Q000458:organization & administration*
keywords: Canada; Elderly care; Health technology assessment; Hospital-based HTA; Interviews; Mental health; User involvement