Trial reportThe Milbank quarterly2014
What are the key ingredients for effective public involvement in health care improvement and policy decisions? A randomized trial process evaluation.
Trial report in The Milbank quarterly, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
60 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Consumers' and health providers' views and perceptions of partnering to improve health services design, delivery and evaluation: a co-produced qualitative evidence synthesis.The Cochrane database of systematic reviews · 2023Pooled it
- Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation.The Cochrane database of systematic reviews · 2021Pooled it
- Patient, Family, and Community Advisory Councils in Health Care and Research: a Systematic Review.Journal of general internal medicine · 2019Pooled it
- Pooled it
- Patient and public engagement in research and health system decision making: A systematic review of evaluation tools.Health expectations : an international journal of public participation in health care and health policy · 2018Pooled it
- Practical Considerations for Using Online Methods to Engage Patients in Guideline Development.The patient · 2018Pooled it
- Bolstering agreement with scarce resource allocation policy using education: a post hoc analysis of a randomized controlled trial.BMC health services research · 2025Trial
- Involving patients in setting priorities for healthcare improvement: a cluster randomized trial.Implementation science : IS · 2014Trial
- Structural Compensation and Participatory Approaches: A Way to Improve Access to Health Care for Undocumented Immigrants? A Scoping Review.Journal of immigrant and minority health · 2026Article
- Strategies, programs and interventions implemented to improve sex workers' access to health services in low- and middle-income countries: a scoping review.BMC public health · 2026Article
- Nothing about us, without us? A reflection on and call for involving children in the process of valuing child health.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- The core values and principles of public health: a contemporary treatise.Frontiers in public health · 2026Review
- Patient awareness, involvement, and learning needs in health technology assessment - a survey of patients, caregivers, and patient advocates.International journal of technology assessment in health care · 2025Article
- [Representation and representativeness in health councils: between formalization and participatory legitimacy].Cadernos de saude publica · 2025Article
- Patient influence on general practice service improvement decision making: a participatory research mixed-methods intervention study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Public Engagement in Health Policy-Making for Older Adults: A Systematic Search and Scoping Review.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Tracking the Development of Community Engagement Over Time: Realist Qualitative Study.Journal of participatory medicine · 2024Article
- Developing a national strategy of consumer and community involvement (CCI) for women's health research.Research involvement and engagement · 2023Article
- Patient and citizen participation at the organizational level in health technology assessment: an exploratory study in five jurisdictions.International journal of technology assessment in health care · 2023Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
contextIn the past 50 years, individual patient involvement at the clinical consultation level has received considerable attention. More recently, patients and the public have increasingly been involved in collective decisions concerning the improvement of health care and policymaking. However, rigorous evaluation guiding the development and implementation of effective public involvement interventions is lacking. This article describes those key ingredients likely to affect public members' ability to deliberate productively with professionals and influence collective health care choices.
methodWe conducted a trial process evaluation of public involvement in setting priorities for health care improvement. In all, 172 participants (including 83 patients and public members and 89 professionals) from 6 Health and Social Services Centers in Canada participated in the trial. We video-recorded 14 one-day meetings, and 2 nonparticipant observers took structured notes. Using qualitative analysis, we show how public members influenced health care improvement priorities.
findingsLegitimacy, credibility, and power explain the variations in the public members' influence. Their credibility was supported by their personal experience as patients and caregivers, the provision of a structured preparation meeting, and access to population-based data from their community. Legitimacy was fostered by the recruitment of a balanced group of participants and by the public members' opportunities to draw from one another's experience. The combination of small-group deliberations, wider public consultation, and a moderation style focused on effective group process helped level out the power differences between professionals and the public. The engagement of key stakeholders in the intervention design and implementation helped build policy support for public involvement.
conclusionsA number of interacting active ingredients structure and foster the public's legitimacy, credibility, and power. By paying greater attention to them, policymakers could develop and implement more effective public involvement interventions.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.