Is Public Deliberation a Relic of America’s Past?

American democracy was built by ordinary people standing up in the town square and engaging with each other to organize, debate, struggle, and decide what was important to them. Yet the evidence today suggests that public deliberation seems to be a relic of the past. Has American politics been too corrupted by those who command the most money, or can Americans from all walks of life still participate in shaping their futures based on the values and issues of the collective, and not just of the few?

One piece of the puzzle might be found from an unexpected corner of the federal government. In the midst of its healthcare.gov struggle, an advocate for public deliberation can be found in the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality.

AHRQ reviews and conducts its own research on the effectiveness of health care tests and treatments. Through its Community Forum, AHRQ seeks to make its research relevant and to broadly disseminate it to the public and to stakeholders from clinicians to policymakers. The AHRQ Community Forum also studies effective mechanisms for public and stakeholder engagement.

To that end, in 2012 AHRQ conducted an evaluation of deliberative methods using a randomized controlled trial involving a representative sample of more than 1,000 participants. Over 75 groups deliberated the same question using one of four different deliberative methods:

Should individual patients and/or their doctors be able to make any health decisions no matter what the evidence of medical effectiveness shows, or should society ever specify some boundaries for these decisions?

In addition to a control group who were emailed educational materials, the four methods evaluated were:

1. One in-person session for 2 hours with active facilitation;
2. Two in-person sessions for 2.5 hours (each) with one week of online discussion in between, also active facilitation;
3. Four virtual sessions (website plus audio conferencing) for 1.25 hours, held over four weeks, with passive facilitation Website and Internet-based audio conferencing; and
4. One in-person session lasting 2.5 days, with expert commentary, active facilitation and breakout groups.

The study made a number of interesting findings related to how participants’ attitudes shifted. While “all four deliberative methods showed significant change on at least one knowledge or attitude measure,” there was significant variation in results between the different methods. Certainly their findings are relevant to other contexts and could be useful to efforts to revive public deliberation.

Read more about the different methods and AHRQ’s findings in a just-released executive summary of its forthcoming report, Community Forum Deliberative Methods Demonstration: Evaluating Effectiveness and Eliciting Public Views on Use of Evidence.

You can learn about a number of other successful efforts and join the conversation on public dialogue and deliberation facilitated by the National Coalition on Dialogue and Deliberation. NCDD offers useful resources and networking and collaboration opportunities for those interested in public deliberation. It also hosts an impressively broad and active series of listservs organized by region and interests.

Filed under In the News, Participation, Technology

Originally published at www.challengestodemocracy.us.