Public Engagement Project On Community Control Measures for Pandemic Influenza

This project centred around the idea that the public policy process can be shaped through involving everyday citizens in participatory, face-to-face sessions. With an eye to building trust and fostering transparency, governmental agencies joined together to sought the feedback of the people as part of an effort to assure both the soundness and effective implementation of plans to slow the spread of pandemic influenza.

To conduct this public engagement, the sponsors made use of the Policy Analysis CollaborativE (PACE), a model for faciliating the participation of both the organised stakeholder public and the general public. Two to 3 representatives from the organised stakeholder public were chosen from approximately 10 major sectors likely to be affected by the control measures (e.g., the education sector, health professional organisations, the faith community), to form a 50-member national-level panel. To outreach to the larger public, a sample of approximately 260 citizens (representative by age, race, and sex) were recruited from each of the 4 principal geographic regions of the United States; they included citizens in Seattle, Washington; Syracuse, New York; Lincoln, Nebraska; and Atlanta, Georgia.

The group processes were structured to provide essential information to the participating citizens, to encourage the diverse participants to engage in discussions with each other in small groups, to weigh tradeoffs, and to reach a collective viewpoint on whether or not United States jurisdictions should implement a package of 5 community-level control measures in the event of a pandemic flu outbreak. In addition, participants were asked to identify the anticipated challenges in implementing such control measures, and what solutions might be possible for these challenges.

Specifically, in each city, citizens heard presentations from subject matter experts from CDC or from the local health departments; the strategy here involved providing participants with information - and encouraging them to ask questions of the experts - so that informed discussion about community control measures for influenza could take place. To frame the deliberations, organisers provided the citizens with a hypothetical scenario describing how an influenza pandemic might unfold in the United States, including assumptions about the severity of the pandemic, the efficacy of control measures, and possible negative consequences caused by the control measures. The citizens then participated in facilitated discussions of about 10 persons each, followed by 2 large-group sessions with all participants to review the challenges and to discuss possible solutions. Voting on the control measures was carried out by electronic devices which produced instantaneous results for the participants and organisers. These results were then discussed and further refined; what emerged was the identification of 4 major categories of challenges associated with implementation of the proposed control measures (the soundness of the planning, the economic impacts on the population, the information needs of the population, and the social stresses that will be created) and they developed 13 priority recommendations for addressing these challenges (to read these recommendations, click here to access a PDF document with details beginning on page 3).

Methodologies for engaging and informing the stakeholders were similar to those described above. In addition, citizen representatives from each of the participating cities were present at the stakeholder meeting and gave their perspectives on the deliberations in their city; the stakeholders were asked to integrate the results of the citizen deliberations into their discussions, and to identify which proposed actions were considered the most important to carry out. The stakeholders participated in 4 small-group discussions organised around each of 4 categories of challenges previously identified by the citizens. They prioritised the actions proposed in the small group discussions and reconvened in a large group to present their results. A final list of recommendations was created. On day two, stakeholders also voted electronically on a series of questions designed to evaluate their level of support for the proposed control measures.

Health, Risk Management.

The Public Engagement Project on Community Control Measures for Pandemic Influenza was been chosen as co-winner of the International Association for Public Participation's 2007 Project of the Year Award (please click here for more information about this award.)

The design of the project was modeled after the Public Engagement Pilot Project on Pandemic Influenza (PEPPPI), conducted in 2005, on the question of who should be vaccinated first in the early days of an influenza pandemic when vaccine supplies are still limited. This model seeks to recruit approximately 100 citizens-at-large from the 4 major regions of the United States and a separate panel of representatives from organisations most affected by the policy decisions (stakeholders). The citizens-at-large produced their perspective on the question of interest and the panel of stakeholders met at the end of the citizen deliberations to integrate the findings from these deliberations and to produce a final report reflecting the best thinking of both groups and the "societal perspective" on the question of interest.

Based in Keystone, Colorado, The Keystone Center is a non-profit organisation working to equip citizens with deliberative frameworks, democratic processes, analytical information, and critical-thinking skills to approach environmental and scientific dilemmas and disagreements creatively and proactively.