Deliberation occurs through group decision-making that seeks the consent of all participants. In order to achieve this goal, the issues have to be framed to help clarify participants’ thinking. Framing a question is a way of structuring an issue that involves different options to resolve a problem. This is an important step as it will influence the planning around any deliberative process: who will be included in the process, how the different stakeholders will view the issue, the range of possible solutions, time needed to answer the questions, etc. Framing the issue for deliberation helps to clarify the range of available perspectives, which can help the different stakeholders navigate more easily through complex issues.
The narrower the questions, the less room there is to learn about unanticipated views. On the other hand, if questions are framed too broadly, then the forum may reach conclusions that are impractical and cannot be translated into policy. The conclusions may be too general to be acted upon, may fail to address relevant areas of ethical concern or may not take into account practical limitations such as laws or protocols (O’Doherty et al., 2012).
THE IMPACT Reality
One activity we performed in IMPACT was deliberative forums: bringing together different stakeholders to explore how they see the problem and getting their input on how to solve it. We invited a broad group of stakeholders, including health policy advisors, planners, managers, clinicians and members of the community, to help us identify primary care access gaps and to discuss how these gaps might be addressed. Some LIPs also included patient partners in deliberative forums as a component of person-centred care.
LIP meetings also provided opportunities for collective decision making. For example, one of the LIPs structured their meetings to include informing members of the actions taken by the research team to address issues/comments raised at the previous meeting, followed by a general update on the progress of the project, small or large group discussions of questions generated prior to the meeting and short evaluation questionnaires to provide feedback on the meeting.
