JMIR Publications

ABSTRACT

Background:

Online democratic deliberation may foster public engagement in relation to new health strategies by providing opportunities for knowledge exchange between experts/policy makers and the public. And at the same time, it can favor decision-making by generating new points of view and solutions to existing problems. Deliberation experts recommend gathering feedback from these processes to optimize their future implementation. However, this modality has not been commonly evaluated.

Objective:

1) To assess the quality of an online democratic deliberation on the prioritization of adult intensive care in a pandemic, held in Quebec and Ontario. 2) To determine its transformative aspect according to the perceptions of participants.

Methods:

An online democratic deliberation was conducted simultaneously with a sample of citizens in June 2022. They were randomized from both communities; healthcare personnel were not included. An online post-deliberation questionnaire was sent to assess their perspectives regarding the quality of the process and identify if they changed their opinions. Descriptive statistics were conducted. An index was calculated to determine equality of participation. A thematic content analysis was conducted from the deliberation and from the comments section.

Results:

The online deliberation involved 47 diverse participants from the public (43% from Quebec, 57% from Ontario). Approximately 98% responded to the post-deliberation questionnaire. The quality of the deliberative process was considered satisfactory by the public regarding: process, information, reasoning, and video conferencing. Four out of five participants reported at least one change of perspective on some of the criteria and values discussed. Regarding the online modality, 95.5% indicated ease of use and 99% were satisfied. Low polarization was found when calculating equal participation. Five themes emerged: a) process appreciation; b) understanding of ethical issues; c) reflecting for the common good; d) technological, and e) transformative aspects. Two aspects to improve were as follows: measures to replace participants unable to go online and optimizing time during discussions.

Conclusions:

Overall, the quality was considered satisfactory by participants. Some participants self-reported a change of opinion post-deliberation. The online modality may be an acceptable alternative for the democratic deliberations in a pandemic context, but with some organizational adaptations.