Abstract
BackgroundRecently, patient engagement has been identified as a promising strategy for supporting healthcare planning. However, the context and structure of universalistic, “one-size-fits-all” approaches often used for patient engagement may not enable diverse patients to participate in decision-making about programs intended to meet their needs. Specifically, standard patient engagement approaches are gender-blind and might not facilitate the engagement of those marginalized by, for example, substance use, low income, experiences of violence, homelessness, and/or mental health challenges—highly gendered health and social experiences. The project’s purpose was to develop a heuristic model to assist planners to engage patients who are not traditionally included in healthcare planning.MethodsUsing a qualitative research approach, we reviewed literature and conducted interviews with patients and healthcare planners regarding engaging marginalized populations in health services planning. From these inputs, we created a model and planning manual to assist healthcare planners to engage marginalized patients in health services planning, which we piloted in two clinical programs undergoing health services design. The findings from the pilots were used to refine the model.ResultsThe analysis of the interviews and literature identified power and gender as barriers to participation, and generated suggestions to support diverse populations both to attend patient engagement events and to participate meaningfully. Engaging marginalized populations cannot be reduced to a single defined process, but instead needs to be understood as an iterative process of fitting engagement methods to a particular situation. Underlying this process are principles for meaningfully engaging marginalized people in healthcare planning.ConclusionA one-size-fits-all approach to patient engagement is not appropriate given patients’ diverse barriers to meaningful participation in healthcare planning. Instead, planners need a repertoire of skills and strategies to align the purpose of engagement with the capacities and needs of patient participants. Just as services need to meet diverse patients’ needs, so too must patient engagement experiences.
Highlights
Patient engagement has been identified as a promising strategy for supporting healthcare planning
Recently patient engagement has been identified as a promising strategy for supporting health services planning by health organizations in British Columbia [1, 2], Canada [3,4,5], and internationally [6,7,8]
Most patient engagement processes consist of “activating” patients, i.e., teaching them to participate in healthcare discussions and inserting them into a healthcare planning process to provide a “patient” perspective
Summary
Patient engagement has been identified as a promising strategy for supporting healthcare planning. Patient engagement has been identified as a promising strategy for supporting health services planning by health organizations in British Columbia [1, 2], Canada [3,4,5], and internationally [6,7,8] Patient engagement, in this context, refers to processes through which patients’ values, needs, and preferences inform health services planning with the intended goal of making health services more accessible, appropriate and acceptable to patients [14]. Most patient engagement processes consist of “activating” patients, i.e., teaching them to participate in healthcare discussions and inserting them into a healthcare planning process to provide a “patient” perspective This approach (and other traditionally-used formats of patient engagement, such as advisory councils and deliberative processes) privileges participation styles similar to those of health service planners. Universalistic, “one-size-fits-all” approaches may not enable diverse patients to participate in decision-making about programs and policies intended to meet their needs or enable planners to develop interventions with diverse patients
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