Deliberative Process Research Articles

Unmasking the Aversive Stigmatizer: Integrating Deliberate and Automatic Cognition in the Study of Mental Health Stigma and Perceived Dangerousness

Scholars posit that mental health stigma may be the product of both deliberate (i.e., intentional and conscious) and automatic (i.e., effortless and nonconscious) cognitive processes. Yet, few sociological studies have empirically tested this theoretical assumption with valid measures of automatic cognition. This study integrates explicit and implicit stigma measures to investigate the presence of a potentially unique actor in the stigma process, the aversive stigmatizer: individuals who deliberately reject negative cultural stereotypes but still hold implicit mental illness-related biases that may inadvertently influence discriminatory behaviors. Findings suggest that a substantial portion of the sample are aversive stigmatizers and that these actors are disproportionately present among certain social groups. Thus, this study sheds light on a previously hidden population that likely contributes to prejudice and discrimination, as well as advances our theoretical understanding of both public stigma and self-stigma.

Deliberation, Polarization, and Emotion: A Deliberative Process about Climate Change with Young Participants

Deliberation, Polarization, and Emotion: A Deliberative Process about Climate Change with Young Participants

Look, over there! A streaker! – Qualitative study examining streaking as a behaviour change technique for habit formation in recreational runners

ABSTRACT Background Running as a form of physical activity is beneficial to overall health and wellbeing. The aim of the study is to examine ‘run streaking’ (i.e. running on consecutive days, for a minimum period of time or distance, typically at least one mile) as a technique for habit formation and behaviour change. Methods Qualitative semi-structured interviews with 21 recreational adult runners (11 female and 10 male). Run streak length ranged from a minimum of 100 days to over 4500 days. Transcripts were analysed using a hybrid deductive–inductive thematic analysis. Results Run streaking was reported to lead to several benefits, health improvements and a sense of accomplishment, although many run streakers reported running through injuries and lack of recovery. Accounts of run streaking showed features of automaticity indicative of habitual behaviour. Other behavioural processes identified included motivation, identity, self-regulation and social support. Behavioural streaking showed the potential to influence change in behaviours other than running. Conclusion Accounts of run streaking demonstrate an interplay between automatic and deliberate processes in the maintenance of running behaviour. Behavioural streaking is a technique that could be used in other behaviour change contexts beyond running to support habit formation.

The development of a roadmap for Health Technology Assessment implementation in Moldova.

Moldova strives for universal health coverage (UHC) and considers health technology assessment (HTA) an important policy instrument to inform the choice of services that should be covered to progressively realize UHC. It plays a key role in determining which technologies are coved, considering various dimensions often including cost-effectiveness, budget impact, and feasibility. This paper reports on work undertaken to develop a roadmap for HTA implementation, using evidence-informed deliberative processes (EDPs) as the guiding framework. Between 2020 and 2022, we undertook several activities that informed the roadmap. We conducted a needs assessment and an assessment of European HTA best practices using a combination of desk research, interviews and surveys. We then conducted a document review of six selected HTA systems, complimented by expert interviews from three neighbouring countries. The roadmap provided a suggested HTA process, which included instructions on how to execute the different steps of the EDP framework to enhance the legitimacy of HTA-informed decision-making. The roadmap encompasses several aspects such as how to organize stakeholder involvement, how to identify and operationalize decision criteria, and how to make the decision process transparent. Guidance was given to the country on establishing a legal framework for HTA; a communication strategy; strengthening capacity and leveraging HTA expertise. The country was also given tailored advice on the positioning of the HTA-agency, first as an entity within the Ministry of Health or the National Agency of Public Health but with the long-term vision for it to be independent of any state institution. Despite several challenges, including a partial disruption because of the Covid-19 pandemic, the development of the roadmap for HTA implementation was completed and agreed upon by the Ministry of Health in Moldova. This work has helped motivate and support the country in HTA institutionalization.

Preparing for pandemics needs a dose of public health and a booster of “complex thought” (Errare humanum est, perseverare diabolicum)

AbstractThe COVID‐19 pandemic has triggered unprecedented governmental responses worldwide, revealing weaknesses in health systems and public health policies due to lack of “complex thought” required to manage complex adaptive systems. Understanding COVID‐19 response strategies' multiple effects is particularly important now that pandemic preparedness and response (PPR) is on top of the global health political agenda. Here, we adopt a complex adaptive systems approach to critically analyze the literature and draw lessons from the COVID‐19 response to inform future PPR strategies. We observe that in many contexts, strategies implemented in response to COVID‐19 were poorly effective, inefficient, and inequitable. We explain the limitations of these prevailing measures and propose approaches and strategies to manage pandemics arising from a “systems thinking” perspective. PPR demands the adoption of an evolving, evidenced‐informed, and context‐specific strategy based on comprehensive approaches reflecting the complexities of health crises. This means moving away from single‐focused health security paradigms to consider the full range of health problems facing populations and adopting a package of interventions chosen via participatory and deliberative processes that are context‐specific and sensitive, as well as evidence‐driven, to ensure a fair balance between various pillars of pandemic responses: health promotion, non‐pharmaceutical interventions, prophylaxis, vaccines, and treatments.

Inclusive Faculty Hiring: Promising Practices for Increasing Higher Education Faculty Diversity

This paper reviews and synthesizes the extant work on promising practices in recruiting and hiring diverse college faculty in an equitable, inclusive process. First, I discuss the substantial demographic mismatch between faculty, the general working-age population, and undergraduate students. I then discuss the evidence that representational faculty diversity benefits students. I then integrate the literature on promising practices in inclusive faculty recruitment to recommend four strategies: better position advertisements, ongoing, proactive recruitment, thoughtful committee assignment and training, and a more deliberate, deliberative process. I offer multiple tactics within each strategy and urge institutions to adopt and prioritize whatever mix of these and other strategies/tactics makes the most sense for them.

A participatory research to assess how a student citizens’ assembly can facilitate the co-creation of nutrition interventions in higher education settings

BackgroundThe transition period from adolescence to early adulthood is critical for developing new nutritional behaviors, making higher education students an important target group for public health nutrition interventions. Given the complexity of nutrition-related behaviors and their various determinants, involving the student population (the future beneficiaries of interventions) and the partners engaged in their implementation when designing campus nutrition interventions is essential. Citizens’ assemblies are deliberative processes which are more and more frequently organized to co-create solutions to complex problems. This study aims 1) to design and implement a student citizens’ assembly using participatory research methods, 2) to describe its process and evaluate its transferability, 3) to evaluate changes in dietary habits, knowledge and citizen practices among students participating in this assembly.MethodsThis study will take place at a French university (University Sorbonne Paris Nord, USPN) located in socio-economically disadvantaged suburbs of Paris. The student citizens’ assembly will gather a mini-public of 30 students enrolled at the time of the study and a co-creation team of academic and non-academic partners involved in student life, nutrition, physical activity, or public policies. The aim of the assembly is to co-create a set of concrete proposals that would enhance USPN students’ access to sustainable diets and physical activity. The protocol is based on a continuous process evaluation and a pre-post design among the mini-public. A mixed-method framework combining quantitative and qualitative approaches will be developed. This study will make use of (i) field observations of the intervention process and transferability, (ii) data collected by questionnaires on pre- and post- dietary habits, knowledge and citizen practices of the mini-public, and (iii) pre-post interviews with a subsample of the same mini-public.DiscussionRelying on participatory research methods, this study will provide new insights into involving higher education students and diverse partners in co-creating campus nutrition interventions. Through the collaborative work of researchers, higher education students, university representatives, public institutions, and local and community actors, this study will provide evidence-based guidance for designing innovative and contextually-relevant nutrition interventions in the higher education setting.Trial registrationThis research was registered at the ClinicalTrial.gov (NCT06580795; registration date: 2024–08-30; https://www.clinicaltrials.gov/study/NCT06580795).

US FDA Advisory Panel Members’ Assessment of Premarket Approval Process and Suggestions for Improvement

The manufacturing and marketing of medical devices is regulated by the US Food and Drug Administration (FDA), and the FDA premarket approval (PMA) process evaluates the safety and effectiveness of medical devices. The PMA process includes a detailed scientific, regulatory and quality system review and is critical to ensure that novel devices are safe, effective, and meet the needs of patients. To survey current voting members serving on panels of the FDA's Medical Devices Advisory Committee to better characterize panel decision-making and identify steps for improvement. This qualitative survey study included 36 questions that were mailed to FDA device panelists regarding their opinions on the influence of sources of information, pivotal trial design, quality of evidence, panel composition and internal deliberative process, time allocation, and impartiality of the FDA. The survey was mailed to the members of all 18 FDA device panels in January and February 2017. Data were collected from January to May 2017 and analyzed from 2018 to 2019. Respondents read and returned the aforementioned paper survey, while nonrespondents did not. The main outcomes included panel members' perceptions, and their implications for process improvement. χ2 or Fisher exact tests were used to test differences between subgroups. Of 64 of 92 panel members who responded (69.6%), 38 of 64 (59.4%) were male, 3 of 63 (4.8%) were Black respondents, 46 of 63 (73.0%) were White respondents, and 36 of 60 (60.0%) were in academic practice. The mean (range) panel service was 6.8 (1-22) years with 3.9 (1-19) meetings attended. Overall, respondents considered information presented by the FDA unbiased, and 28 of 61 (45.9%) believed that pivotal trials were frequently well-designed, 55 of 62 respondents (88.7%) suggested FDA consult panel members preemptively regarding trial design and 54 of 64 (84.4%) regarding the device label. Most indicated that prior FDA approval of another device serving the same medical purpose (43 of 62 [69.4%]) or approval in other countries with comparable regulatory regimes, such as Canada and Europe (39 of 62 [62.9%]), would make them more likely to recommend approval. Respondents rated written information (50 of 60 [83.3%]), live presentations (43 of 58 [74.1%]), and prior professional knowledge (41 of 60 [68.3%]) as the most important sources of information in deciding whether to recommend approval. Additionally, 52 of 58 respondents (89.7%) recommended that a panel member-only executive session would allow more clarity and honesty in deliberations, and 33 of 59 (55.9%) believed a three-fourths majority appropriate for recommending approval, which would be a deviation from the current system in which an overall vote is reported without designation of a vote threshold. In this survey study of FDA device panel members, respondents wanted improved study designs, more relevant clinical data, including from other countries, involvement of panelists in study design and device label development, and inclusion of an executive session. Demographically, panels could be made more diverse.

Stated preferences for the colours, smells, and sounds of biodiversity

Forest creation and restoration are embedded in global policy. Both result in landscape changes that have far-reaching socioeconomic consequences. However, there is limited evidence on public preferences for the biodiversity these forests contain. Here we used a choice experiment to explore the British public's willingness to pay (WTP) for different forest biodiversity attributes. We began with a multiple-step deliberative participatory process. This revealed that participants conceptualised forest biodiversity through visual, aural and olfactory senses. We subsequently developed and pre-tested sensory attributes based on colours, smells and sounds. Depending on the size of the proposed change, participants (N = 1711) were willing-to-pay for a greater variety of sensory attributes and for an indicator of improved ecological functioning (deadwood for decomposition). WTP for sensory attributes was influenced by participants' having related sensory impairments or visiting forests frequently. Our wider contribution highlights the importance of participatory methods to unearth novel and uncommon attributes that can then be used in stated preference studies. Ensuring that we evaluate stated preferences in a manner that reflects how the public conceives biodiversity is important if we are to improve the alignment between forest creation/restoration and public views, which could thus help bolster public support for the planning and implementation of landscape changes.

The "effects of wind turbine sound on working memory" (a pre-registration plan)

Although research on the effects of wind turbine sound (WTS) over mental health factors is increasing, very little attention has been given to the potential effects of WTS over subtle cognitive processes, such as concentration or memory. The "brainwave entrainment hypothesis" is rooted in neuropsychological research demonstrating that brain oscillations are modulated by external rhythms. In addition, perceived annoyance to wind turbines seems to be a phenomenon in which both visual and psychological variables interact with acoustic stimulation. However, annoyance is a concept rarely operationalised in the literature. Our study aims to experimentally assess the effects of WTS on working memory. Working memory is recognised as a basic process, playing a crucial role in unconscious everyday processes (e.g., perceiving an object's trajectory despite input interruptions when blinking), as well as deliberate processes (e.g., carrying out arithmetic operations). By exploring variations in performance during a memory task, while being exposed to WTS samples, we could highlight acoustic characteristics of the WTS stimuli that interfere-or not-with cognitive processes. These data, combined with within-block ratings of annoyance, can provide us with index of annoyance directly related to the acoustic properties present in WTS recordings.

Democratizing Social Scientists’ Words and Distinctions: Where and Why Moral Reasons Are Decisive

Sitting at your desk, working on your social science paper, you take yourself to be free to use key words and distinctions as you see fit. I argue that these decisions aren’t up to you. Instead, they should be made collectively, by the social science community you’re embedded in, talking to, and contributing to, along with its stakeholders. Such democratic and deliberative processes will be driven by the common good, as opposed to benefiting particular social scientists, schools, research programs, methods, or regions of the world. My book, Words and Distinctions for the Common Good, is an invitation: I invite social science communities to democratically work on how to use their key words and distinctions—and which epistemic and moral goods these uses should help attain.

8Rs for circular water and sanitation systems: Leveraging circular economy thinking for safe, resilient and inclusive services

To achieve their normative health, environmental and social objectives, water and sanitation services must be safely managed, inclusive and climate resilient. Meeting these imperatives presents a need and opportunity for innovative thinking about water and sanitation service systems. Circular economy concepts are being applied across a multitude of product and service sectors with the aim to facilitate regenerative flows of resources. Given the dependence on water resources, associated climate risks, and the generation of reusable waste products in water and sanitation service delivery, circular economy concepts can be usefully leveraged to drive sustainability outcomes. This article contributes a heuristic in the form of a conceptual framework for applying circular economy concepts in the design and delivery of water and sanitation services in diverse Global South contexts. The framework seeks to drive multiple outcomes relevant to water and sanitation initiatives: safely managed services, social inclusion, and climate resilience. Co-developed by an international research team applying a theoretical multiplicity approach and collaborative sensemaking, the heuristic takes the form of a suite of eight adapted circular economy ‘R strategies’ for water and sanitation. The R strategies were selected and articulated to reflect theory-based principles of circular economy, climate resilience and inclusion. They are intended to prompt thinking and action in pursuit of safely managed, climate resilient, inclusive water and sanitation services that align with the broader sustainability directions that circular economy narratives aspire to. The heuristic offers a conceptually rigorous, practical tool that can support collaborative, deliberative processes to realise the potential benefits of circularity in water and sanitation service systems.

Contesting the public interest in AI governance

This article argues that public contestability is a critical attribute of governance arrangements designed to align AI deployment with the public interest. Mechanisms to collectively contest decisions which do not track public interests are an important guardrail against erroneous, exclusionary, and arbitrary decision-making. On that basis, we suggest that efforts to align AI to the public interest through democratic participation will benefit substantially from strengthening capabilities for public contestation outside aggregative and deliberative processes. We draw on insights from democratic and regulatory theory to explore three underlying requirements for public contestability in AI governance: (1) capabilities to organise; (2) separation of powers; and (3) access to alternative and independent information. While recognising that suitable mechanisms for contestability will vary by system and context, we sketch out some possibilities for embedding public contestability in AI governance frameworks with a view to provoking further discussion on institutional design.

The Dynamic Nature of European Identity

EU citizenship requires a multilayered and dynamic concept of European identity. The idea of European identity embodied in the Declaration on European Identity and within A Charter on European Identity needs to be rethought. These documents should not contain essentialist assumptions based on the difference between "Europe" and "Other" that excludes and marginalizes a number of citizens. European identity should not create new forms of nationalism. That is why the concept of European identity should be flexible and dynamic. The concepts of identity, values, and Europe need to be rebuilt and reinterpreted in a multifaceted, adaptable, and dynamic manner. We can only discuss the dynamic nature of the European Union and the European identity in this sense. The concept of European identity should be developed less in terms of a predetermined past and more in terms of shared projects, long-term goals and connections resulting from a long-term, deliberate process.

A new approach to Health Benefits Package design: an application of the Thanzi La Onse model in Malawi.

An efficient allocation of limited resources in low-income settings offers the opportunity to improve population-health outcomes given the available health system capacity. Efforts to achieve this are often framed through the lens of "health benefits packages" (HBPs), which seek to establish which services the public healthcare system should include in its provision. Analytic approaches widely used to weigh evidence in support of different interventions and inform the broader HBP deliberative process however have limitations. In this work, we propose the individual-based Thanzi La Onse (TLO) model as a uniquely-tailored tool to assist in the evaluation of Malawi-specific HBPs while addressing these limitations. By mechanistically modelling-and calibrating to extensive, country-specific data-the incidence of disease, health-seeking behaviour, and the capacity of the healthcare system to meet the demand for care under realistic constraints on human resources for health available, we were able to simulate the health gains achievable under a number of plausible HBP strategies for the country. We found that the HBP emerging from a linear constrained optimisation analysis (LCOA) achieved the largest health gain-∼8% reduction in disability adjusted life years (DALYs) between 2023 and 2042 compared to the benchmark scenario-by concentrating resources on high-impact treatments. This HBP however incurred a relative excess in DALYs in the first few years of its implementation. Other feasible approaches to prioritisation were assessed, including service prioritisation based on patient characteristics, rather than service type. Unlike the LCOA-based HBP, this approach achieved consistent health gains relative to the benchmark scenario on a year- to-year basis, and a 5% reduction in DALYs over the whole period, which suggests an approach based upon patient characteristics might prove beneficial in the future.

Abstract B076: Qualitative insights into building an effective community advisory board for cancer disparities research

Abstract To address cancer disparities in minority and underserved communities, many organizations and research studies use a community advisory board (CAB) to better understand the needs, preferences, and perceptions of communities experiencing health inequities. Researchers have described a range of problems resulting in less than optional engagement of CAB members. Academic members of an NCI-funded cancer partnership interviewed 15 of the 20 members of their CAB to better understand their perceptions of their roles and expectations, as well as barriers and facilitators of engagement. Two trained team members coded the transcripts and conducted qualitative analysis using an iterative inductive/deductive framework. Deductively, we used principles of community-engaged research, and inductively we used coded quotes to identify details in the CAB members’ perspectives. The research team collaborated in organizing major themes into a conceptual framework to describe context, expectations, barriers and facilitators, and recommended strategies for strengthening involvement and benefit of CAB participation for its members. CAB members identified individual factors associated with their involvement including skills (communication, problem solving, interpersonal, leadership, professional, and advocacy), and motivations (community commitment, personal or family experience with cancer). The interviews indicated that there is a gap between CAB members’ perceptions of their roles and what they expect from participation and attendance in CAB meetings, and those of the academic team as conveyed verbally, in the CAB manual, and during onboarding activities. Barriers to enthusiastic engagement include disruptions associated with the COVID experience, members’ competing priorities, and role ambiguity. The CAB members’ resources and connections to the community were identified as facilitators. All these factors influenced the amount and quality of engagement of members with the academic partners and the community at large. Participants suggested many useful adaptations of the CAB-academic partnership, including enhanced training, improved communication, explicit role definitions, clear expectations around engagement with research, and better onboarding for new members. Scientists using a CAB to enhance community engagement should approach building a robust CAB as a deliberate process involving considerable planning, organization, and attention. Projects using a CAB can use the findings from this project to organize a community-academic partnership that will effectively and efficiently contribute to clinical, translational, and community-engaged work addressing cancer health disparities. Citation Format: Leah Alexander, Jennifer Erves, Rebecca Selove, Ila McDermott, J'la Jenkins, Phillip Morris, David Schlundt. Qualitative insights into building an effective community advisory board for cancer disparities research [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B076.

Enhancing public dialogue about inclusion in school education: a citizens’ panel pilot

IntroductionThis paper reports on a small-scale Citizens’ Panel pilot project using deliberative democratic methods to produce policy ideas about inclusion in school education of young people with special educational needs and disabilities (SEN/D) in England. The project had two aims: (i) to obtain information about modifying a Citizens’ Panel process to enhance the effective participation of young people with SEN/D; and (ii) to generate more nuanced, grounded and integrated policy ideas about inclusion than can be found in recent English school education policy.MethodsThe Citizens’ Panel was a two phase deliberative process. Phase 1 involved working with six young people with SEN/D and their parents/carers to shape the Citizens’ Panel agenda, and to obtain information about how they could participate and communicate their perspectives during the events. Phase 2 involved the delivery of the Citizens’ Panel itself, which comprised 28 people: the six young people from phase 1, plus four young people without SEN/D, 13 parents/carers, and five education professionals.ResultsThe process evaluation revealed the need for and impact of meticulous planning using a differentiated and strengths-based approach to design. While participants reported that taking part in the Citizens’ Panel was overall, a positive and worthwhile experience, the differentiated approach involved trade-offs that affected the experiences of some participants without SEN/D, though not detrimentally. The panel produced distinctive ideas about more inclusive schools, where almost all of the themes were about general school changes for everyone. Most general themes involved some specific SEN/D aspects, with only one theme being SEN/D specific. This paper illustrates how these ideas are more nuanced, grounded and integrated than those in current national policy.DiscussionThis paper provides evidence of how deliberative approaches can be used within and between schools, groups of schools (e.g., multi academy trusts), local networks (including local authorities), as well as at the national level. Lessons drawn show how deliberative methods used by advocacy groups, protest movements and non-governmental organisations in support of more transformational change can be developed in ways that enable young people with SEN/D to participate and have their voices heard.

Global analysis of social learning’s archetypes in natural resource management: understanding pathways of co-creation of knowledge

Although social learning (SL) conceptualization and implementation are flourishing in sustainability sciences, and its non-rigid conceptual fluidity is regarded as an advantage, research must advance the understanding of SL phenomenon patterns based on empirical data, thus contributing to the identification of its forms and triggering mechanisms, particularly those that can address urgent Anthropocene socio-ecological problems. This study aims to discover fundamental patterns along which SL in natural resources management differs by identifying SL archetypes and establishing correlations between the SL process and overall geopolitical conditions. Using a systematic literature review comprising 137 case studies in the five continents, content analysis, and correlations were performed. Results show two main archetypes of social learning (endogenous and exogenous). Their occurrence was linked, to where social learning occurs and how venues/preconditions for social learning are placed. In the Global South, endogenous SL should be better potentialized as a catalyzer of deliberative processes for sustainable natural resources management.

Development of an multicriteria decision analysis framework for rare disease reimbursement prioritization in Malaysia.

Rare diseases (RD)-related policies have received significant attention due to the pressing medical requirements associated with these medical conditions and the substantial impact and treatments they may have on healthcare budgets. Nevertheless, policymakers frequently encounter difficulties in managing issues concerning resource allocation and prioritization within this population. Realizing the need to address such problems, this study was conducted to develop a framework based on the multicriteria decision analysis to improve RD reimbursement prioritization in Malaysia. Primarily, a scoping review was performed to identify the methods and criteria used for the reimbursement of RD treatment, followed by strategic stakeholder engagement and a deliberative process on determining the best approach for the framework, including criteria identification, elicitation of weights, and a pilot assessment using the framework. The findings reflected the priorities and perspectives of the stakeholders, which identified eight key criteria and their associated weights, namely effectiveness (19.6 percent), disease severity (15.6 percent), safety (14.2 percent), access to treatment (12.6 percent), economic consideration (12.2 percent), type of therapeutic treatment (11.5 percent), availability of alternatives (8.3 percent), and population group (6 percent). In summary, the developed framework was well-accepted by the Rare Disease Committee, which will be applied as part of the committee deliberation for transparent and equitable decision making on fund allocation and reimbursement of orphan and RD treatment in Malaysia.

Menyelami Filosofi Lonto Leok: Persatuan dan Konsensus dalam Budaya Manggarai

Lonto Léok, a tradition from Manggarai, Indonesia, reflects a significant transformation in the context of unity and communal decisions. Originating from inter-tribal conflicts, this tradition has evolved into a symbol of family unity. In Lonto Léok, formal interaction mechanisms are led by a leader known as "Tu'a Golo," who serves as a facilitator and guides the deliberation process. There are three main stages in Lonto Léok: "caca" (unpack), "cica" (discuss), and "congko" (finalize), reflecting an intensive deliberation process to reach collective agreements. This research aims to elucidate the history, meaning, and mechanisms of Lonto Leok in Manggarai culture while highlighting issues that still need to be addressed. The author adopts a qualitative method based on literature review, interviews, and the author's direct experiences as data sources. The research findings reveal that the shift in the meaning of Lonto Léok from battle to family unity demonstrates cultural adaptability in the face of social change. Lonto Léok represents how the Manggarai community manages conflicts and achieves consensus through deliberation and agreement.