The shift from traditional models of public service design to public-driven ones has been slow in the health service and particularly in the General Practice Consultation in the UK. This hesitation about fully adapting these design methods has been found to be motivated by a lack of evidence regarding the successful implementations of public involvement activities and the use of its tools, partial coverage of these tools, and failures to report on the use of alternative tools, among other reasons. This research therefore aimed to propose Human-Centred Design (HCD) as an underlying philosophy and a pragmatic set of methodologies to better understand the challenges related to the application of customer involvement activities and the use typical methods when deployed in the investigation of issues and opportunities for the design of healthcare settings. This research consisted of three stages. An exploration stage, in which it was identified and confirmed several research gaps as well as a specific case for study with a degree of complexity and known for supporting customer involvement approaches. These activities involved a literature review about customer involvement processes and a qualitative interview study (with 30 participants) in which it was identified that, a suitable case for study to perform a large ethnographic investigation using representative Human-Centred Design tools could be 'Communication and relationship between GPs and patients'. A development stage, in which it was investigated the design of public involvement activities as well as the identification and selection process of some ideal HCD tools (Focus Groups, Future Workshops / Rich Pictures. Love & Break-up Letters, and Crowdsourcing) to work with the selected case. For these activities, a total of 72 participants were recruited (n=18 per activity). Lastly, an evaluation and proposal phase, analysed these tools through a comparative study to identify several of their strengths and weakness in order to identify the best tool or combination of tools. The outcome from this comparison suggested that among the tools used for this research there was not a most optimal option or combination of options and that the success of an involvement activity relies in the careful and thorough preparation of such processes. This research concludes, that the most optimal form of helping health researchers to undertake public involvement research and to better understand the process of identifying and selecting ideal engagement tools, could be by providing a best practice informative guide containing a simplified and comprehensive version of the most commonly found steps embedded in this kind of design practices.

AIM - To explore the perspectives of service users and professional staff towards service user involvement within the context of a changing cultural environment at a UK hospice. METHOD - Case study and thematic analysis including interviews with 16 staff including the CEO and 6 service users at a UK hospice. FINDINGS - Three overarching themes were identified: involvement and disempowerment in decision-making; belonging and alienation in a period of organisational change; struggle to maintain wellbeing and identity in a changing culture. A key finding is that service users receiving care from the hospice wanted their voices to be heard, valued and respected for their personal care and issues affecting the hospice. Service users did not consider it a burden to be asked for their views. They felt disempowered by a consultation process about organisational changes that appeared not to take their views on board. There is a need to consider whether a reliance on surveys for involving service users is sufficient or can become tokenistic. External social-political-economic pressures plus increasing privatisation of public services could influence the way that hospices operate in future. This could involve moving from a sanctuary to a business culture and potentially towards managerialism by adopting a regulatory rather than rights-based approach with an emphasis on increasing reach, measuring numbers and hitting targets. Service users being viewed as consumers with a focus on reablement/rehabilitation activities and less on psychosocial support could also serve to push hospices to start behaving more like hospitals. CONCLUSION - More qualitative research is needed to ensure the voices of service users living with a life-limiting illness are heard. The contributions they make towards co-production of services and research should also be heard and influence practice and policy. Service users should also be more involved in education and training of staff.

This study explored public involvement within the Florida Department of Transportation (FDOT) using the co-orientational theory. Effective public involvement gives the public opportunities to be involved early in the planning and implementation of transportation projects that directly affect or may concern them. The co-orientational model looks at what an organization (FDOT) thinks about an issue (public involvement), what the public thinks of the issue, what the organization thinks the public thinks about the issue, and what the public thinks the organization thinks about the issue. This study investigated whether the FDOT management has an accurate understanding of the perceptions of the public and communicates effectively with them. To achieve accurate perceptions of the public, management must interact with the public to identify issues that could become potential crises if not addressed at an early stage. This study examined whether there is true consensus or dissensus among the public and the FDOT management and looked at the perceptions of both groups and the distance between them to see if the needs of the public and the Department can both be met. A critical part of this research included analyzing the opinions of the public to see if the public trusts government and the FDOT. Furthermore, this study set out to determine a relationship between trust and involvement and the different techniques used to communicate.Research was gathered through surveys to the public and to FDOT management. The public surveys were handed out at transportation public meetings across the state of Florida over a period of six months to gain the publics perception of the issue and the publics estimate of the management perceptions.

No description available.

Every healthcare system faces unlimited demands and limited resources, creating a need to make decisions that may limit access to some new, potentially effective technologies. It has become increasingly clearer that such decisions are more than technical ones. They require social value judgements - statements of the publics distributive preferences for healthcare across the population. However, these value judgements largely remain ill-defined. The purpose of this thesis was to explicate distributive preferences of the public to inform funding/coverage decisions on new health technologies. It contains six papers. The first comprises a systematic review of current coverage processes around the world, including value assumptions embedded within them. The second paper presents findings from an expert workshop and key-informant interviews with senior-level healthcare decision-makers in Canada. A technology funding decision-making framework, informed by the results of the first paper and the experiences of these decision-makers, was developed. Their input also highlighted the lack of and need for information on values that reflect those of the Canadian public. The third paper provides a systematic review of empirical studies attempting to explicate distributive preferences of the public. It also includes an analysis of social value arguments found in appeals to negative coverage decisions. From the results of both components, possible approaches to eliciting social values from the public and a list of factors around which distributive preferences may be sought were compiled. Such factors represented characteristics of unique, competing patient populations. Building on findings from the third paper, the fourth paper describes a citizens jury held to explicate distributive preferences for new health technologies in Alberta, Canada. The jury involved a broadly representative sample of the public, who participated in decision simulation exercises involving trade-offs between patient populations characterized by different combinations of factors. A list of preference statements, demonstrating interactions among such factors, emerged. The fifth and sixth papers address methodological issues related to citizens juries, including the comparability of findings from those carried out in the same way but with different samples of the public, and the extent to which they changed the views of individuals who participate in them.

Kyoto University (京都大学) / 0048 / 新制・課程博士 / 博士(工学) / 甲第14144号 / 工博第2978号 / 新制||工||1442(附属図書館) / 26450 / UT51-2008-N461 / 京都大学大学院工学研究科都市社会工学専攻 / (主査)教授 小林 潔司, 教授 岡田 憲夫, 教授 川﨑 雅史 / 学位規則第4条第1項該当

Due to global warming, sea levels will irreversibly continue to rise around the world throughout this century. Therefore, coastal urban communities will need to adapt to new environmental challenges, such as more frequent and intense flood events. The participation of the public in climate change adaptation planning has been widely recognized as beneficial, but the roles and tangible value of citizens in planning processes remains a contested and insufficiently researched topic. In the city of Venice, Italy, a technologically advanced mobile barrier system designed for flood prevention serves as the centerpiece of the city’s climate change adaptation plans. This study sought to uncover how the level of citizen participation in the development of this system has influenced its construction and how it is currently being perceived by the city’s residents. In this context, the potential roles and outcomes of citizen participation in sea level rise adaptation are explored, resulting in numerous findings that build on the growing body of research that exists within this domain. Limited citizen participation in sea level rise adaptation planning was evident in the case of Venice—the findings from this study indicate that tolerance, transparency and corruption were significant factors in determining the outcome of the construction of the mobile barrier system and how it has been perceived by citizens. The findings allude to citizen participation in public climate change adaptation projects being both directly and indirectly beneficial to both citizen satisfaction and project development, but it should be noted that there are intricate links that exist between the level of public participation in an adaptation project and citizen perspectives on it. Therefore, the study posits that public participation is not absolutely positive nor negative in the context of public climate change adaptation planning, and thus more research needs to be conducted on how citizens can participate in relevant planning processes in more meaningful and productive ways. / Enligt FN:s mellanstatliga klimatpanel (IPCC) stiger det globala medelvattenståndet i en ökande takt på grund av den globala uppvärmningen. Följaktligen kommer kustnära urbana områden behöva anpassa sig till stigande hav och relaterade problem, såsom mer frekventa och intensiva översvämningar. För att kunna hantera dessa utmaningar krävs holistiska lösningar som tar hänsyn till de gemensamma värderingar och behov hos människor som bor i utsatta kustområden. I mycket av den befintliga vetenskapliga litteraturen inom klimatanpassning betraktas deltagande från invånare i planeringen av offentliga klimatanpassningsprojekt som något som är genomgående gynnsamt för utvecklingen av sådana projekt. Det finns dock en tydlig brist på forskning kring vilka specifika fördelar medborgardeltagande faktiskt bidrar med till dessa projekt i praktiken. I staden Venedig i Italien blev skadorna som orsakas av översvämningar uppenbara för nästan sjuttio år sedan, i november 1966, när staden drabbades av den största dokumenterade översvämningen i sin moderna historia. Sedan dess har höga tidvatten i Venedigs kustområde ansetts vara ett nationellt problem som den italienska regeringen har varit djupt engagerad i. År 1973 inledde den italienska regeringen en långsiktig satsning för att rusta upp Venedig inför framtida miljöhot. En av de avgörande delarna i denna satsning var ett system av mobila barriärer som strategiskt placerades vid de tre inloppen mellan den venetianska lagunen och Adriatiska havet. Syftet med systemet var att skydda staden från översvämningar när tidvattnet översteg en viss gräns. Under åren har detta projekt—som kallas MOSE (en akronym för experimentell elektromekanisk modul på italienska)—varit föremål för kontroverser och har lett till delade åsikter bland de inblandade parterna. Projektet har ännu inte slutförts, konstruktionen av barriärerna har hittills kostat över fyra miljarder euro mer än förväntat och dessutom har projektet missat flera förväntade slutdatum. Det är viktigt att notera att planeringen av projektet har genomförts av offentliga parter utan betydande medborgardeltagande. Mot denna bakgrund kan det vara värdefullt att analysera fallet MOSE i Venedig och hur utvecklingen av offentliga klimatanpassningsprojekt påverkas av medborgarnas deltagande. Syftet med denna studie är att identifiera hur bristen på medborgarengagemang i planeringen av MOSE har påverkat invånarnas syn på projektet, samt hur denna brist kan ha påverkat konstruktionen av MOSE-systemet. Denna studie använde Gioia-metoden för att bevara och betona invånarnas röster genom hela analysen av insamlad data. Datainsamlingen i denna studie bestod av en översyn av tillgängliga och relevanta sekundärkällor relaterade till MOSE, samt femton informella, semi-strukturerade intervjuer med invånare i Venedig som genomfördes i mars 2023. Dataanalysen ledde till identifieringen av tre olika grupper av perspektiv på MOSE som var särskilt framträdande bland Venedigs invånare: tolerans av icke-deltagande, varaktig frustration och grundat ogillande. Dessutom framkom några inflytelserika faktorer som påverkade invånarnas attityder till projektet under dess konstruktion: systemisk korruption, bristfällig planering och betydande händelser kopplade till projektet. Därtill kan samtliga dessa faktorer kopplas antingen direkt eller indirekt till bristen på medborgardeltagande i planering av MOSE med stöd av vetenskaplig litteratur. Den analyserade datan visar att tolerans, transparens och korruption har varit viktiga faktorer som påverkat utvecklingen av MOSE under dess konstruktion och invånarnas inställning till projektet. Resultaten från denna studie tyder på att medborgardeltagande i utvecklingen av offentliga klimatanpassningsprojekt inte nödvändigtvis är positivt. Mer forskning behövs inom detta område för att identifiera på vilka specifika sätt invånare kan spela en mer betydelsefull och gynnsam roll i beslutsfattandet kring framtida projekt som syftar till att anpassa tätbefolkade områden till de nya förhållanden som klimatförändringar skapar.

This dissertation examines the public participation activities of State Departments of Transportation (SDOTs) in the United States. A review of existing literature and legal frameworks suggests that an "authentic" public participation results when dimensions of representativeness, use of public inputs, interactiveness, and quality of citizen inputs have been achieved. The study sought to identify conditions that serve as measurements that must presumably be satisfied for authenticity to exist in public participation. The result was a Model of Authentic Public Participation that served as the basis for creation of a new four-tiered methodology to assess the performance of these districts relative to authenticity requirements. This study also sought to identify the key determinants that lead districts to achieve Authentic Public Participation in District public involvement programs. A Predictor Model for Authentic Public Participation was created to test whether the key internal and external determinants are responsible for districts achieving authenticity in their public participation programs. The data for this study came from a mail-back survey that was administered to senior district administrators in 380 State Departments of Transportation districts in the United States. A total of 233 surveys were returned for a response rate of 61.3 percent. The results of the study suggest that most SDOT districts struggle to implement public participation programs that achieve high levels of authenticity. The increased use of public participation tools, specifically those active tools that allow for increased interaction between district staff and the public, can assist districts in achieving higher levels of authenticity in their programs. Of key importance to achievement of authenticity is the willingness of district staff to adopt new ideas and innovation learned from dealings with the public. District public participation programs benefit from training that increases the individual's acceptance of public participation as a valid mechanism for serving the public. Recommendations were made for SDOTs to work toward: • The creation of increased opportunities for the occurrence of Authentic Public Participation • The creation of individual ownership of authenticity in public participation • The creation of community partnerships to foster authenticity in public participation

Development of goals (desired future conditions (DFCs)) based on substantial public involvement is critical to the success of ecosystem management on public lands. I evaluated DFCs of riparian areas on national forests in the southern Appalachian mountains and evaluated a process for involving the public in development of DFCs for riparian areas on the Jefferson National Forest. First, I identified the major components, structures, and functions that are essential to riparian health through a literature review. Second, I examined how the key components, structures, and functions identified in the literature review were addressed in the DFCs and standards and guidelines for eight southeastern national forest management plans. In reviewing forest plans, I found a clear shift from emphasizing water quality in older forest plans to a more comprehensive incorporation of the values and functions of riparian areas in more recent plans. Riparian attributes included in DFCs varied widely and disparities between DFCs for forest plans and measurable criteria in the standards and guidelines often occurred. Finally, I designed, tested, and evaluated a public involvement process that identified public values for use in the development of DFCs for riparian areas on the Jefferson National Forest. I used a combination of alternative dispute resolution techniques and the Analytic Hierarchy Process (AHP), a participatory decision-making tool. I used surveys before and after the riparian meetings to evaluate the effectiveness of the public involvement process. Survey respondents generally were middle-aged, well-educated, high-income males who were long-time residents of the area. Riparian meeting participants indicated that the DFC for riparian areas on the JNF should strongly emphasize water quality and quantity, protection of riparian-dependent species and their habitats, and maintenance of the integrity of the relationship between riparian areas and the surrounding environment. Participants indicated recreational and commodity uses of riparian areas could occur as long as they did not negatively affect the other, more highly valued characteristics of riparian areas. Participants felt that the meetings were fair, that diverse interests were represented, that they had enough information to participate in the process, and that it was a wise use of their time. / Ph. D.

No description available.