Closer to Home: The Case for Experiential Participation in Health Reform

By Higgins, Joan Wharf | Canadian Journal of Public Health, January/February 1999 | Go to article overview
Save to active project

Closer to Home: The Case for Experiential Participation in Health Reform


Higgins, Joan Wharf, Canadian Journal of Public Health


A B S T R A C T

This article describes partial results from a case study of community participation in "New Directions for a Healthy B.C.", a nowabandoned health reform policy. For this study, focus groups were conducted to explore the perspectives of traditionally under-represented citizens in understanding reasons for nonparticipation and to identify strategies for fostering participation in the health reform process. The findings indicate that participating in traditional ways - committee meetings, public fora, completing surveys - was not relevant to the realities of these individuals. Yet, rather than merely refusing to be involved, focus group members extended an invitation for health planning group members to experience their daily lives; an idea that is referred to in the literature as `experiential participation.' In order to foster broad-based participation in community health initiatives, the findings from this study argue for a new understanding of, and appreciation for what actually constitutes participation.

The concept of public participation, or citizen involvement, in planning and implementing health programs, has been articulated and supported in various national and international documents for many years1-4 and is a core element of both health promotion and community development.5-7 The concept is considered to be the bedrock of practice,8 one that is integral to the "health" of a democratic community and is significant to governance and management issues in regionalized health services.9 Yet it is also a concept that has been realized only in a limited sense.'o

The literature on citizen participation contains demographic and psychological profiles of participants, and accounts of their activities, most often committee or public meetings.10-14 Despite the eclectic assortment of research in the field,15-24 the conclusions to be drawn are profoundly similar: the difficulty of enlisting participants from a broad base of citizens. Participants in community endeavours are characterized by their skill in public speaking, ability to understand policy and technical language, familiarity with meeting etiquette and by discretionary resources (education, income, previous experience) and professional status that motivates and enables them to become involved.25-29

Academics and professionals have criticized the design flaws of traditional participation techniques, including the economic and sociocultural barriers that make public fora inconvenient and inaccessible, citizen advisory meetings that require educational and financial resources, and an overreliance on superficial opinion surveys.14,30-32 The deficiency of such methods, then, is that they are exclusionary and fail to represent those who they are supposed to represent.25,33 These impediments are beyond the citizens' control, yet contribute to keeping the traditionally voiceless silent.34 Those unemployed, or who are stereotyped because of youth or old age, gender, physical or mental impairment, low income or ethnicity, are the politically and socially marginalized, and comprise the traditionally voiceless ranks of Canadian society.35-40

Why is it difficult for community initiatives seeking public participation to achieve inclusive, broad-based involvement? Are there alternatives to committee meetings and public fora that may be more accessible and inviting, particularly to and by under-represented segments of the community? Scholars of participation in community association and health promotion have called for research which would further identify feasible strategies for fostering broad-based participation.2641-45 The purpose of this paper is to begin to address the gap between the promise and reality of participation. This article presents some of the findings from a case study documenting the community development experience of local health planning groups as they implemented the now-abandoned health reform initiative "New Directions for a Healthy B.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Closer to Home: The Case for Experiential Participation in Health Reform
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?