Nisker Jeff, Martin Douglas K, Bluhm Robyn, Daar Abdallah S
Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada.
Health Policy. 2006 Oct;78(2-3):258-71. doi: 10.1016/j.healthpol.2005.10.009. Epub 2005 Dec 6.
To explore theatre as a public engagement tool for health-policy development.
In a justice-based democracy, engagement of a large number of citizens of diverse perspectives is required for legitimate health-policy development. However, all current strategies of citizen participation are limited in their capacity to engage, either by lack of opportunity to educate citizens prior to soliciting their opinions or lack of large numbers of citizens.
A series of 12 nested case studies was conducted, with each case study consisting of a performance of a 70-min play, specifically written to educate citizens to scientific, clinical, and psychosocial issues of adult predictive genetic testing, and to foster empathy for persons immersed therein; and a 1-h audience discussion that was taped and transcribed for qualitative analysis (modified thematic). The script was based on key informant interviews, literature review, and six script readings for key informants and communities. Audience members were recruited through conference or educational event programs, posters, newsletters, and electronic announcements, as well as newspaper advertisements and other public, community and institutional postings.
More than 1,000 citizens were engaged. The analysis indicated that audience members were engaged emotionally and cognitively in the position of the characters and the health-policy issues. Audience members' comments forwarded from personal or professional lived experience confirmed the validity of the script and promoted further emotional and cognitive engagement of other audience members. Audience members offered informed and diverse opinions on policy issues, including resource allocation, patenting of genetic tests, research funding, genetic test-based insurance discrimination, and imperative for public education. The potential for harm to key informants and audience members (and those in relationships with them) were observed, usually related to learning or offering personal information regarding their genetic risk.
As many citizens can be engaged in theatre-based policy development as surveyed through public opinion polls, and many times the number that can be engaged in strategies that educate citizens prior to soliciting their opinions, likely at a similar cost per citizen engaged.
探索将戏剧作为健康政策制定的公众参与工具。
在基于正义的民主制度中，合法的健康政策制定需要众多具有不同观点的公民参与。然而，当前所有公民参与策略在参与能力方面都存在局限，要么是在征求公民意见之前缺乏对公民进行教育的机会，要么是缺乏大量公民参与。
开展了一系列12个嵌套式案例研究，每个案例研究包括一场70分钟戏剧的演出，该剧专门编写用于让公民了解成人预测性基因检测的科学、临床和社会心理问题，并培养对其中人物的同理心；以及一场1小时的观众讨论，讨论内容进行录音和转录以进行定性分析（改良主题分析）。剧本基于关键信息提供者访谈、文献综述以及为关键信息提供者和社区进行的六次剧本朗读编写而成。通过会议或教育活动项目、海报、时事通讯、电子公告以及报纸广告和其他公共、社区及机构张贴物招募观众成员。
超过1000名公民参与其中。分析表明，观众成员在情感和认知上都融入了角色的立场以及健康政策问题。观众成员基于个人或职业生活经历发表的评论证实了剧本的有效性，并促进了其他观众成员进一步的情感和认知参与。观众成员就政策问题提出了明智且多样的意见，包括资源分配、基因检测专利、研究资金、基于基因检测的保险歧视以及公众教育的必要性。观察到对关键信息提供者和观众成员（以及与他们有关系的人）存在潜在危害，通常与了解或提供有关其基因风险的个人信息有关。
通过基于戏剧的政策制定能够参与的公民数量与通过民意调查所能参与的公民数量相当，并且是在征求公民意见之前对公民进行教育的策略所能参与公民数量的数倍，而且每位参与公民的成本可能相近。
