Developing consensus when tackling highly technical and emotive challenges: an observational study of JLA Preterm Birth Priority Setting Partnership

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Authors
Uhm S1
1University College London Institute of Education, UK
Abstract
Background: Setting priorities for research requires engaging with highly technical and value-laden issues. Guidance developed by the James Lind Alliance (JLA) for setting priorities is unusual in drawing on both formalised and tacit knowledge held by clinicians and service users.

Objectives: To learn how people in a mixed group interact during discussions and decision making. The research questions were: how do service users and clinicians interact when making collective-decisions about research, in particular, what makes some messages more persuasive than others? The Elaboration Likelihood Model of persuasion was used as a theoretical framework.

Methods: An observational study of the Preterm Birth Priority Setting Partnership (PSP) at 14 meetings and two public surveys from 2011 to 2014. The study adopted an ethnographical approach with participant observation and discourse analysis of discussions at meetings. This involved digital recording and transcription of discussions, field notes and analysis of documentary records of meetings and steering group (SG) activities.

Results: Final workshop priorities did not always match priorities expressed by the public voting. Communication patterns and methods to persuade others differed depending on the stages of the group development. For example, at the final workshop the SG used more rational than emotive ways to persuade others compared to new participants. As the PSP progressed to its second phase of public voting, the SG reflected on its ways of working, whereas this was rare at the workshop.

Conclusions: The SG showed typical stages in group development: forming, storming, norming, performing and adjourning. However, when the new participants were added at the final stage of the decision-making process, the PSP returned to the very beginning stage of the development (forming). This may explain differences between the public voting, which adapted the Delphi method, and the final workshop, which adapted the Nominal Group technique.