AHRQ Community Forum

The purpose of the Community Forum initiative is to improve and expand public and stakeholder engagement in the Patient-Centered Outcomes Research (PCOR), or Comparative Effectiveness Research (CER), supported by the Agency for Healthcare Research and Quality (AHRQ). This research compares drugs, medical devices, tests, surgeries, or ways to deliver health care. The information generated helps patients and their families understand what treatments work best and how treatment risks compare, while allowing for choices for each individual patient. These research efforts are part of AHRQ’s Effective Health Care (EHC) Program.

The Community Forum initiative, funded under the American Recovery and Reinvestment Act of 2009 (ARRA), has two components:

1. It builds on existing AHRQ efforts to involve stakeholders who have a specific interest in CER studies or methods. These stakeholders include clinicians, patients, caregivers, health services researchers, and health care payers.
2. It will advance the science for obtaining input from both stakeholders and the general public about questions related to CER.

Community Forum updates and materials are posted to the Resources for Getting Involved and Involving Others page as they become available.

Stakeholder Input

AHRQ engages stakeholders at all stages of the CER process. This practice helps ensure that the EHC Program addresses issues that are relevant and important. It also improves the Program’s products, making them accessible, user-friendly, and responsive to stakeholders’ information needs. Generally, stakeholders contribute to CER by:

• Nominating topics.
• Commenting on draft research questions and reports.
• Advising on the distribution of CER products and findings.

AHRQ also has a formal panel, the Effective Health Care (EHC) Stakeholder Group, which has provided guidance on broad elements of the Program. The Agency convenes other stakeholder groups to assist with new research on specific topics. Clinicians, payers, patient representatives, researchers, and others who are experts in a specific priority area (e.g., mental health, diabetes) comprise these groups. They help identify useful research topics and set priorities for EHC Program research.

Community Forum stakeholder activities include:

1. Support for stakeholder input to all parts of the EHC Program. The initiative is developing technical infrastructure, tools, and educational supports needed by various AHRQ programs and researchers—the DEcIDE Research Network, the Evidence-based Practice Centers Program, and others—to obtain input from stakeholders. At the same time, the initiative is developing resources for patients, consumers, clinicians, and other stakeholders to support their participation in CER and other research processes within and outside of the EHC Program.
2. A review of innovative practices for stakeholder engagement and recommendation of promising practices to enhance current EHC Program efforts.
3. Support of the EHC Stakeholder Group as it addresses broad issues related to CER and the use of evidence by patients, clinicians, and policymakers.

Public Input

The Community Forum will help the EHC Program to identify more systematic and effective approaches for obtaining public views to inform its work. This initiative will focus on deliberative methods, public consultation approaches well suited for exploring complex questions because they allow participants to:

• Learn in depth about topics under consideration.
• Explore various perspectives.
• Refine their views before coming to a final opinion.

The Community Forum will develop, demonstrate, and evaluate five types of deliberative methods. The approaches used will vary in the length and number of sessions participants attend and in their reliance on technology to support or facilitate discussion among participants. Overall, the demonstrations will convene nearly 100 groups and an estimated 1,200 participants. These groups will include members of AHRQ priority populations, including Hispanics, African-American women, the elderly, and rural residents. Participants will deliberate on the use of evidence in healthcare decision-making.

The Community Forum deliberative methods study will be the most comprehensive evaluation of these methods to date. It will advance the state of the art in deliberative methodology, assessing the strengths, weaknesses, costs, and feasibility of various approaches. AHRQ will be able to use the findings to broaden public input into its programs, as well as to gain insights on fundamental questions that will enhance the value of its research products.

The Community Forum team is led by the American Institutes for Research (AIR), a behavioral and social science research firm. Organizational partners include the Center for Medical Technology Policy, the Center for Deliberative Democracy at Stanford University, AcademyHealth, the Center for Healthcare Decisions, Polimetrix, and Consumers’ Union.