Closer to home : Using social marketing to study participation in health reform

• Main Author: Higgins, Joan Wharf
• Format: Others
• Language: English
• Published: 2009
• Online Access: http://hdl.handle.net/2429/6821

The concept of broad-based public participation is a fundamental element of health promotion and citizenship. There is a gap, however, between the promise and reality of citizen participation in health reform. The purpose of this study was to describe the experience of public participation in a health reform initiative in one regional district; to elucidate the perspectives of both participants and nonparticipants in a particular health reform process entitled "New Directions for a Healthy British Columbia"; and, to assess the utility of social marketing concepts as an analytical tool for understanding citizen participation. The study built on diverse literatures including health promotion, citizen participation, citizenship and social marketing in order to provide a new way to conceptualize citizen participation in health reform. The study utilized the data collection methods of participant observation (n=76 meetings), key informant interviews (n=12), focus groups (n=48), street corner interviews (n=5), and a documentary review of the health reform process. A social marketing framework was used to interpret the data, including the concepts of understanding the consumer perspective, exchange, marketing mix and segmentation. In contrast to the criticism that social marketing ignores the broader context of individual behaviour, the analysis facilitated an understanding of the societal circumstances that inhibited or fostered participation. Specifically, the analysis suggested that participation was influenced by (1) citizens' perceptions of a sense of belonging to, and equality in, the community; (2) citizens' perceptions of their ability to shape policy; (3) the attainment of a minimum threshold of social and economic well-being; (4) the responsiveness of government to citizens' efforts; and, (5) the ways in which the opportunity to participate was structured. In this particular study neither the breadth of broad-based citizen participation, nor the ability of participants to shape policy was realized. The findings suggest that refraining the context of participatory democracy is necessary to facilitate citizens acting on their right and responsibility to participate meaningfully. This may be accomplished through (1) understanding, respecting and accommodating diverse citizens' perspectives about participation; (2) providing different opportunities for participation; and, (3) representing the needs and experiences of disempowered groups in health reform initiatives. === Graduate and Postdoctoral Studies === Graduate