A New Way to Engage the Public:
The Redefining Readiness Small Group Discussion Process

• Overview of the Redefining Readiness Small Group Discussion Process

• With the Public's Knowledge:
  A User’s Guide to the Redefining Readiness Small Group Discussion Process [7536 KB]

Overview of the Redefining Readiness Small Group Discussion Process

Working together and with a support team organized by the Center for the Advancement of Collaborative Strategies in Health at The New York Academy of Medicine, teams in the four demonstration sites have developed a powerful new way to enable community members to contribute their knowledge to preparedness efforts. The foundation of this public engagement process, completed in August 2006, was a series of small group discussions (SGDs) with a broad range of people who live and work in each of the demonstration sites.

• Objectives of the SGDs
• Situation-based discussions
• Inclusive participation
• Expression of ideas
• Recording of ideas
• Applicability of the SGD process

• Tap into the public's common-sense knowledge to find out what the community would need to do to protect as many people as possible if certain kinds of emergencies occur

• Build resilience by giving community residents an opportunity to think about emergency situations in advance

Situation-based discussions. To achieve these objectives, the SGDs were organized very differently than traditional focus groups, public deliberations, or town hall meetings. Rather than asking people to think about emergency preparedness in the abstract or to provide their input about plans or policy options that have already been developed by experts, the SGDs used specific and realistic scenarios that enabled participants to think about emergencies in a frame of reference that was meaningful to them.

Over the course of two hours, ten people discussed two emergency scenarios. The discussion about each scenario started by exploring the particular problems the participants would face trying to protect themselves in that situation. Then the group explored the kinds of actions that they and others in the community could take to address the problems they had identified.

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Inclusive participation. Although, on average, only ten individuals were involved in each discussion, a large and representative group of people participated overall. In the four sites, almost 2,000 people participated in over 200 discussions. A comparison with census data shows that the participants in the SGDs closely resemble the people who live in each community, according to their age (18 and over), gender, race, ethnicity, education, income, household size, and access to telephone service. To achieve such inclusive participation, the discussions were held at convenient times and in places like community centers, churches, and residents' homes where people felt comfortable. Transportation, child care, and refreshments were provided. Discussions were conducted in Spanish as well as English.

Expression of ideas. To make sure that participants could express what really mattered to them during the SGDs, the discussions about the scenarios were unconstrained - focusing on whatever problems and actions were raised by each group - and no value judgments were made about anything that people said. The community residents who served as facilitators were trained to make participants feel comfortable expressing their ideas and to help them express their ideas as specifically as possible.

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Recording of ideas. Care was also taken to ensure that the participants, and the community as a whole, have a complete, accurate, anonymous, and accessible record of the SGDs. The recorders wrote down exactly what each person said on flip charts - without identifying who said what. No one's ideas were reinterpreted or eliminated. Participants received a timely record of their own discussion. After combining the ideas generated in all of the SGDs, sets of illustrated 8x10 cards were prepared to give this knowledge back to the people who live and work in the demonstration communities.

Applicability of the SGD process. The Redefining Readiness demonstration sites used the small group discussion process to explore what community residents would face in two kinds of emergencies: (1) shelter-in-place emergencies, where the protection of people in the danger zone involves staying inside whatever building they happen to be in for a few hours to several days; and (2) deadly contagious disease outbreaks, where the protection of certain groups of people - those who don't have access to an effective vaccine and those who have underlying conditions that make an available vaccine dangerous - depends on limiting their contact with other people by isolating themselves at home for a prolonged period of time.

As the manual, entitled With the Public's Knowledge: A User's Guide to the Redefining Readiness Small Group Discussion Process, describes, the SGD process can be adapted to understand what people would face trying to protect themselves in other kinds of emergencies as well - particularly those most likely to occur in their community (such as evacuating in communities that are frequently threatened by severe hurricanes). Going further, the process can also be used to enable a large and inclusive group of people to contribute their specific ideas to understanding and addressing many other community problems, including those unrelated to emergencies.

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