proposal for a demonstration project-the vaccine policy analysis collaborative (vpac)
Post on 14-Jan-2016
47 Views
Preview:
DESCRIPTION
TRANSCRIPT
Proposal for a Proposal for a Demonstration Project-the Demonstration Project-the
Vaccine Policy Analysis Vaccine Policy Analysis Collaborative (VPAC)Collaborative (VPAC)
Roger H. Bernier, Ph.D.
On behalf of:
The Wingspread Public Engagement Planning Group
Presentation to the NVAC
June 2003
Thank you for this opportunity to provide another progress report on our project to enhance public engagement
The first progress report was presented here one year ago in June 2002
Wingspread Public Wingspread Public Engagement Planning GroupEngagement Planning Group Purpose: Created as part of a special
assignment to explore how the immunization community might enhance public engagement in decision making about vaccines
Assumption: Bring together all the interest groups that normally do not interact, work together to create a supportable proposal, and hope that this achievement attracts wider interest in the immunization community and funding support from multiple sources.
Wingspread Public Wingspread Public Engagement Planning GroupEngagement Planning Group Ad hoc group—no official standing Not an official government view which is
being presented Any proposals discussed here require further
Departmental review Enhancing public engagement is a work in
progress No endorsement intended or implied by this
presentation for the work completed to date
Purposes TodayPurposes Today
Quick recap of public participation
Describe the process we used in the Planning Group
Describe the proposal we developed
Ask NVAC if it has thoughts on the topic, as refinement of the proposal continues to evolve
The Driving VisionThe Driving Vision
Citizens and public officials interacting honestly, learning from each other, and working together to better inform decisions and achieve better solutions on policy issues related to vaccines.
Inform Consult Collaborate
Levels of Public ParticipationLevels of Public Participation
Increasing Level of Participation in Decision Making
Why Engage The Public?Why Engage The Public?
It’s the right thing to do
It’s the best thing to do
It earns more support
All of the above are Trust Building
Original Wingspread Original Wingspread Planning GroupPlanning Group
Health Professionals (AAP, AAFP, NMA) PHNursing)
Minority Groups (API, NHMA, AA) Government Agencies (FDA, CDC, NVPO,
HRSA, NIH) “Critical” Public (SafeMinds, NVIC, PROVE,
Rollens) “Neutral”Public (PTA, League of Women
Voters) “Supportive” Public (PKids, IAC)
Original Wingspread Original Wingspread Planning GroupPlanning Group
Academia (Brown, Morehouse)
Industry (Aventis, Merck, Wyeth, GSK)
Private Consultants (Fine, Keystone, Study Circles, America Speaks, Moran, Heierbacher, Perspectives Group, DDC, Princeton Partners, Marcuse)
NGO’s (ASTHO, IOM)
Post-Wingspread Steering Post-Wingspread Steering CommitteeCommittee
Mona Steele, League of Women Voters
Sallie Bernard, Safe Minds Trish Parnell*, PKids Barbara Loe Fisher, NVIC Stan Music**, Merck Tom Zink**, GSK Lou Cooper, NNII Ed Marcuse, Children’s
Hospital Seattle Kathleen Stratton, IOM Debbie McCune Davis, TAPI
Geoff Evans, HRSA Jon Abramson, AAP Amy Fine, Consultant Roger Bernier, CDC Shaunette Crawford, NVPO Bruce Gellin, NVPO Sandra Jo Hammer,
California DOH Mary Davis Hamlin,
Keystone Center
* Withdrew early
**Late participation limited
The Group Worked In A New The Group Worked In A New Way To Help Create A New Way To Help Create A New
Way of Working Way of Working
“Collaborative problem-solving around interests to get the optimal solutions”
-We discussed interests first not solutions first -We did joint fact finding -We sought broad solutions meeting the full
range of interests -We worked to refine the most promising
options to make them the best they could be
ChronologyChronology
October 2001 Funds awarded from NIP and Unmet Needs
Early 2002 Stakeholders on board from government, industry, public, and health professionals
April 2002 Johnson Foundation has awarded grant to hold a Wingspread Conference
April 2002 Keystone Center selected as neutral convener and facilitator
ChronologyChronology
July 2002 First Wingspread Conference—Topic deemed worth exploring further
Sept 2002 Steering Committee created Nov 2002-May 2003 Steering Comm meetings May 2003 Draft proposal recommended by Steering C May 2003 Second meeting of Wingspread Planning
Group May 2003 Proposal agreed upon for a Demonstration
Project—VPAC June 2003 & beyond Transitioning from planning by
the Wingspread Group to review and consideration by others
continued
Principles of Good Public Principles of Good Public EngagementEngagement
(Adapted From OECD)(Adapted From OECD)
Commitment
Training & Guidance
Clarity
Linkage
Accountability
Transparency
Timing
Resources
Information
Equity
Representation
Dialogue
Participants
Independence
Evaluation
Key Features Of Enhanced Key Features Of Enhanced Process IProcess I
Participation: Stakeholder groups + general public phased in in Tier 1 and Tier 2
Mode of Operation: To have a “Safe Harbor” environment and a “Not Strictly Partisan” work ethic
Activities: Dialogue, analyses of pending decisions, tracking
Agenda: Pending decisions of government Products: List of options with pros and cons,
NO recommendations
Key Features of Enhanced Key Features of Enhanced Process IIProcess II
Issue type: Technical + values, cross-cutting program and implementation
Linkage: Government to consider and provide feedback
Funding: Mixed sources if possible through a foundation (e.g. CDC Foundation)
Duration: Three year demonstration project Goal: Better decisions Name: VPAC---Vaccine Policy Analysis
Collaborative
Key Features of Enhanced Key Features of Enhanced Process IIIProcess III
Need mechanism which can carry out the key functions of VPAC 1) dialogue, 2) info gathering & interpreting and 3) report writing
Also need mechanism which exists because 1) participants more comfortable this way and 2) will be quicker to implement
Also need mechanism which has flexibility because some functions and techniques of “enhanced” public engagement are and not “business as usual” and need to be integrated
Key Features of Enhanced Key Features of Enhanced Process IVProcess IV
Two mechanisms which meet these criteria are the workgroups of federal advisory committees and the roundtables of the Institute of Medicine
Roundtables are to the well known study committees of the IOM as Workgroups are to the well known vaccine advisory committees of the federal government —working level, pre-policy, information exchange mechanisms for groups of participants with relatively few regulations governing them
Key Features of Enhanced Key Features of Enhanced Process VProcess V
Org Structure: Operated jointly and simultaneously as an NVAC Workgroup and an IOM Roundtable
Why using two mechanisms at once? Key tension is around independence—not too much or not too little
1) Neutral contractor works by consensus with NVAC and the Wingspread Steering Group to appoint workgroup members in a bona fide committee workgroup
2) IOM appoints these NVAC Workgroup members as members of an IOM Roundtable in a bona fide IOM Roundtable group.
Key Features of Enhanced Key Features of Enhanced Process VIProcess VI
NVAC Workgroup functions “normally” side by side with a “normally” functioning IOM Roundtable
The Roundtable serves as the info gathering or research arm of the Workgroup
NVAC Workgroup writes the report to the full committee. IOM writes NO report.
The Options Considered and The Options Considered and The Support GarneredThe Support Garnered
IOM implements VPAC –Off the table early on
#1 NVAC implements VPAC using a neutral contractor--N=3
#4a NVAC+IOM implement VPAC jointly (IOM Roundtable members appointed, NVAC Workgroup named from the Roundtable roster)—N=0
#4b NVAC+IOM implement VPAC jointly (NVAC Workgroup members appointed, IOM includes Workgroup in the Roundtable roster) N=15
NVAC Evaluates For Itself Whether To Enhance Public Engagement, And If So, How To—N=3 (+ Industry 4) Not mutually exclusive of other options. Could do both
Preferred OptionPreferred Option
#4b NVAC+IOM implement VPAC jointly (NVAC Workgroup members appointed, IOM includes Workgroup in the Roundtable roster) N=15+
Judged by the majority of participants to be the best way of meeting the widest range of interests identified at this time
Feedback
Stakeholders
Analyses
NVAC WGReport on
Decision Options
Dialogue
IncreasedMutual
Understanding
Tracking
Increased Accountability
Staff
VPACNVAC WG as part of an IOM RoundTable (Tier 1)
Inputpending
decisions Inputwith public judgment
Fed Govtvia NVAC
GeneralPublic
(Tier 2) Outreach
on decisions taken
Stakeholders
GovernmentHealth Professionals
Organized PublicIndustry
Where We Have Come ToWhere We Have Come ToII
We have designed jointly with six major interest groups an enhanced way of engaging the public on immunization issues
The proposal meets the interests of the majority of stakeholders and has their support.
For implementation, the proposal needs a linkage or gateway to and from government agencies and/or immunization advisory committees
Now making presentations to groups in the immunization community
Where We Have Come ToWhere We Have Come ToIIII
The proposal does not meet the interests of some industry and pro-vaccine advocates who participated in some or most of the planning process.
Most objections have been about procedural aspects of the planning process (e.g., predetermined, unfair, inappropriate…)
Some objections have been raised about design features of the enhanced proposal (e.g., too critic friendly, not likely to succeed, just about safety…)
Where We Have Come ToWhere We Have Come ToIIIIII
We have made every attempt to retain the participation of all stakeholder groups
We have recruited replacements for those withdrawing whenever possible
All stakeholders are welcome to return to the Wingspread type of collaborative problem solving process at any time
Others with a mutual interest who have not participated yet are welcome to join the process at any time
Our goal is to remain intact until our process can find a home or be adopted
Key MessagesKey MessagesII
The potential benefits are large Anticipated outcomes are: Citizens and stakeholders with an enhanced
role & voice in immunization Better solutions/decisions More ownership and support for decisions
taken As a consequence of the above, more trust
built up on all sides
Key MessagesKey MessagesIIII
The potential risks are low Not a new activity—an enhancement of public
engagement Not a new advisory committee—no
recommendations Not a commitment to a permanent change—a
time limited demonstration project Enhances capacity and does not supplant
other tools in the public engagement toolbox Not likely to be a platform for any one group
Key MessageKey MessageIIIIII
The benefits are very worth having…and the risks worth taking.
What Will Success What Will Success Look Like?Look Like?
In the future we see for our nation's immunization program…
citizens fulfill their responsibility to be informed about vaccines, engage actively and respectfully with public officials, hold them accountable for meeting their immunization needs, and support the good decisions which are made...
What Will Success What Will Success Look Like?Look Like?
In turn, public officials earn and increase trust as they hear citizens’ voices fairly and openly, seek citizens' ideas and the wisdom of the group on vaccine topics, fully consider the views of citizens, make better decisions informed by citizen input, and meet with citizens to describe the decisions taken and the principal reasons behind them.
AcknowledgementsAcknowledgements
Mary Davis Hamlin, The Keystone Center
Members of the Planning Group (Wingspread & Denver)
Members of the Steering Group
National Vaccine Program Office
National Immunization Program
The Johnson Foundation
Thank youThank you
We welcome NVAC’s thoughts as the thinking continues to evolve on enhancing public engagement.
Extra SlidesExtra Slides
Drivers For The ProjectDrivers For The Project
Lack of understanding about vaccines in the general population
Lack of trust in government in some segments of the public
Increasing public expectations for involvement in decision making
Polarized debates on vaccine issues wasteful and unproductive
Familiar Examples of Familiar Examples of Public ParticipationPublic Participation
FOIA documents Hearings Public meetings Public comment periods Open public meetings Consumer representatives on advisory committees Focus groups Public opinion surveys Workshops
Unfamiliar Examples Of Unfamiliar Examples Of Public ParticipationPublic Participation
Deliberative Polling
Citizens Advisory Committees
Citizens Juries
Policy Councils
Consensus Building Exercises
Examples Of Design Choices Examples Of Design Choices Wrestled WithWrestled With
What should be the organizational home and structure?
What work products to focus on? Who will set the agenda? Who is the public? More than 20 elements have been
considered and preferences expressed in the current design
Intermediate Outcomes
Final Outcomes
Dialogue MutualUnderstanding
Problem Solving Capacity, Trust,
Decision Analysis
Ownership, MutualUnderstanding,
Qual. of Thinking
Support, Effectiveness,
Trust
Outreach to General Public
Understandingabout Vaccines
Relevance, Support, Trust
TrackingUnderstandingof Decisions,
Accountability
Support, Credibility, Trust
Logic ModelLogic Model
Increased Public
Participation
Examples of Situations Suitable Examples of Situations Suitable for VPACfor VPAC
Decision truly not made yet Decision not urgent Values at issue, not facts alone Really want input not just consulting for
appearances
Examples of Potential VPAC Examples of Potential VPAC IssuesIssues
Should doctors oust children from their practice if parents refuse vaccination?
Should philosophical exemptions to school laws be available in all states?
Should the rotavirus vaccine be reintroduced into the US?
Should we require less proof of causality for awards in the Vaccine Injury Comp Program?
Myths about VPACMyths about VPAC
That it is only about appeasing vaccine critics
That it makes a negative statement about NVAC
That it preempts NVAC on public participation
That it creates another advisory committee That the outcome of the planning process
was predetermined
Fears about VPACFears about VPAC
That it will provide a platform for vaccine critics to gain more power and influence
That we will not get a truly representative public viewpoint
That it is fixing something which is not broken
That we will alienate pro-vaccine supporters
That vaccine critics will never change their views
Anticipated OutcomesAnticipated Outcomes
Citizens and stakeholders with enhanced roles in immunization
Better solutions/decisions
More ownership and support for decisions taken
As a consequence of the above, more trust built up on all sides
ChallengesChallenges
1. Lip service vs real commitment and resources
2. Sharing power on decision making
3. Convincing that public participation improves decisions
4. Proving that public participation improves decisions at a price worth paying and a level of effort worth making
ChallengesChallenges
5. Dealing with complexity and technical topics
6. Picking suitable decisions to analyze
7. Dealing with the timing of decisions
8. Finding funding
9. Shifting the paradigm to see the public as a resource not a drag
continued
ImplicationsImplications
Extension to other programs where citizens distrust government and feel disenfranchised
Useful for the conduct of science in democratic societies where the science is complex, citizen consent or support is needed, and scientists and citizens must interact for proper resolution of the issues.
VPACVPAC “Working Together For Wise
Decisions About Vaccines”
top related