Deliberating at a Distance: Evaluating the Feasibility of a Fully Virtual CHAT Exercise Among Low-Income Communities.

INTRODUCTION: Alongside software developers, our community-academic partnership adapted an exercise designed for participatory priority setting to engage low-income community members in online deliberations about health and welfare spending priorities. This study evaluated the feasibility and quality of a fully virtual deliberative exercise using an adapted Choosing All Together (CHAT) tool among low-income community members. METHODS: Twenty-one groups including 128 low-income individuals diverse in age, household size, race/ethnicity and urbanicity used an online version of the CHAT exercise. Sessions included both English- and Spanish-speaking participants. Pre- and post-CHAT surveys assessed participant experiences and views of online public deliberations. RESULTS: Mean item and scale scores (on a 0-4 Likert scale, where 0 = strongly disagree and 4 = strongly agree) demonstrated that online use of the CHAT exercise was rated as enjoyable (3.4) and easy to do (3.2). Participants rated the information and choices provided as sufficient (3.4), with most participants agreeing that the choices offered in the deliberation were realistic (3.4) and believable (3.4). Participants generally thought they had enough information (2.4). The view of deliberation scale was scored (3.5), showing deliberative quality was rated highly. Participants agreed they gained an understanding of the arguments that opposed their own (3.2), that they had lots of chances to share their views (3.7) and that their views were considered (3.5). Some (2.8) stated that a few people dominated the discussion. DISCUSSION: Virtual modes of engagement could enable greater group heterogeneity, the participation of less mobile and more remote persons. Online deliberations added increased comfort and convenience for participants. Many participants stated that they expect and prefer online research participation, demonstrating that Covid may have shifted the paradigm. Participants indicated some technology problems, but these did not hinder participation as demonstrated by favourable mean item scores. CONCLUSION: Participants found the online CHAT deliberation easy and enjoyable and felt that the choices and information provided to them were sufficient. Despite technological problems, virtual modes of deliberation appear to be well-received by participants, adding comfort and convenience. PATIENT OR PUBLIC CONTRIBUTION: DECIDERS, a steering committee of community partners, co-created the virtual CHAT game and guided its design. Participants shared their stories and provided feedback on the virtual experience, informing both the evaluation and interpretation of the findings.