Influencing health policy through public deliberation: Lessons learned from two decades of Citizens'/community juries Chris Degeling a, * , Lucie Rychetnik b, a , Jackie Street c , Rae Thomas d , Stacy M. Carter a a Centre for Values, Ethics and the Law in Medicine, School of Public Health, K25, University of Sydney, NSW, 2006, Australia b School of Medicine Sydney, The University of Notre Dame, Broadway, NSW, 2077, Australia c School of Public Health, North Terrace Tower, The University of Adelaide, SA, 5005, Australia d Faculty of Health Sciences and Medicine, Bond University, Gold Coast, 4229 QLD, Australia article info Article history: Received 8 June 2016 Accepted 1 March 2017 Available online 2 March 2017 Keywords: Public deliberation Health policy decision making Policy work Research translation abstract Citizens’/community juries [CJs] engage members of the public in policy decision-making processes. CJs can be employed to develop policy responses to health problems that require the consideration of both community values and scientific evidence. Based on the principles of deliberative democracy, recent reviews indicate that findings from CJs have successfully been used to influence health policy decision- making. Despite this evidence of success, there appears to be a gap between the goals of health re- searchers who organize CJs and the needs of policy actors and decision makers. Drawing on our expe- riences working with CJs and recent research on CJ methods, we describe a synopsis of the current state of the art organized around four key questions, and informed by insights from deliberative theory and critical policy studies. Our intention is to stimulate further discussion as to the types of health policy questions that can be usefully addressed through public deliberation, and provide guidance on the methodological and political dimensions that need to be considered in deciding whether a CJ is an appropriate approach for informing a policy decision-making process. © 2017 Elsevier Ltd. All rights reserved. 1. Introduction Public engagement is the process through which stakeholders and publics can contribute to discussions, and influence policy decisions and actions that affect them (Rowe and Frewer, 2005). Engaging different publics on health policy questions is attractive to decision-makers because people's values and beliefs are often central to healthcare debates (Abelson et al., 2012). There are a number of models and methods currently being used, with differing levels of opportunity for the public to contribute to decision-making processes (Mitton et al., 2009; Rowe and Frewer, 2005). Citizens'/community juries [CJs] are an increasingly promi- nent approach to public engagement that aims to elicit the per- spectives and preferences of groups of people who have been educated about, and given time to discuss, how to address a specific policy problem (Dryzek, 2000; Street et al., 2014). Because CJs emphasize the importance of listening to divergent views and facilitating public deliberation, CJs are appropriate for engaging members of the public in developing solutions to controversial health policy problems that require the consideration of both values and evidence (Abelson et al., 2012; Rychetnik et al., 2013). The emergence of CJs as a form of policy engagement is part of the ‘deliberative turn’ in governance, in which those with power seek to step beyond mere consultation by creating active roles for the public within decision-making processes (Barnes et al., 2007; Dryzek, 2000). Formal deliberation is more than a dialogue and not just a debate. In theory, at least, the deliberative process ex- tends the thinking of participants beyond their own interests to think about public goods and the collective needs of the commu- nity: the aim is to generate recommendations or other advice on a defined topic (Carson, 2008; Solomon and Abelson, 2012). Health policy researchers have adapted jury methods in a variety of ways (Street et al., 2014), and the increasing use of CJs on health policy issues might suggest an increasing appetite amongst policymakers for this type of ‘publicly’ generated evidence (Davies et al., 2006). Paradoxically, however, many CJs are not directly connected to policy processes, few are subsequently evaluated, and the vast * Corresponding author. VELiM, Level 1, Medical Foundation Building (K25), University of Sydney, 2006, Australia. E-mail addresses: chris.degeling@sydney.edu.au (C. Degeling), lucie.rychetnik@ saxinstitute.org.au (L. Rychetnik), jackie.street@adelaide.edu.au (J. Street), rthomas@bond.edu.au (R. Thomas), stacy.carter@sydney.edu.au (S.M. Carter). Contents lists available at ScienceDirect Social Science & Medicine journal homepage: www.elsevier.com/locate/socscimed http://dx.doi.org/10.1016/j.socscimed.2017.03.003 0277-9536/© 2017 Elsevier Ltd. All rights reserved. Social Science & Medicine 179 (2017) 166e171