IDEAS home Printed from
   My bibliography  Save this article

Beyond tokenistic participation: Using representational artefacts to enable meaningful public participation in health service design


  • Morrison, Cecily
  • Dearden, Andy


A number of recent policies promote public participation in health service design. Yet, a growing literature has articulated a gap between policy aims and actual practice resulting in public participation becoming tokenistic. Drawing on theory from participatory design, we argue that choosing appropriate artefacts to act as representations can structure discussions between public participants and health professionals in ways that both groups find meaningful and valid. Through a case study of a service improvement project in outpatient services for older people, we describe three representational artefacts: emotion maps, stories, and tracing paper, and explain how they helped to mediate interactions between public participants and health professionals. We suggest that using such representational artefacts can provide an alternative approach to participation that stands in contrast to the current focus on the professionalisation of public participants. We conclude that including participatory designers in projects, to chose or design appropriate representational artefacts, can help to address the policy–practice gap of including public participants in health service design.

Suggested Citation

  • Morrison, Cecily & Dearden, Andy, 2013. "Beyond tokenistic participation: Using representational artefacts to enable meaningful public participation in health service design," Health Policy, Elsevier, vol. 112(3), pages 179-186.
  • Handle: RePEc:eee:hepoli:v:112:y:2013:i:3:p:179-186
    DOI: 10.1016/j.healthpol.2013.05.008

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Boote, Jonathan & Telford, Rosemary & Cooper, Cindy, 2002. "Consumer involvement in health research: a review and research agenda," Health Policy, Elsevier, vol. 61(2), pages 213-236, August.
    2. Tenbensel, Tim, 2002. "Interpreting public input into priority-setting: the role of mediating institutions," Health Policy, Elsevier, vol. 62(2), pages 173-194, November.
    3. Tritter, Jonathan Quetzal & McCallum, Alison, 2006. "The snakes and ladders of user involvement: Moving beyond Arnstein," Health Policy, Elsevier, vol. 76(2), pages 156-168, April.
    Full references (including those not matched with items on IDEAS)


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:112:y:2013:i:3:p:179-186. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu) or (). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.