Why so far ahead? Climbing the participation ladder in public health foresight

ISSUE: In the Netherlands, the National Public Health Foresight Study (PHF) is published every 4 years, as starting point for national and local public health policy development. As these policies impact citizens’ health and lives, it is important to include their voices. We piloted an approach to strengthen this engagement to learn and to inspire PHF in other (country) settings. PROBLEM DESCRIPTION: PHF is usually expert-based. Citizen engagement, beyond consultation, is not yet common practice. In the Dutch PHF-2024, we engage citizens both as advisors (citizen council, N = 30 and panel, N = 500) and as target group (focusgroups N = 40). Intentionally the scope is diffuse, allowing for unexpected input. What can we learn from this approach, and how do the citizens contribute to the PHF? RESULTS: - Citizens of all ages, backgrounds and education types are well able to discuss health (determinants), data and indicators; - They have intrinsic motivation to contribute to better knowledge, feel responsible for effective engagement and are eager to engage across different backgrounds and population groups; - Integration of outcome into the PHF process is valuable, enriching scientific with experiential knowledge and facilitating results communication; - Fundamental questions, e.g., about foresight time frames (“why look so far ahead as the world is in crisis right now!”) are raised by the citizens, showing that these need to be better addressed in order to make PHF relevant for a broader public. LESSONS: - More permanent engagement of the citizens is needed to enable learning and development; - earlier engagement in the PHF process may enable joint development of core questions and issues to be addressed; - The results are highly encouraging; piloting this approach in other foresight types and in various contexts is therefore needed to refine and further develop it. KEY MESSAGES: • Citizen engagement can and should be strengthened to include citizen voices in the PHF process, informing policies that impact on their lives. • Citizens of all backgrounds, with their experiential knowledge, can be valuable partners in PHF, that provide important input.