The Impact of Panel Composition and Topic on Stakeholder Perspectives: Generating Hypotheses from Online Maternal and Child Health Modified-Delphi Panels
Abstract Background: Multi-stakeholder engagement is crucial for conducting health services research. Delphi-based methodologies combining iterative rounds of questions with feedback on and discussion of group results are a well-documented approach to multi-stakeholder engagement. The aim of this study is to develop hypotheses about the impact of panel composition and topic on the propensity and meaningfulness of response changes in multi-stakeholder modified-Delphi panels.Methods: We conducted three online modified-Delphi multi-stakeholder panels using the same protocol. We assigned 60 maternal and child health professionals to a homogeneous (professionals-only) panel, 60 pregnant or postpartum women (patients) to a homogeneous panel, and 30 professionals and 30 patients to a mixed panel. In Round 1, participants rated seriousness of 11 maternal and child health outcomes using 0-100 scale and explained their ratings. In Round 2, participants saw Round 1 results and discussed them using anonymous, moderated online discussion boards. In Round 3, participants revised their original ratings. Our outcome measures included binary indicators of response changes to ratings of low, medium, and high severity maternal and child health outcomes and their meaningfulness, measured by a change of 10 or more points on a 0-100 scale.Results: Participants changed 55% of responses; the majority of response changes were meaningful. We developed three main hypotheses. First, stakeholders may be more likely to change their responses on preference-sensitive topics where there is a range of viable alternatives or perspectives. Second, patients may be more likely to change their responses and to do so meaningfully in mixed panels, whereas professionals may be more likely to do so in homogeneous panels. Third, the association between panel composition and response change may vary according to the topic.Conclusions: Results of our work not only helped generate empirically-derived hypotheses to be tested in future research, but also offer practical recommendations for designing multi-stakeholder online modified-Delphi panels.Registration: International Registered Report Identifier: DERR1-10.2196/16478