From Motives to Actions: A Study of Citizen Engagement in Health and Human Service Contracts

ABSTRACT

Analyzing data from 93 semi-structured interviews, this paper identifies common forms of citizen participation, motives driving these efforts, uses of feedback, and engagement challenges. It also explores interrelationships among these aspects of participation. The findings suggest that organizations with more motives for engagement offered a wider array of opportunities for participation and used the input in more ways. In addition, organizations more active in engaging citizens and using feedback were more likely to experience challenges. This study highlights the complexity of public participation and encourages public and private managers to be informed about its many benefits and barriers.

KEYWORDS:

• Citizen participation
• citizen engagement
• contracting
• public-private partnerships
• human services

Notes

1. Instruments are available from the authors upon request.

2. According to the Census Bureau, population ranged between approximately 50,000 and 1,000,000 residents in the counties included in the sample (Census.gov, 2010). On average 10% of individuals were living in poverty, with 6% living in the county with the lowest poverty rate and 16% living in the county with the highest (Census.gov, 2009). Population density ranged from an average of 57 people per square mile to an average of 7,993 people per square mile across the six counties (Census.gov, 2010).

3. Other, less prevalent service areas included employment support, gang violence, domestic violence, food distribution, services related to intellectual/developmental disabilities, child abuse and neglect services, health insurance counseling, immigrant assistance, heating eligibility services, HIV/AIDS services, intergenerational services, legal assistance, medical care for the uninsured, occupational and speech therapy, services targeting non-English speakers, child policy development/evaluation services, emergency assistance to low-income groups, health outreach services, and women’s health services. Less than 10% of the contracts were in each of these service areas.

4. They achieved a weighted Kappa score of .83 before they began coding interviews separately.

5. Motives related to strengthening democracy and communities include empowering clients, being responsive and accountable to the community, and educating the community.

6. Motives related to service delivery include assessing and improving program quality, understanding and serving client needs, being consistent with the treatment model, helping establish goals and planning for the future, generating new programmatic ideas, developing stronger relationships with clients, and advocating for clients.

7. Other managerial motives related to organizational culture (reflecting an organization’s broader participatory culture), community-outreach (fostering community support of the program, learning about community perceptions of the program, and sharing program information with the community); finances (obtaining additional funding, identifying ways to be more cost effective, and being more competitive for county contracts), process (having a neutral body make funding decisions in the RFP process and improving the process of matching volunteers and clients), and compliance (meeting requirements of outside organizations).