The use of deliberative dialogue in health services research: a scoping review

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Deliberative Dialogue (DD) is a structured participatory approach that brings together research evidence, professional expertise, and lived/living experience to support informed discussion and decision-making in health research. DD is increasingly used in the co-design, co-implementation, and co-evaluation of health-promoting interventions, where decisions must be both evidence-informed and responsive to local contexts, priorities, and needs. However, published studies vary considerably in how DD is described and reported, particularly in relation to facilitation, evidence use, participant preparation, power dynamics, and follow-up. This scoping review examined the application of DD in health services research, focusing on its methodological processes, reported outcomes and challenges, engagement of different interest-holders, and the rationales underlying its use. A scoping review was conducted following Arksey and O’Malley’s framework and reported in accordance with PRISMA-ScR guidelines. Searches of OVID Medline, PsycINFO, PubMed, CINAHL, and Scopus identified 1,793 records. After screening and consolidating duplicate reports, 15 unique studies met the inclusion criteria. Data were extracted using a template informed by the Guidance for Reporting Involvement of Patients and the Public (GRIPP2), the Consolidated Standards of Reporting Trials (CONSORT), and Boyko et al.’s model of DD. The review was conducted using a critical Patient-Oriented Research (cPOR) approach, which centres lived/living experience, promotes shared decision-making between patient partners and researchers, and attends to the influence of power and structural contexts on knowledge production. The interdisciplinary team, including patient partners, researchers, clinicians, policymakers, and decision-makers, co-developed the study, contributed to data interpretation, and collaboratively refined the findings through iterative and reflexive discussion. The 15 included studies were published between 2012 and 2024 and represented diverse geographic and health-system contexts. DD was used to support intervention co-design, implementation planning, evaluation, priority-setting, guideline development, and service improvement. Studies consistently reported the involvement of multiple interest-holder groups and the development of practical outputs, including curricula, decision aids, care models, action plans, guidelines, and priority-setting frameworks. However, reporting of methodological processes was inconsistent. Only a minority of studies described facilitation protocols, participant preparation, strategies to address power dynamics, accessibility supports, or follow-up activities. While DD was associated with enhanced trust, mutual understanding, contextual relevance, and collaborative decision-making, evidence of longer-term impacts was limited. The synthesis also revealed substantial variation in how studies reported participant engagement, evidence use, consensus-building processes, and the translation of deliberative outputs into intervention-related decisions. This review highlights DD as a valuable approach for collaborative, evidence-informed, and context-sensitive health services research. Across the included studies, DD was used to bring together diverse forms of knowledge and generate practical outputs to support intervention development and improvement. However, methodological details related to facilitation, accessibility, participant support, management of power dynamics, decision-making processes, and longer-term impacts were often underreported. These gaps point to the need for more transparent and equity-oriented reporting of DD, particularly in relation to how people with lived/living experience are engaged and how their contributions influence intervention-related decisions. Strengthening reporting in these areas may improve the transparency, reproducibility, and accountability of DD in the co-design, co-implementation, and co-evaluation of health interventions. Patients and members of the public are increasingly involved in health research as partners rather than participants. This means they help shape research questions, programs, services, and decisions based on their experiences and expertise. However, it is not always clear how these partnerships work in practice, how decisions are made, or how patient contributions influence outcomes. This study examined deliberative dialogue, a structured approach that brings together patients, community members, health professionals, researchers, and decision-makers to discuss health issues and make decisions. Through guided discussions, participants exchange knowledge, explore different perspectives, and work together to identify solutions. We reviewed 15 published studies that used deliberative dialogue in health research. The research team included two patient partners with experience in collaborative research. As members of the team, they contributed to developing the research questions, refining the review methods, interpreting findings, identifying gaps in the literature, and developing study outputs. Their lived and living experience informed decisions throughout the study and strengthened the relevance of the findings for patients, communities, and researchers. Most studies used deliberative dialogue to inform the design of health programs or services (9 studies). Fewer used it to support implementation (4 studies) or evaluation (2 studies), highlighting an important gap in the field. All studies involved participants from diverse backgrounds, including patients, health professionals, researchers, and decision-makers. However, only a small number clearly described how discussions were facilitated, how accessibility or equity considerations were addressed, or what happened after the dialogue ended. For example, only five studies reported facilitation processes, three described strategies to support accessibility or equity, and two reported follow-up activities. Across the studies, deliberative dialogue helped build trust, strengthen shared understanding, and develop solutions that reflected local needs and priorities. At the same time, many studies did not provide enough detail about how the process was conducted, including how decisions were made and how power differences were addressed. This makes it difficult to assess the quality of deliberative dialogue processes, apply them in new settings, and improve them over time. Overall, our findings suggest that deliberative dialogue is a valuable approach for collaborative decision-making in health research. However, clearer and more consistent reporting is needed to improve transparency, accountability, and the quality of participation. Better reporting can help researchers, patients, and communities understand what works, identify areas for improvement, and strengthen the development of health programs and services that are responsive to the people they are intended to serve.

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