The Effectiveness of Adaptations for Online Remote Public Deliberation Across Three Continents: Mixed Methods Study.

Background: Public deliberation is a qualitative research method that has successfully been used to solicit laypeople's perspectives on health ethics topics, but it remains unclear whether this traditionally in-person method can be translated to the online context. The MindKind Study conducted public deliberation sessions to gauge the concerns and aspirations of young people in India, South Africa, and the United Kingdom with regard to a prospective mental health databank. This paper details our adaptations to and evaluation of the public deliberation method in an online context, especially in the presence of a digital divide.

Objective: The purpose of this study was to assess the quality of online public deliberation and share emerging learnings in a remote, disseminated qualitative research context.

Methods: We convened 2-hour structured deliberation sessions over an online video conferencing platform (Zoom). We provided participants with multimedia informational materials describing different ways to manage mental health data. We analyzed the quality of online public deliberation in variable resource settings on the basis of (1) equal participation, (2) respect for the opinions of others, (3) adoption of a societal perspective, and (4) reasoned justification of ideas. To assess the depth of comprehension of the informational materials, we used qualitative data that pertained directly to the materials provided.

Results: The sessions were broadly of high quality. Some sessions were affected by an unstable internet connection and subsequent multimodal participation, complicating our ability to perform a quality assessment. English-speaking participants displayed a deep understanding of complex informational materials. We found that participants were particularly sensitive to linguistic and semiotic choices in the informational materials. A more fundamental barrier to understanding was encountered by participants who used materials translated from English.

Conclusions: Although online public deliberation may have quality outcomes similar to those of in-person public deliberation, researchers who use remote methods should plan for technological and linguistic barriers when working with a multinational population. Our recommendations to researchers include budgetary planning, logistical considerations, and ensuring participants' psychological safety.