Designing a Framework for Attracting Public Participation in the Iranian Health System: A Comparative and Mixed-Method Study

Background: Public participation strengthens the public presence in healthcare. Objectives: This study aimed to determine the dimensions of attracting public participation in the Iranian health system. Methods: A mixed-method research was conducted from May 2019 to July 2020. A comparative study (using the documents of five countries that were selected purposefully), tool design and validation (through holding two expert panels with the participation of 26 people who were selected based on the inclusion criteria), and finalization of the participation framework (field test with the participation of 283 recruited people based on the inclusion criteria) were performed. Exploratory and confirmatory factor analyses (CFA) were applied using SPSS-v26 and AMOS-v26. Results: Forty-eight components on five factors, including citizenship rights and customer orientation, socioeconomic factors, communication with people and non-governmental organizations, research and technology, and managerial and organizational factors with impact factors of 0.967, 0.951, 0.957, 0.944, and 0.955 were loaded, respectively. The CFA denoted the approval of the framework with the five mentioned factors. Conclusions: In this study, a framework was developed and approved during different stages. Using this framework, healthcare policymakers can adopt the best strategies for engaging public participation and improving the effectiveness of decisions through evidence-informed policymaking.