The Added Value and Unintended Negative Consequences of Involvement Processes

Background
Public involvement is widely considered a way to improve health and quality of health services. The research literature reveals ambiguities concerning the added value and the unintended negative consequences of public involvement processes. The aim of this study was to identify, synthesize and present an overview of added value and unintended negative consequences of public involvement processes in the planning, development, and implementation of community health services.

Methods
36 peer-reviewed articles retrieved from a systematic search (published in a review article) in the CINAHL, Cochrane Library, Embase, PsycINFO, PubMed, ProQuest, and Scopus databases in 2021 were coded and extracted according to the aim of the study. A thematic synthesis was conducted involving (1) line-by-line text coding, (2) developing descriptive themes and (3) generating analytical themes.

Results
Two main themes with corresponding subthemes were identified providing an overview of the added value of public involvement processes (theme 1) at individual, service, and political levels. Unintended negative consequences (theme 2) show how individual resources is required, and uncertainty about the effect of involvement on services and power differences among providers and the public revealed.

Conclusions
The added value of public involvement processes is primarily reported on an individual and service level and often accompanied by unintended negative consequences. Professional facilitators and recruitment of a wider group of participants representing vulnerable groups is important to promote equality in public involvement.