Consumer involvement incorporates the consumer perspective into the process of planning and decision making. We have found a helpful working definition of consumer involvement from Creighton (1981): "a process, or processes by which interested and affected individuals are consulted and included in the decision making of an agency, planning group or collaborative entity" (p. 3). What that process looks like may vary greatly, but ultimately a key result of consumer involvement is that consumers' views and experiences are directly included in the planning and decision making processes. "One measure of an effective public involvement program," says Creighton, "is whether you can identify specific ways in which the final decision is responsive to public comment. If nothing has changed as a result of the program, it has probably met the letter of the law but not the spirit of public involvement" (p. 4). Consumer involvement falls under the broader umbrella of citizen involvement, which has its roots in the democratic political process. Both encourage individuals to take an active role in the shaping and development of policies, procedures, and programs that impact society. Lappé and Du Bois (1994) use the term "living democracy" to describe a way of life "that meets the deep human need to know that our voices count [and] to shape the decisions that most affect our well-being" (p. 3). They see a new wave of activity among citizens eager to participate and effect change in all segments of society. Howell, Olsen and Olsen (1987) identify three major themes which provide a theoretical framework for citizen involvement. Throughout our project, we saw evidence of these themes at work. Democratic theory stems from Jean Jacques Rousseau, John Locke, and other eighteenth century political philosophers, who believed that "all citizens have the right to influence political decisions that affect them" (p. 5). For this to happen effectively, individuals need to have ongoing opportunities to acquire the information and develop the skills necessary to participate in collective decision making. Howell, et al. suggest that this can happen at the community level through greater democratization of decision making and participation in community-based systems, including families, schools, churches, voluntary associations, and work places. Consumer participation thus requires the constant acquisition of information and the development of specific skills. Strengthening consumer participation in all community systems can lead to increased involvement in more broad-based groups such as Step Ahead and First Steps. Social mobilization theory focuses on the power of participation as a springboard to further action. "As people join and participate in local organizations and activities, they tend to become more aware of and informed about public issues, they develop skills in discussion and decision making, and they seek greater influence on decisions that affect them" (p. 5). In other words, as people become mobilized, they are more likely to pay attention and participate in public affairs. Research suggests that this process not only effectively draws citizens into the political arena, but that it can be applied to people of all ages and socioeconomic levels regardless of previous experience with political affairs. Perhaps the following quote from a consumer involved in our project best describes this theory at work. "There was a Medicare hearing that I went down to in Indianapolis and I never would have gone if I had not been involved in the consumer involvement group first. I also wrote letters to my representative, and I had never done that. I wouldn't have done it if I didn't know there were other people around me, behind me, other people doing it, other people who were saying, 'do it,' 'yes, what you have to say is worthwhile,' and 'yes, you should stand up, and people do need you to speak up for them too.' That was another thing. I didn't feel like I was just talking for myself, and that's important. You know, when you have personal opinions, you think maybe you're the only one who feels this way, and you find out you're not. You find out you're also representing even a small group and speaking for them." Social exchange theory suggests that people usually participate in social activities to acquire benefits. Since there is also a cost to their participation (such as resources, time, and sacrifice of other activities), individuals will seek to minimize costs and maximize benefits. Thus, when looking at consumer involvement, it is essential to pay attention to those factors which draw from or add to a consumer's "participation bank." Once individuals perceive the rewards as sufficient for participation, they then need to feel confident that those rewards will be realized. Therefore, trust in individuals or organizations to actually follow through is an important issue in social exchange theory. "To avoid a breakdown in confidence, officials must stress that the results of surveys, committee meetings, and other activities of the involvement program will be used to guide the planning process and develop policy proposals-and they must carry out their promises" (p. 9, italics added).
When consumers are meaningfully involved, everyone wins. There are several compelling reasons for consumer involvement which offer benefits to the organization or group as well as to the consumer. Looking at consumer involvement from the broader perspective of citizen involvement is again helpful. Howell et al. (1987) suggest that "if involvement programs are adequately designed and conducted, they can make valuable contributions to solving societal problems and developing stronger communities, as well as prevent costly litigation and public cynicism" (p. 1). They cite four frequently mentioned benefits of citizen involvement:
Creighton (1981) offers three similar goals for public involvement:
As a result of increased communication and broadened perspectives, programs are more effective in meeting the actual needs of consumers. Decision making is strengthened when it draws upon the experience of people who are directly affected and when it emerges from an interplay of diverse experiences and viewpoints. Heightened credibility translates into greater acceptance and participation of those being served. We no longer believe that experts or parents can fix today's problems alone. "Why?" ask Lappé and Du Bois (1994). "Because they touch us all; our problems are interrelated. Second, they're complex; they involve our attitudes, our daily behavior, even such intangibles as hope itself. This means that whether they relate to environmental degradation, poverty, racism, crime, drugs, or failing schools, those problems elude hierarchical and expert-driven strategies" (p. 16). Many consumers seem to be aware of this unique contribution they bring. "It would smoothen all the processes so much if [consumers] were allowed to speak back and to share their experience, how it worked, how it didn't work-it would make such a difference at every level." "I brought up a perspective that is not always brought up when you're sitting around the table. Whether it was better or worse, I don't know, but at least it was another angle, so I think that it's important that consumers increasingly get involved." "I think it's important that consumers-regular people-go on occasion and make them [professionals] clarify what they are doing. . . . They get so used to speaking in 'committee-eese' that they forget how to communicate with the public. I think it was helpful to the group to have me there, because it makes them answer questions, even for the committee members who feel stupid asking because they're supposed to know." "I don't think that is going to be on their priority list unless there's a parent involved who is constantly nudging saying 'What about the parents? What about the parents? What about the parents?'" The involvement of consumers brings new information, broadens perspectives, increases accountability, and steers direction. It also has the capacity to empower participants. Lappé and Du Bois (1994) describe several categories of rewards that citizens report receiving from their increased involvement in public life.
Our consumers, too, felt they gained benefits from their involvement, including new relationships, information, skill-building, and the ability to contribute to work towards positive change. "I really felt like here was a view of what was 'really going on' and getting acquainted with some of the agencies that are involved. It was very good for me." "[The best thing about this project was] that I got a chance to work with people like myself who wanted to make a difference. Knowing there was somebody else out there [who felt as I did]." A person who is in need of, is currently using, or previously has used a particular service or resource brings an important consumer perspective to the planning and decision making process. It is interesting that with all the focus on consumer participation, there appears to be little consensus on just who a consumer is. Responses from a survey of Step Ahead council members show a wide range of definitions, from "any citizen" and "someone who trades something of value for something of equal or greater value" to "any county resident in need of a service provided by a Step Ahead participant," "any person that has their life impacted on or receives services from a specific entity that provides the service," and "anyone who lives in our county who has children." While the state has never clearly defined a consumer in regards to Step Ahead, a current loose definition that is being used is "children and families." First Steps, because of its focus on the special needs child and family, has a narrower focus of consumer. Therefore, within the Interagency Executive Council (IEC), which is the oversight council for First Steps in St. Joseph County, perceptions of who is a consumer are somewhat more consistent, from "anyone who has used any part of the First Steps system," to "parents, grandparents, foster parents and guardians of children with special needs who make use of available programs," to "an individual who is experiencing first hand services directly." One member also pointed to service providers as "secondary consumers" who may need "assistance, training and support to make them better able to meet the needs of the primary consumers." Simply put, consumers use services or resources. Another way of defining consumers comes from Gray (1989). She identifies two groups of stakeholders who need to be present in a collaborative process: those who are the experts and those who will be affected by the consequences. At times, consumers may actually fit into either or both of these categories. Emery (1989) suggests that only people who have a legitimate material interest should have input into decision making. In other words, those who may in some way be affected by the decision. On the other hand, one participant in our project stressed the importance of including consumers who are not currently using services, but who have used services in the past, because she felt there may be a reluctance among some consumers who currently receive services to "bite the hand that feeds them." Those who are no longer dependent on services are more free to criticize or challenge the system. Kretzmann and McKnight (1994) bring up an interesting point in their discussion about community-building. "Unfortunately, in some communities local residents have come to mistakenly believe they can build their community by an inventory of deficiencies. The common name for this deficiency inventory is a 'needs survey.' It is basically an effort to count up the emptiness in an individual or a neighborhood. The problem is that this information is not useful for community-building because it deals with people as potential clients and consumers. To be powerful, a community must have people who are citizens and producers" (p. 14). From this perspective, it would seem that using the label of "consumer" relegates a person to a receiving position and thus makes it difficult to also appreciate and support what that person has to give. Perhaps our consumers had a sense of this when they had the following dialogue. "Consumer--I hate that word." "Why did they pick that name?" "It's in--PC." "It sounds very cold." Sometimes providers attempt to wear both a parent and a professional hat at the same meeting. While, technically speaking, anyone who is a parent might also be considered a consumer, wearing two hats in the same meeting doesn't appear to work well. The difficulty is that when a person is in attendance at a meeting because of his or her professional position, the parent perspective gets superseded by the professional role. Consumers are especially sensitive to this distinction. Although our work in the area of consumer involvement stems directly from our experience as parents, the consumers in our project clearly labeled us as professionals: "Ann and Sue--you put more of your professional hat on because that's what you're here to do, and so things that, if you were sitting here as a parent would normally pop in your head aren't doing it." At times, a parent's involvement may lead to employment or a leadership role. This is a natural and desirable outcome of consumer involvement. Once "in the system" for a period of time, however, that parent/professional is at risk of losing legitimacy as a consumer with other consumers. "One of the problems when you get involved in official stuff is that you start acting like an official instead of a parent and I think it gets very complicated-parents lose the parent perspective and start wearing their professional hat." " . . . [One of the other consumers] said I was more than just a parent and that it made her feel very funny, so I've learned from that--since then, I am very careful to say 'parent' because I think they need to feel like there's more of us than of them so we can get that bond going together . . . "
Consumers get involved when they believe they can make a difference. Research by The Harwood Group (1991) suggests that "before they will act, citizens need to know that there is the possibility to create change from their efforts. They know that such change will not always come about; the results, in the end, may not even be positive. . . . But the potential for change must always exist. This is a pre-condition for citizen involvement in public life" (p. 45). Implicit in this idea is the need for citizens to believe that
Creighton (1981) also refers to research showing that one of the reasons people do not participate is that they "don't believe they can influence the decision" (p. 44). This echoes the tenets of social exchange theory--that people need rewards if they are to invest their time and energy in an activity, and they need to trust that these rewards have a good chance of being realized. However, trust does not always come easily. Gates (1991) talks about the shift that has taken place in community life. "There was a time [when] citizens had fundamental trust in the large institutions of their community to 'do the right thing.' They assumed that government and business made decisions with the best interests of the community in mind. Clearly those days have changed" (p. 117). He cites a national Gallup poll in which respondents were asked which institutions they trusted "a great deal" or "quite a lot" to solve community problems. The respondents' answers illustrate this lack of faith. Municipal government rated a confidence score of 23 percent, the federal government rated 18 percent, and the political parties rated 13 percent. This distrust also surfaced in our consumer group. "We were brought up to trust people in authority. To believe what they tell you. But it's not true. They just give you enough information to keep you under control." "I was very hesitant about [joining] initially . . . 'cause I am very wary of community involvement groups that tend to be not community involvement but just talk with no purpose and nothing gets done." "Why are we there? What can we say that makes any difference to them? Can we really change their minds?" Looking at involvement from the social exchange theory, the importance of trust cannot be overemphasized. "Perhaps the greatest cost occurs when citizens feel that their contribution to the planning process is meaningless. . . . when they perceive their roles as purely symbolic, as merely fulfilling a legal requirement or as undesired by [professionals] . . . " (Howell, 1987, p. 8).
Consumers get involved if they have formed meaningful relationships. Kretzmann and McKnight (1994), writing on asset-based community development, emphasize the importance of building relationships. "If a community development process is to be asset-based and internally focused, then it will be in very important ways 'relationship driven.' Therefore, one of the central challenges for asset-based community developers is to constantly build and rebuild the relationships between and among local residents, local associations and local institutions" (p. 9). Lappé and Du Bois (1994) also talk about the power of relationship-building. Simply sitting and talking with citizens (consumers) helps to establish a relationship of trust. This, they say, "is where effective citizen action begins, long before any decision is made on which issues to address" (p. 58). Our experience points to the same conclusion. Having an established relationship with someone already connected with Step Ahead or First Steps seemed to be a factor in recruiting consumers as well as in their ongoing involvement. Attendance of participants in the focus group we conducted also was related to the existence of a prior relationship with the recruiter. "Knowing [both of you] . . . helped me. Made me feel more willing to give it a shot." "The consumers were down to earth people. I felt at home." "Parents that start and then aren't there--you say, 'we'll send them this and that'--that's not as good as we can do. We need to make a personal phone call, go to their homes, call three times a week, sit down with them, check on whether they need child care, pick them up and take them with us. We have to show them we really want them."
Consumers get involved when they become "engaged"--when the issues they are dealing with have meaning for them. "Typically," states Creighton (1981), "a particular public will last only as long as there is some continuing interest that the members share" (p. 37). Veteran community organizers like those at the Gammaliel Foundation stress that we should move away from a focus on problems, which are "broad, vague, theoretical, chronic" and begin to deal with issues, which are "immediate, specific, realizable, concrete, and controversial." Problems seem overwhelming; issues create hope.
Further studies by the Harwood Group (1993) emphasize the importance of "building relationships between people and the public concerns around them" (p. 43). They identified nine key factors that are constantly at work, providing what they call a "meaningful chaos" through which people become engaged to issues. These include:
These factors do not happen in a linear, step-by-step process; rather, they occur over time, occur at different times, and occur in ways that actively reinforce one another. "The interplay between and among the various factors is critical . . . that is where the factors draw their power and relevance to citizens" (p. 43). And, they continue, if these factors are not taken into consideration, "some of the entry points and leverage points where relationships with public concerns can begin to grow" will be missed (p. 43). Copyright 1994 by Sue Christensen and Ann Rosen. This report is based on learnings from the Step Ahead/First Steps Consumer Involvement Project which was conducted for the Indiana Bureau of Child Development, Division of Family and Children by The Family Connection of St. Joseph County, Inc., 132 N. Lafayette Blvd., South Bend IN 46601 - 219-237-9740 ~ e-mail: famconn@michiana.org The report may be copied in part or in whole to further advance the involvement of parent consumers in agency and coalition planning and decision-making, providing credit is given to the authors and The Family Connection of St. Joseph County, Inc.
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