Deliberative democratic theory has proposed the use of mini-publics to discern a more reflective public opinion, which can then be conveyed to policymakers or back to the wider public. In 2009, the legislature in the State of Oregon (USA) created one such process in the Citizens’ Initiative Review to help the public make informed choices on statewide ballot measures. This study investigated how the public conceptualizes and assesses the Citizens’ Statements that Citizens’ Initiative Review panels place in the statewide Voters’ Pamphlet. We pose a series of research questions concerning how the public perceives the role of the Citizens’ Initiative Review in initiative elections. We investigate those questions with usability testing sessions held in the final weeks before the 2014 election. Forty interviews were conducted in Portland, Oregon, and 20 were held in Denver, CO, where a pilot version of the Citizens’ Initiative Review was held. Online survey data collected in Oregon and Colorado followed up on the themes that emerged from the usability tests to obtain more general findings about these electorates’ views of elections and the Citizens’ Initiative Review. Key results showed that voters found the Citizens’ Initiative Review Statements to be a useful alternative source of information, although they required more information about the Citizens’ Initiative Review to make robust trust judgments about the process. Voters were uncertain of the value of the vote tally provided by Citizens’ Initiative Review panelists, but reading the Citizens’ Initiative Review Statement inspired some to vote on ballot measures they might have skipped.

Public deliberation on the Internet is a promising

We employed the risk information seeking and processing (RISP) model to inform the design of antibiotic stewardship messages aiming at influencing intentions to seek or avoid antibiotic risk information. College-age respondents ( N = 400) from a national sample viewed one of three versions of a RISP-informed message or no message (control group). Relative to the control group, all RISP-informed messages increased perceptions of information insufficiency. The most complete version of the RISP-informed message increased severity perceptions and information seeking intention and decreased information avoidance intention. Approaches to designing antibiotic stewardship messages are recommended accordingly.

Current guidelines recommend “watchful waiting” (WW) as an alternative to immediate antibiotic treatment. Continued high rates of antibiotic use suggest that WW may be underutilized. We conducted a retrospective chart review of 474 pediatric acute otitis media (AOM) cases at a clinic in central Pennsylvania. We assessed physical examination findings, diagnostic behavior, WW utilization, prescription writing, and filling in cases of pediatric AOM to evaluate the underutilization of WW. We evaluate diagnostic consistency with published guidelines and rates of antibiotic prescription resulting from misdiagnosis. We report WW instructions and compliance, and prescription filling behaviors. Fifty percent of AOM diagnoses in this sample were not supported by physical examination findings. The majority of these AOM diagnoses received antibiotic prescriptions, suggesting that unsupported diagnoses translated to injudicious prescribing. WW instructions corresponded to 57% fewer filled prescriptions and longer fill delay. We discuss the implications and recommendations to improve antibiotic stewardship.

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