The aim of this systematic review was to summarize systematically the existing evidence for the effects of student participation in designing, planning, implementing and/or evaluating school health promotion measures. The focus was on the effects of participation in school health promotion measures rather than on student involvement at school in general. Participation is a core value for health promotion but empirical evidence of its outcomes is scarce. We searched major bibliographic databases (including ASSIA, ERIC, PsycINFO, Scopus, PubMed and the Social Sciences Citation Index). Two reviewers independently decided about inclusion and exclusion of the identified abstracts (n = 5075) and full text articles. Of the 90 full text articles screened, 26 papers met the inclusion criteria. We identified evidence for positive effects, especially for the students themselves, the school as organization, and interactions and social relations at school. Almost all included studies showed personal effects on students referring to an increased satisfaction, motivation and ownership, an increase in skills, competencies and knowledge, personal development, health-related effects and influence on student perspective. Given that student participation has more been discussed as a value, or ideal of health promotion in schools, these findings documenting its effectiveness are important. However, further research is needed to consider the level or intensity of involvement, different approaches and stages of participation in the health promotion intervention, as well as mediating factors such as gender, socio-cultural background or academic achievement, in a more systematic manner.

Despite the rise of health consumer and patientsÕ organizations (HCPOs) in modern health-care systems, studies are few and far between. In particular there is a lack of comparative research across Europe and at the pan-European level. In an effort to address this gap, an expert workshop was held in Vienna in February 2006. This involved 22 delegates from 10 European Countries and was funded by the European Science Foundation (ESF). The workshop reviewed the development of HCPOs in Europe and their role in the policy process in order to establish a platform for further research in this field. It found evidence of an increase in HCPOs across European countries, increased engagement with policy makers and political institutions, and the creation of alliance organizations bringing together HCPOs across the sector. However, variations between countries were observed, relating to different political, cultural and health system contexts. There was no consensus on whether the rise of HCPOs constituted a new social movement. An increase in HCPO activity at the pan-European level was noted, reflecting the increased interest of EU institutions in health policy. At both domestic and European levels, concerns about the representativeness and legitimacy of HCPOs were raised as well as questions about their independence (notably with regard to the drugs industry). HCPOs face a number of obstacles including: lack of capacity and resources, fragmentation and the power of more established interests within the health-care system. The workshop concluded that further research is needed in this field, in the form of a comparative study of HCPOs in European countries and an analysis of their activities at the pan-European level.

Involving patients, caregivers, and citizens in health care and health policy has been recommended by international organizations for over a decade. This article focuses on developments in England under New Labour, places them in the context of broader health policy, and assesses them in the light of the limited empirical evidence. The authors consider a range of possible explanations for these developments. They suggest that we need to distinguish between individual and collective forms of patient involvement, and they chart patient and public involvement in England before New Labour and in three distinct phases under New Labour. There has been a significant extension of opportunities for individual patients and the public to communicate their views, albeit with twists and turns in the policy over time. The authors explain these developments in terms of New Labour's ideological attachment to pragmatism and the Third Way, political calculations about the need to reinvigorate political culture, and attempts to enhance cost-effectiveness. Patient and public involvement seems to be here to stay, but whether this will result in greater equity and a real shift in power away from professionals to citizens and patients is another matter.

Published in: Evaluation and Program Planning, 40 (2013) [42][43][44][45][46][47][48][49][50][51][52][53][54] A B S T R A C T Participatory evaluation has been increasingly used in health promotion (HP) and various forms of participatory evaluation have been put into practice. Simultaneously, the concept of participation has become more important for evaluation research in general, which is equally diverse and the subject of various discourses. This study addresses the issue of how the concept of participation has been established in HP evaluation practice. An analytical framework was developed, which served as a basis for a literature review, but can also be used as a general framework for analyzing and planning the scope of participation by various stakeholders within different phases of participatory evaluation. Three dimensions of participation, which refer to decision making (decision power, deliberation) and action processes are distinguished. The results show that only a few articles discussed participatory evaluation processes and participatory (evaluation) research was largely put forth by participatory (action) research in communities. The articles analyzed referred mostly to three stakeholder groups -evaluators, program staff and beneficiaries -and to participation processes in the initial evaluation phases. The application of the framework revealed that decision power seems to be held predominantly by program staff, evaluators seem to be more involved in action processes and beneficiaries in deliberation processes.

The participation of lay people in health care decision-making lacks an adequate analysis from an organizational perspective. This article aims to develop conceptual devices to analyze policies and practices and to discuss ways in which these policies and practices could be further developed. By recapping established frameworks and drawing on theories of professional organizations, four roles for the participation of lay people and their potential to adapt organizational decision processes to internal requirements and external challenges are elaborated. While individual patient participation is widely acknowledged, there is still a lack of systematic approaches to the roles of significant others, patient groups and the broader community and their implementation within health care organizations.