Brazil project tests a clearer route into health policy

Brazilian researchers have developed and tested a public education programme designed to help citizens understand how decisions are made about treatments, medical devices and procedures in the country’s public health system. The project focused on making participation in consultations more accessible before technologies are considered for inclusion in SUS, Brazil’s unified health system.

The work, reported by Scienmag.com and published in Health Research Policy and Systems, was carried out by a team at Rio de Janeiro’s National Institute of Cardiology. It addressed the work of Conitec, the national committee that advises on health technology incorporation. Conitec’s consultations provide a formal opportunity for patients and members of the public to comment before coverage decisions are reached.

The researchers argue that the existence of a consultation does not guarantee meaningful participation. Technical vocabulary, limited health literacy and a lack of straightforward explanations about health technology assessment can prevent people from contributing effectively. Their project, called Participa SUS-ATS, examined whether those obstacles could be reduced through a structured programme of knowledge translation.

Building the programme around public needs

The project followed the knowledge-to-action framework, which treats the movement of research into practical use as a series of connected steps. Work took place between 2022 and 2025, covering topic selection, development, testing, revision and distribution.

Rather than deciding independently what citizens needed to know, the researchers began by surveying patient and civil society representatives. Sixteen people took part. Their responses identified five broad subject areas that were then used to shape the educational curriculum.

The team produced 10 video modules, translating specialist material about health technology assessment into more accessible language. Researchers prepared the content, HTA specialists reviewed it, and a pilot assessment tested whether the materials met a predetermined standard. The threshold was set at 70 percent across five areas, including clarity, relevance and usefulness.

There were 430 responses to the pilot evaluation. Approval levels ranged from 75 to 97 percent across the five measures, meaning every area exceeded the target. Feedback also led to practical changes. The programme added Brazilian Sign Language interpretation, introduced a glossary and altered aspects of the presentation format.

That process made users contributors to the design rather than simply an audience for finished material. The researchers describe the repeated cycle of testing and revision as central to the intervention, distinguishing it from a one-time campaign that produces information without checking whether it works for the intended public.

Reaching people beyond the consultation room

Participa SUS-ATS used two main routes for distribution. A free virtual learning environment offered animated videos and interactive exercises in a gamified format. A separate digital campaign used social media to promote the project and its resources.

The learning platform recorded 4,355 visits during the study period. Completion rates varied by module, from 11.1 percent to 42.9 percent. Those figures show that making material available does not ensure that users will finish it, although the resources remained free and accessible after project funding ended.

The social media figures showed stronger growth after paid promotion. Instagram followers rose from 576 to 7,514, an increase of 1,200 percent. Some reels were viewed as many as 47,000 times. The project’s LinkedIn account reached 1,778 followers, while YouTube videos received more than 5,000 views.

For public agencies and research institutions, the results point to a practical challenge: useful information may not find an audience without deliberate investment in distribution. Public participation depends not only on opening a consultation, but also on ensuring that people know about it and can understand the questions being asked.

Evidence of feasibility, not proof of policy change

The researchers do not claim that the programme altered Conitec’s final decisions or increased the number of public submissions. Instead, the study demonstrates that an educational intervention can be designed, assessed against clear criteria, revised using participant feedback and distributed through several channels.

The research received approval from the National Institute of Cardiology’s Research Ethics Committee, and participants gave informed consent. Brazil’s National Council for Scientific and Technological Development funded the work, without taking part in its design, analysis or publication decisions.

The findings matter because public and patient involvement is widely presented as a requirement for fair, patient-focused health technology assessment, yet technical processes can still exclude the people they are intended to serve. Participa SUS-ATS offers one tested model for narrowing that gap. Its results suggest that accessible language, audience-led revision and active promotion can make the foundations for participation stronger, even though sustained engagement remains difficult to achieve.