Transforming Intractable Policy Conflicts: A Qualitative Study Examining the Novel Application of Facilitated Discourse (Track Two Diplomacy) to Community Water Fluoridation in Calgary, Canada
Abstract
:1. Introduction
2. Methods
2.1. Aim and Design
2.2. Participants
2.3. Data Collection
2.4. Interpretation
3. Results
3.1. Contextual Factors of the CWF Debate
3.1.1. Issue
Binary Issue
“So, what is the goal? I’m sure we could find agreement, even across the most intractable individuals. I think the goal is good dental health. And then what are the steps that we need to take as a society to help us achieve that goal?”—Interview 5
“The conversation from public health is focused on fluoridation.... but it’s much broader than fluoridation. And yet it stays focused on that one thing which is the most polarizing thing. And so, I think we really missed the whole heart of the matter and that’s where I think we failed as leaders.”—Interview 5
Disciplinary Silos
Failed Public Engagement
3.1.2. Societal
Populism
“There’s two challenges that we currently face. One is the death of expertise—that I have an opinion and my opinion is the same as your opinion and concurrent with the second is the rise in populism. It is really challenging to make these decisions.”—Interview 21
“The project of Western Democracy was set up with the idea that we would have periodic competition with ideas for the right to govern, and… what’s happened is that we’ve become so skilled in that competition, that it’s become the canary that’s eaten the cat, and now instead of competing for the right to govern, the governing is in active constant competition, and that is an existential threat to the entire makeup of our society.”—Interview 4
“Are you making a decision that’s rooted in the data, in the science and the ethics of what you’re supposed to do or are you doing it because you’re worried about getting re-elected—and that’s when your ethics goes right out the door.”—Interview 1
“You are rewarded as a politician for doing what is popular. What is popular is not always right.”—Interview 21
Lack of Disposition to Dialogue
3.1.3. Individual
Adverse Impact of Conflict
“And so, [period of time] ago, I would have told you, “Diversity is strength,” but right now, being the different one, being the diverse one, has taken a serious toll, personally and workwise …. I’m not gonna lie.”—Interview 19
“I’m not scared of it. And like I said, not worried about my reputation. But for younger people who are involved in this, this is what really has been upsetting to me.”—Interview 18
“Things that happen that I don’t agree or, uh, makes me a little upset or frustrated but no, it’s just the nature of the job. (Laughs). It happens everywhere, and at the personal level, I don’t see anything.”—Interview 8
Extreme and Rigid Positions
“Both sides often think that that they’re open to persuasion and that they’re open—but in practice I have found that they’re not amenable because they’re only willing to trade with others who are on the same level of discourse as them. And this problem happens a lot.”—Interview 21
“Dental health promotion has been recommending water fluoridation for decades. And to [potentially] all of a sudden reverse course is just one of those seminal moments that every professional must feel incredible anxiety about. Because this is something that they’ve been telling the community for years.”—Interview 16
“Just asking questions and trying to figure out the balance of evidence—classic systematic review type questions like: here are some doubts—what should the future look like in terms of asking the right questions? You can’t do that with [this issue], right.”—Interview 13
“I think the perception was when we entered the room that there was already a position, and when it was clear that this was more neutral and maybe they had anticipated, there was a willingness to engage in the conversation.”—Interview 3
“A community of anti-fluoridation folks have been beating this drum against water fluoridation, but some of it on pretty shoddy science which stoked passions for decades and created these polarized communities.”—Interview 16
“I’m struck right now by the amount of people that cannot be moved positionally. I’m stunned, I don’t get it.”—Interview 20
Issue Fatigue and Apathy
“I think with people like me, you’ve reached a point of fatigue. Like I, I’m so sick and tired of doing the same thing over and over again, and that’s what we do. We will do this all over again.”—Interview 1
Lack of Humility
“You have to have leadership that’s interested in practicing some humility, to not always have to win and understand that sometimes losing on your idea actually results in a better solution, but that’s not what we have. I would say globally, we do not have political systems that operate on that level. Everything’s a show of force.”—Interview 1
“A flaw in reasoning is the fact that we tend to think we know more than we do. I, myself have found that when I say, “Oh, look, the literature shows that it saves 0.5 of the tooth surface” and I’ll say, “Oh that looks like a very small effect”. And then, it’s my colleague who is the dentist will correct my thinking and say, “Actually, that’s a large effect”. And explain it to me in a way that I didn’t think of at a population level and how maybe one cavity then is predictive of other cavities over the lifespan. So, I think humans are just motivated to pretend that they know more than they actually do. And we’re not aware of our limitations. It’s not intentional; it’s just that we are not aware of what we don’t know the gaps are in our knowledge.”—Interview 7
3.1.4. Policy-Making
Perceived Lack of Leadership
“Procedurally, you know that if you have eight votes, you don’t have to listen to anybody else. It’s just easy. And so, do you want to make quick, easy decisions as a politician? A hundred percent you do because it’s easy.”—Interview 1
“Now that Notice of Motion has become a tool to say, I have 10 people who signed onto this. So, you know what? Screw you guys. I don’t care that you don’t like this. I’ve already got my 10 votes. Let’s go. That’s how we do things. It is very much bravado. It is very much chest thumping, it’s performative. It is theatre at its best. It’s not good decision-making.”—Interview 1
Lack of Forum to Dialogue
“They say technically the lawyers have advised that if eight of us in Niagara Falls or wherever the hell we happen to be, decide to get together at a bar and say that everybody’s gotta wear socks in the city tomorrow, we could pass a bylaw that everybody has to wear [redacted] socks. Which is ridiculous.”—Interview 18
“It’s systemic; the inability to make a decision using a proper tool or method is what gets in our way.”—Interview 1
“You will never have a durable political decision because that’s not what we do. We don’t make decisions based on facts. We make decisions based on going through this whole process of, if I do this, what will happen? If I do that what will happen? If I just wait and see how the others are gonna vote, does that put me in a better position? That’s what politicians do.”—Interview 1
Polarization and Silos
“You can’t ask a question without immediately trying to put you into one side or the other, right?”—Interview 13
“The conversation has been framed as binary… either you believe in it or you don’t, it’s good or it’s bad, it’s right or it’s wrong, you do it or you don’t, there’s, there’s been very little space in the middle for what else it could look like.”—Interview 3
3.2. Designing a Track Two Process
3.2.1. General Structure
Reframe to a Nonbinary Issue
“If we can have a conversation about how that entire thing could look, like thinking of this as children’s health.... I think that as long...as we could get everyone on the same page of figuring out what that [umbrella topic] is, then for sure I think the conversations within it would be much more productive.”—Interview 21
Need for a Skilled Facilitator and a Deliberate Process
“You need a thoughtfully designed agenda, so that it’s very clear what, what they’re there to discuss. There may need to be a, a kind of caucusing or pre-conversation before bringing anybody together. And probably throughout—a kind of facilitation—going apart, coming together, going apart, coming together and, and actively working with the groups in the apart phase as well.”—Interview 3
“The facilitator sets the tone around participation in wanting to hear from and seek out different voices…”—Interview 20
“Throughout the meeting, there needs to be a commitment from people at the table that we are going to treat all members with dignity and respect and provide a safe space for people to be vulnerable and listen.”—Interview 24
Begin with Academics
“I would feel more comfortable with academics first…it’s, it’s an added layer of complexity to bring the public who may not have the training to understand what we’re saying. I mean, if we speak a common language and we don’t understand each other anyway, it’s complex to bring in somebody who doesn’t.”—Interview 19
“I have mixed feelings about people who are too close to the science.”—Interview 7
“As an academic in that conversation, regardless of how I’m presenting myself or to what extent my identity is disclosed, I still will want to put my best foot forward and have at least a more open conversation than just, oh, I’m gonna dismiss everything you’re saying or just stick in my heels and refuse to listen.”—Interview 13
“You need some scientists who are senior. Senior as being unbiased who would take enough interest or been recruited to essentially be impartial by conveners of the discussion.”—Interview 16
“…we wanna have a balance of bias, not balance of conflict.”—Interview 6
“At some point, all of that needs to be brought together in some kind of a national strategy, uh, federal strategy, to protect children from tooth decay. And, and at some point, we have to broaden that out beyond fluoride because focusing solely on fluoride is just idiotic.”—Interview 6
Generate Bundles of Solutions
“With most complex problems, there is not a single bullet policy intervention that’s gonna solve it. So, for us to believe (in) that one single policy intervention is problematic. It is the multitude of voices around the table that bring different options forward, thinking about how to collectively get to that outcome, where we can bring multiple solutions forward that would work in concert with one another, not compete with one another.”—Interview 20
Hold Multiple Tracks of Conversations
“…hold a series of these discourses so the transfer occurs naturally because you have a multiple, um, conversations that may all each go different directions, but along the way, there’s better understanding of the issues than each other.”—Interview 17
3.2.2. First Theory of Change in CWF
Changing Personal Attitudes and Relationships
Changing Culture
“I mean, women are typically the ones who look after and care for kids in most different societies, but it is the men who make the decisions on whether to allow that to happen or not in some cultures. And so, how do you hear the voice and concerns of the mom that’s raising the child and what they see is happening and the father who is ultimately determining whether the child gets [intervention] or not.”—Interview 2
“…reality is that we need an epochal shift in our governance structure to reflect our current reality, which is 180 degrees different from the governance environment when we first set things up.”—Interview 4
3.2.3. Evaluation
“Wouldn’t the success be the, that orders of government adopt the measures that are recommended?”—Interview 5
“Say we came up with a [Track Two process] and just start using fluoride as an example of how to solve that problem and then how to use the way we solve that problem to develop a framework of how society interacts with science.”—Interview 15
“Do I feel like I’m being heard? Do I feel that we’re working towards whatever shared goals that we originally [set].”—Interview 21
“That it’s not just talking heads or that people who are there to represent specific scientific expertise or a health agency, that it was … mothers, who are gonna be the ones impacted by the decisions made in this group.”—Interview 6
“You have to look back at the process several years later to see if you got it right.”—Interview 18
3.2.4. Anticipated Benefits of such a Dialogue
Generative
“It has to be part of the future because I really am concerned that if we don’t figure this out or figure something out and try something that I just fear for the future of democracy.”—Interview 21
“It feels like these intractable conflicts just go in circles in some way. And so disrupting that and kind of breaking it up and bringing in other people, I think that’s exactly what we need—getting people to think through something rather than default to just a position.”—Interview 11
Steward Common Purpose
“I think if you’d started with the outcome around healthy teeth and a full health perspective, a physical health perspective, and you focused on the outcome that you were seeking as opposed to the intervention and whether or not you support the intervention, that might be an entirely different dialogue.”—Interview 20
Cautious Optimism
“In conflict situations war, it’s been successful, but both parties have no choice, but to come the table because they can’t go on in, in a serious conflict, they can’t go on like that. But in these discussions of policy and health, how do we make it so people have a vested interest to have that conversation and to be open to those ideas and move from their position.”—Interview 9
“The more we can do on the human side, I think the better. But the more that fails on the human side, the more we hate each other too. So, (laughs) you know, when you try and reconcile with someone on a personal level, and if, if it doesn’t work out, it almost reinforces that people are unreasonable. It never works out.”—Interview 21
“In an international colonized environment and someone with very strong colonial approaches, then there are, there’s an ethical factor there in how you’ve set the table for different people to participate to come at, to come at a challenge. And then, there would be different factors around gender, around inclusion.”—Interview 19
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Bharwani, A.; Federer, J.P.; Roach, P.; Jones, P. Health in All Policies—From Dream to Reality through Track Two Diplomacy. PLOS Blogs. Available online: https://speakingofmedicine.plos.org/2022/03/18/health-in-all-policies-from-dream-to-reality-through-track-two-diplomacy/ (accessed on 15 March 2023).
- Tonelli, M.; Tang, K.C.; Forest, P.G. Canada needs a “Health in All Policies” action plan now. Can. Med. Assoc. J. 2020, 192, 61–67. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Head, B. Understanding “Wicked” Policy Problems. Policy Options. Available online: https://policyoptions.irpp.org/magazines/january-2018/understanding-wicked-policy-problems/ (accessed on 24 February 2023).
- Harding, S. Whose Science? Whose Knowledge? Thinking from Women’s Lives; Cornell University Press: Ithaca, NY, USA, 2016; ISBN 978-0801497469. [Google Scholar]
- Meyer, R.E.; Quattrone, P. Living in a post-truth world? Research, doubt, and organization studies. Organ. Stud. 2021, 42, 1373–1383. [Google Scholar] [CrossRef]
- Funtowicz, S.O.; Ravetz, J.R. Science for the post-normal age. Futures 1993, 25, 739–755. [Google Scholar] [CrossRef]
- Hindenlang, K.E.; Heeb, J.; Roux, M. Sustainable coexistence of ungulates and trees: A stakeholder platform for resource use negotiations. In Handbook of Transdisciplinary Research; Hadorn, G.H., Hoffman-Reim, H., Biber-Klemm, S., Grossenbacher-Mansuy, W., Joye, D., Pohl, C., Eds.; Springer: Dordrecht, The Netherlands, 2008; pp. 315–326. [Google Scholar]
- Fanelli, D. How many scientists fabricate and falsify research? A systematic review and meta-analysis of survey data. PLoS ONE 2009, 4, e5738. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Latour, B. The politics of explanation: An alternative. In Knowledge and Reflexivity: New Frontiers of in the Sociology of Knowledge; Woolgar, S., Ed.; Sage Publications: Newbury Park, CA, USA, 1988; pp. 155–176. [Google Scholar]
- Bharwani, A.; Billington, E.; Boulet, F.; Cabaj, J.; Day, J.; Elliott, C.; Fernandez, P.B.; Ganesh, A.; Ghali, W.; Hardcastle, L.; et al. Community Water Fluoridation: A Report for Calgary City Council; University of Calgary O’Brien Institute for Public Health: Calgary, AB, Canada, 2019. [Google Scholar]
- Bharwani, A.; Palmiano, F.J.; Latour, J. Healing dialogue: Can the techniques and practices of Track Two diplomacy play a role in resolving public health conflicts? Int. J. 2022, 77, 313–334. [Google Scholar] [CrossRef]
- Olson, R. The Politics of Water Fluoridation from a Problem Definition Perspective. Ph.D. Thesis, Northeastern University, Boston, MA, USA, 2008. Available online: https://repository.library.northeastern.edu/files/neu:1887/fulltext.pdf (accessed on 7 July 2023).
- Biswas, M.R.; Alzubaidi, M.S.; Shah, U.; Abd-Alrazaq, A.A.; Shah, Z. A Scoping Review to Find out Worldwide COVID-19 Vaccine Hesitancy and Its Underlying Determinants. Vaccines 2021, 9, 1243. [Google Scholar] [CrossRef] [PubMed]
- Jones, P. Track Two Diplomacy in Theory and Practice; Stanford University Press: Stanford, CA, USA, 2015; ISBN 978-0804796323. [Google Scholar]
- Conflict Resolution Relies Increasingly on Diplomatic Back Channels. The Economist. Available online: https://www.economist.com/international/2020/01/21/conflict-resolution-relies-increasingly-on-diplomatic-back-channels (accessed on 12 April 2023).
- Federer, J.P. Policy Brief 1: “Is There a New Track Two? Taking Stock of Unofficial Diplomacy in Peacemaking”. Ottawa Dialogue. Available online: https://ottawadialogue.ca/news-events/resource/policy-brief-is-there-a-new-track-two-taking-stock-of-unofficial-diplomacy-in-peacemaking-by-dr-julia-palmiano-federer/ (accessed on 10 April 2023).
- Neuman, L. Social Research Methods: Qualitative and Quantitative Approaches, 7th ed.; Pearson: Boston, MA, USA, 2007. [Google Scholar]
- D’Estrée, T.P.; Fox, B.B. Incorporating Best Practices into Design and Facilitation of Track Two Initiatives. Int. Negot. 2021, 26, 5–38. [Google Scholar] [CrossRef]
- Fisher, R.J. Transfer Effects from Problem-Solving Workshops to Negotiations: A Process and Outcome Model. Negot. J. 2020, 36, 32. [Google Scholar] [CrossRef]
- Ross, M.H. Creating the conditions for peacemaking: Theories of practice in ethnic conflict resolution. Ethn. Racial Stud. 2000, 23, 1002–1034. [Google Scholar] [CrossRef]
- Kelman, H.C. Evaluating the contributions of interactive problem solving to the resolution of ethnonational conflicts. Peace Confl. J. Peace Psychol. 2008, 14, 29–60. [Google Scholar] [CrossRef]
- Jones, P. Talking for the Sake of it, or Making a Difference? Measuring and Evaluating Track Two Diplomacy. In New Directions in Peacebuilding Evaluation; D’Estrée, T.P., Ed.; Rowman & Littlefield: New York, NY, USA, 2019; ISBN 978-178661244. [Google Scholar]
- Shapiro, I. Theories of Change. In Beyond Intractability; Burgess, G., Burgess, H., Eds.; Conflict Information, Consortium University of Colorado: Boulder, CO, USA, 2005. [Google Scholar]
- Paffenholz, T. Civil society and peace negotiations: Beyond the inclusion-exclusion dichotomy. Negot. J. 2014, 30, 69–91. [Google Scholar] [CrossRef]
- Paffenholz, T.; Zartman, I.W. Inclusive peace negotiations—From a neglected topic to new hype. Int. Negot. 2019, 24, 1–6. [Google Scholar] [CrossRef]
- Nilsson, D. Anchoring the peace: Civil society actors in peace accords and durable peace. Int. Interac. 2012, 38, 243–266. [Google Scholar] [CrossRef]
- Krause, J.; Krause, W.; Bränfors, P. Women’s participation in peace negotiations and the durability of peace. Int. Interac. 2018, 44, 985–1016. [Google Scholar] [CrossRef] [Green Version]
- McLaren, L.; Petit, R. Universal and targeted policy to achieve health equity: A critical analysis of the example of community water fluoridation cessation in Calgary, Canada in 2011. Crit. Public Health 2018, 28, 153–164. [Google Scholar] [CrossRef] [Green Version]
- Fisher, R. Paving the Way: Contributions of Interactive Conflict Resolution to Peacemaking; Lexington Books: New York, NY, USA, 2005; ISBN 978-0739112274. [Google Scholar]
- Johnson, S. Where Good Ideas Come from; Riverhead Books: New York, NY, USA, 2011. [Google Scholar]
- Kahneman, D. Experiences of collaborative research. Am. Psychol. 2003, 58, 723–730. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Snowden, D.J.; Boone, M.E. A Leader’s Framework for Decision Making. Harvard Business Review. Available online: https://hbr.org/2007/11/a-leaders-framework-for-decision-making (accessed on 7 July 2023).
Issue | Societal | Individual | Policy-Making |
---|---|---|---|
Binary Issue | Populism | Adverse Impact Of Conflict | Perceived Lack Of Leadership |
Disciplinary Silos | Lack of Disposition To Dialogue | Extreme and Rigid Positions | Lack of Forum To Dialogue |
Failed Public Engagement | Issue Fatigue and Apathy Lack of Humility | Polarisation and Silos |
General Structure | First Theory of Change | Evaluation | Anticipated Benefits |
---|---|---|---|
Reframe to Nonbinary Issue | Changing Personal Attitudes and Relationships | Driven by Theory of Change | Generative |
Need for a Skilled Facilitator and a Deliberate Process | Changing Culture | Steward Common Purpose | |
Begin with Academics | Cautious Optimism | ||
Generate Bundles of solutions | |||
Hold Multiple Tracks |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Bharwani, A.; Van Dyke, J.; Santamaria-Plaza, C.; Palmiano Federer, J.; Jones, P. Transforming Intractable Policy Conflicts: A Qualitative Study Examining the Novel Application of Facilitated Discourse (Track Two Diplomacy) to Community Water Fluoridation in Calgary, Canada. Int. J. Environ. Res. Public Health 2023, 20, 6402. https://doi.org/10.3390/ijerph20146402
Bharwani A, Van Dyke J, Santamaria-Plaza C, Palmiano Federer J, Jones P. Transforming Intractable Policy Conflicts: A Qualitative Study Examining the Novel Application of Facilitated Discourse (Track Two Diplomacy) to Community Water Fluoridation in Calgary, Canada. International Journal of Environmental Research and Public Health. 2023; 20(14):6402. https://doi.org/10.3390/ijerph20146402
Chicago/Turabian StyleBharwani, Aleem, Jessica Van Dyke, Cristina Santamaria-Plaza, Julia Palmiano Federer, and Peter Jones. 2023. "Transforming Intractable Policy Conflicts: A Qualitative Study Examining the Novel Application of Facilitated Discourse (Track Two Diplomacy) to Community Water Fluoridation in Calgary, Canada" International Journal of Environmental Research and Public Health 20, no. 14: 6402. https://doi.org/10.3390/ijerph20146402