Challenge	Core Issue
Clarity of roles and objectives	No reiteration after the initial session; ambiguity persists
Confidentiality	Restricted document access despite signed agreements
Participation and contribution	PPs’ input not systematically solicited
Language used	Acronyms and jargon hinder participation
Recognition of presence	Symbolic gaps (e.g., absence from website listing)
Healthcare system reform	Uncertainty linked to Santé Québec’s new security/confidentiality rules