Table 2.

Additional barriers and facilitators to engagement at the policy level

Description	Barriers	Facilitators
Communication skills	Patient engagement depends on the patient's ability to share their experiences. Lack of communication skills may hinder patient engagement in policy.	Education and encouragement of patient partners to voice their needs.
Judgement and blacklisting	Patient partners may feel judged for their experiences and opinions. Patient partners may not feel comfortable sharing their opinions because they are afraid it will impact the quality of, and access to, care. ‘Many seniors worried about being blacklisted, worried about payback from the hospital or if they go in to the local doctor… you'll never get a doctor again’. (Participant O004)	Mutual respect for patient perspectives. Building trusting relationships.
Time constraints and compensation	Work/personal commitments. ‘I'm not getting any time off work to be a patient advocate, but it is literally a part‐time job’. (Participant O006) Lack of incentive, reimbursement or honorarium to involve diverse populations, such as working individuals, youth and individuals from marginalized communities. ‘Why don't we offer some pay to the people who can't afford and then the rest of us can still be volunteers… it's always been, like, ‘well no, we have to do it for everybody’. And then, of course, nobody has the budget to pay everybody, right?’. (Participant O002)	Short‐term commitments (1 or 2 meetings) for committees for patients who may not be able to be regularly involved as it may interfere with important personal needs (e.g., work, family, health).
Knowledge and awareness	Patients/caregivers not already connected to engagement opportunities do not learn about them. Lack of efforts to reach patient partners, ‘There wasn't any public announcements that I'm aware of that looked for general members of the general public’. (Participant O004)	Awareness that these positions do not require patients to have previous knowledge about the health care system and that their personal experiences are valuable. Advertising engagement opportunities in social media, newspapers and on television.