Operationalizing knowledge translation to strengthen patient and public participation in health technology assessment: a multicomponent intervention to support enabling environments for learning health systems in Brazil

Public participation in health technology assessment (HTA) is recognized as essential for legitimate, equitable and patient-centred health policy decision-making and constitutes a structural enabling condition for learning health systems. In Brazil, meaningful patient and public engagement in National Committee for Health Technology Incorporation (Conitec) public consultations remains constrained by low health literacy, technical jargon and scarce educational resources, limiting the participatory infrastructure that learning health systems require. We describe the Participa public health system-health technology assessment (SUS-ATS) project, a knowledge translation (KT) initiative combining a free virtual learning environment (VLE) with multichannel digital outreach to translate HTA knowledge for the general public. The project followed the knowledge-to-action framework across seven phases (2022–2025). Priority topics were identified through a survey with patient and civil society representatives, organized into thematic areas and adapted into educational video modules. Content was developed in plain language and validated through internal review by HTA researchers and a structured pilot evaluation (prespecified acceptability threshold of 70% across five domains), with user feedback directly informing content revisions. A free gamified VLE with animated videos and interactive activities was deployed alongside a multichannel dissemination strategy. A needs assessment survey ( n = 16) identified five thematic areas, which guided the development of 10 educational video modules. The pilot evaluation collected 430 responses, with acceptance rates of 75–97% across five domains; user feedback generated content revisions, including Brazilian Sign Language interpretation, glossary creation and format adjustments. The VLE recorded 4355 accesses, with module completion rates of 11.1–42.9%. The Instagram account grew 1200% (576–7514 followers) following a paid campaign, with reels reaching up to 47 000 views. LinkedIn reached 1778 followers and YouTube accumulated more than 5000 views. All content remained freely accessible after funding ended. The Participa SUS-ATS project demonstrated that a KT-informed, iteratively refined educational intervention is feasible and acceptable for translating HTA knowledge to patients and the public. High content acceptance, iterative user-driven improvement and rapid audience growth following a paid campaign support its potential as a replicable model for strengthening patient and public participatory capacity in HTA, and, by extension, as a structural enabling condition for participatory governance within learning health systems across low- and middle-income countries.