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In designing the AF4Q program, RWJF viewed consumer engagement as one of the key drivers to improving the overall quality of health care in the United States. More specifically, AF4Q focused on improving patient self-management of health and health care, and encouraging consumer choice of high-quality health care providers. To achieve this, alliances integrated consumer voices into their leadership and decision-making, and convened consumer workgroups to develop implementation strategies. The AF4Q evaluation team explores the various aspects of this approach.