Applying influence for systems change in a large-scale community-based prevention intervention

Bensberg, Monica

doi:10.17061/phrp30122005

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…(Although a coordinate professional development plan may have increased the reach of the training provided.) Nonetheless, the HTC practitioners' systems thinking capacity was built and they were aware of systems theory, and to varying levels able to apply the tools and undertake its practice . Perhaps this resulted from the strong organisational and structural factors such as supportive leaders, teams, policies and governance that legitimised health promoters' systems practice within the HTCs and local government .…”

Section: Discussionmentioning

confidence: 99%

“…For example, the different knowledge and skills of a coordinator working via adaptive leadership who might benefit from change management coaching versus a team leader facilitating system dynamics who might benefit from attending a group model‐building workshop, considering their place and purpose in the system . Initial planning for the practitioners' requirements, possibly via a needs assessment, may have assisted to better understand the professional development needs of the inaugural and inexperienced HTC workforce.…”

Section: Discussionmentioning

confidence: 99%

“…Practitioners were familiar with systems thinking tools and some had developed skills in applying them . They had trailed systems competencies such as recognising themselves as an active participant in the system, in addition to using trust and relationship‐based ways of working to achieve health‐promoting goals . Some practitioners had implemented systemic interventions that displayed their new practice arising from their HTV employment …”

Section: Introductionmentioning

confidence: 99%

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Building a systems thinking prevention workforce

Bensberg¹,

Allender

Sacks

2020

Health Prom J of Aust

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In the quest for more effective prevention, health promotion practitioners are becoming increasingly interested in the use of systems thinking to address the complexity of health problems. 1 Systems thinking is drawn from system sciences that are concerned with the interrelationships between system parts where the emphasis is on understanding the functioning whole, rather than focusing on individual components. 2 A systems approach moves the focus of health promotion activities away from a reductionist perspective to a holistic one, looking beyond what may appear to be isolated and independent events. 3 In application,

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Building a systems thinking prevention workforce

Bensberg¹,

Allender

Sacks

2020

Health Prom J of Aust

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“…Healthy Together Victoria (HTV) was a major state government-led initiative implemented in Victoria, Australia between 2011–2016, which aimed to deliver a multi-level, multi-setting complex systems approach to obesity prevention [ 38 , 39 ]. HTV represented a significant investment in obesity prevention by the Victorian Department of Health and Human Services (DHHS), with the vast majority of funding for HTV coming from the Australian Commonwealth Government through the now defunct National Partnership Agreement on Preventative Health [ 40 ].…”

Section: Methodsmentioning

confidence: 99%

Understanding the dynamics of obesity prevention policy decision-making using a systems perspective: A case study of Healthy Together Victoria

et al. 2021

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Introduction Despite global recommendations for governments to implement a comprehensive suite of policies to address obesity, policy adoption has been deficient globally. This paper utilised political science theory and systems thinking methods to examine the dynamics underlying decisions regarding obesity prevention policy adoption within the context of the Australian state government initiative, Healthy Together Victoria (HTV) (2011–2016). The aim was to understand key influences on policy processes, and to identify potential opportunities to increase the adoption of recommended policies. Methods Data describing government processes in relation to the adoption of six policy interventions considered as part of HTV were collected using interviews (n = 57), document analyses (n = 568) and field note observations. The data were analysed using multiple political science theories. A systematic method was then used to develop a Causal Loop Diagram (CLD) for each policy intervention. A simplified meta-CLD was generated from synthesis of common elements across each of the six policy interventions. Results The dynamics of policy change could be explained using a series of feedback loops. Five interconnected balancing loops served to reduce the propensity for policy change. These pertained to an organisational norm of risk aversion, and the complexity resulting from a whole-of-government policy approach and in-depth stakeholder consultation. However, seven virtuous reinforcing loops helped overcome policy resistance through policy actor capabilities that were improved over time as policy actors gained experience in advocating for change. Conclusion Policy processes for obesity prevention are complex and resistant to change. In order to increase adoption of recommended policies, several capabilities of policy actors, including policy skills, political astuteness, negotiation skills and consensus building, should be fostered and strengthened. Strategies to facilitate effective and broad-based consultation, both across and external to government, need to be implemented in ways that do not result in substantial delays in the policy process.

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“…Their work was adaptive within the local context, consistent with emergent practice [ 35 ]. They were testing systems thinking tools and skills to achieve health-promoting goals [ 41 , 42 ]. These previously inexperienced systems thinkers were grasping the new prevention agenda [ 43 ].…”

Section: Methodsmentioning

confidence: 99%

Building a Prevention System: Infrastructure to Strengthen Health Promotion Outcomes

Bensberg

Joyce

Wilson

2021

IJERPH

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Prevention systems improve the performance of health promotion interventions. This research describes the establishment of the Australian state government initiative, Healthy Together Victoria’s (HTV) macro infrastructure for the delivery of large-scale prevention interventions. Methods: This paper reports on findings of 31 semi-structured interviews about participants’ understanding of systems thinking and their reflections of the strengths and weaknesses of the HTV prevention system. A chronic disease prevention framework informed the coding that was used to create a causal loop diagram and a core feedback loop to illustrate the results. Results: Findings highlighted that HTV created a highly connected prevention system that included a sizeable workforce, significant funding and supportive leadership. Operating guidelines, additional professional development and real-time evaluation were significant gaps, which hindered systems practice. For inexperienced systems thinkers, these limitations encouraged them to implement programs, rather than interact with the seemingly ambiguous systems methods. Conclusions: HTV was an innovative attempt to strengthen health promotion infrastructure, creating a common language and shared understanding of prevention system requirements. However, the model was inadequate for HTV to achieve population-level reductions in chronic disease as system oversight was missing, as was an intervention delivery focus. Clarity was needed to define the systems practice that HTV was seeking to achieve. Importantly, the HTV prevention system needed to be understood as complex and adaptive, and not prioritized as individual parts.

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Applying influence for systems change in a large-scale community-based prevention intervention

Cited by 7 publications

References 12 publications

Building a systems thinking prevention workforce

Building a systems thinking prevention workforce

Understanding the dynamics of obesity prevention policy decision-making using a systems perspective: A case study of Healthy Together Victoria

Building a Prevention System: Infrastructure to Strengthen Health Promotion Outcomes

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