Community, Culture and Sustainability in Multilevel Dynamic Systems Intervention Science

Abstract

This paper addresses intertwined issues in the conceptualization, implementation and evaluation of multilevel dynamic systems intervention science (MDSIS). Interventions are systematically planned, conducted and evaluated social science-based cultural products intercepting the lives of people and institutions in the context of multiple additional events and processes (which also may be referred to as interventions) that may speed, slow or reduce change towards a desired outcome. Multilevel interventions address change efforts at multiple social levels in the hope that effects at each level will forge synergistic links, facilitating movement toward desired change. This paper utilizes an ecological framework that identifies macro (policy and regulatory institutions), meso (organizations and agencies with resources, and power) and micro (individuals, families and friends living in communities) interacting directly and indirectly. An MDSIS approach hypothesizes that change toward a goal will occur faster and more effectively when synchronized and supported across levels in a social system. MDSIS approaches by definition involve "whole" communities and cannot be implemented without the establishments of working community partnerships This paper takes a dynamic systems approach to science as conducted in communities, and discusses four concepts that are central to MDSIS--science, community, culture, and sustainability. These concepts are important in community based participatory research and to the targeting, refinement, and adaptation of enduring interventions. Consistency in their meaning and use can promote forward movement in the field of MDSIS, and in community-based prevention science.

County-level outcomes of a rural breast cancer screening outreach strategy: a decentralized hub-and-spoke model (BSPAN2)

“…As a result, spoke outreach reached local population niches through ORIGINAL RESEARCH community members sharing information about BSPAN with their informal social networks [26]. Local champions leveraged social networks to reach large numbers of community members; acting as opinion leaders, they also helped foster trust among other program partners, streamlining coordination with other stakeholders for promotional events [27]. The balance between centralized functions of scheduling or reimbursement and outreach tailored to local settings enabled the program hub to accommodate partner organization independence while retaining a key level of centralization necessary to broaden overall program uptake and increase individual opportunities for women to receive screening services.…”

A Systematic Review of Urban Sustainability Assessment Literature

“…Diverse scales were used based on the need to situate a city within a multi-scale context [35] and design sustainability interventions that integrate across spatial scales [36]. Including cases from diverse contexts around the world can create confusion for analysis, but ultimately excluding cases based on location would also lose valuable lessons and insights.…”

Understanding the Context of Health for Persons With Multiple Chronic Conditions: Moving From What Is the Matter to What Matters

“…[14][15][16] Context involves the many factors that influence a person's life, from the biology of interacting diseases or treatments, to the values and life goals of the individual and family, the health and functioning of family and friend caregivers, and relevant health care system factors, community resources, and policies. These multilevel, [17][18][19][20][21] complexly interacting factors are important for understanding MCC, for ensuring optimal benefit of preventive and therapeutic interventions, and for improving the lives of persons living with MCC.…”