Developing indicators to evaluate systems thinking and application in state injury and violence prevention programs

Abstract

Systems thinking principles are increasingly recognized as an important part of public health research and practice. However, the extent to which systems thinking is being integrated into public health practice, and its impact on health outcomes, is largely unknown. This is in part due to the paucity of options for measuring systems thinking at the organizational level and in the context of public health practice. Building on existing frameworks of public health competencies, infrastructure, and systems thinking principles, this article proposes a conceptual model and corresponding indicators for measuring organizational systems thinking and application within state public health departments. We describe our process for developing this model and indicators, drawing from both research and practice‐based evidence on systems thinking, and offer a set of indicators for measuring organizational‐level systems thinking in the context of public health practice.

Systems thinking in practice when implementing a national policy program for the improvement of women's healthcare

“…There are challenges in studying how ST is manifested in practice. At the same time, identifying how ST can be expressed in actions and strategies is an important step in building knowledge about the practical application of ST in public health (22) and the mechanisms behind the effects of quality improvement initiatives (23). ST emphasized the coordination of interventions across multiple levels of change, e.g., individual, organizational, and community levels (24).…”

“…Operationalization of ST on the organizational level is also scarce. Indicators that can provide insights into how and to what extent organizations apply ST are limited or even seen as lacking, especially within the public health domain (22,47). Smith et al (47) have recently proposed a framework for ST in public health, which combines ST, collaborative inquiry and action, and systemic science and methods.…”

“…Smith et al (47) have recently proposed a framework for ST in public health, which combines ST, collaborative inquiry and action, and systemic science and methods. The framework is based on previous public health frameworks (48), and the framework's initial concepts (49) were further refined drawing on insights from public health scientists and practitioners with experiences from nine policy programs (22). It has been further operationalized and tested by Wilkins et al (22), and eight principles of a systems orientation have been proposed (Table 1).…”

“…The framework is based on previous public health frameworks (48), and the framework's initial concepts (49) were further refined drawing on insights from public health scientists and practitioners with experiences from nine policy programs (22). It has been further operationalized and tested by Wilkins et al (22), and eight principles of a systems orientation have been proposed (Table 1). Wilkins et al (22) also developed and tested quantitative indicators of the ST principles within organizations (i.e., state public health departments) focusing on the area of state injury and violence prevention.…”

“…It has been further operationalized and tested by Wilkins et al (22), and eight principles of a systems orientation have been proposed (Table 1). Wilkins et al (22) also developed and tested quantitative indicators of the ST principles within organizations (i.e., state public health departments) focusing on the area of state injury and violence prevention. Their attempt…”