Endogenous wisdom in action - the positive deviance approach: an alternative conceptualization of communication and social change praxis

Singhal, Arvind; Sternin, Monique; Shafique, Muhammad; Durá, Lucía

doi:10.4337/9781789906356.00017

Cited by 4 publications

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“…From the standpoint of the discipline of communication, there is much to learn from the pandemic success of countries such as Bhutan, Vietnam, Rwanda, and Senegal and failures of countries such as the USA. The Bhutanese response represents what one would call a ‘positive deviant’ case: Positive because they were able to successfully protect their citizens, and Deviant as their early, comprehensive, and relentless response was non-normative, especially considering their resource-poor status (Dearing & Singhal, 2020; Singhal, 2021; Singhal & Svenkerud, 2018; 2019). In contrast, the pandemic failure of the USA is an extreme case of negative deviance.…”

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confidence: 99%

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The Role of the Communication Discipline to Tackle COVID-19: Interrogating Positive Deviations and Critical Discourses

Singhal

Kim

2021

Journal of Creative Communications

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The COVID-19 pandemic descended on us in an unexpected, uncontrollable, and unpredictable manner, disrupting the world order and affecting all sectors of human society. The world had little time to prepare for the ravages of a novel and highly infectious coronavirus. By February 2021, some 112 million people had contracted COVID-19 globally, and 2.5 million had died. Even with the availability of vaccines at warp speed, and vaccination efforts rolling out in early 2021, it is still uncertain how the pandemic-with all its highly infectious mutant variants-would play out. No one knows with any certainty what the endpoint will be, and what lies ahead.Since the spread of the COVID-19 was uncontrollable from the beginning, and little was known about the novel virus, the pandemic response has varied greatly at the global, national, and regional levels. Remarkably, several scientifically advanced countries had dismal pandemic responses, notably the USA and the UK. The U.S. arguably had the worst response, accounting for 25% (28 million) of the global COVID-19 cases, and 20% (500,000) of the deaths. In contrast, several developing countries of Asia and Africa have done a remarkable job of controlling COVID-19 with scant resources. For instance, to date, Bhutan has recorded only one death among its population, and Vietnam, Rwanda, and Senegal have, respectively, recorded 35, 226, and 700 deaths (Drexler, 2021).While the reasons for pandemic success vary from country-to-country, the key reasons for success centre around various communicative functions-the exercise of political will through the setting of media and public agendas (Dearing & Rogers, 1996), attentive and compassionate leadership with safety nets for the most vulnerable (Singhal & Rogers, 2003), clear cut publichealth guidance (Kim et al., 2014), early and relentless contact-tracing of people's social networks, and a shared understanding of the value of preventive practices such as quarantining, social distancing, masking, and hand hygiene (Kim, 2020;Kim & Kreps, 2020).Unlike the disastrous leadership of Donald Trump in the USA, in Bhutan, King Jigme Khesar Namgyel Wangchuck set the policy, media, and public agenda for COVID-19 right off the bat by telling government officials that even one death was too many, that detailed plans be made,

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confidence: 99%

“…It had zero COVID-19 infection among its 106 residents with an average age of 87 years. This is a remarkable pandemic success story in the country of France where 37% of all COVID-19 occurred in nursing homes (Singhal, 2021). What did Vilanova do—that is, its uncommon positively deviant communicative practices—that other nursing homes did not?…”

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confidence: 99%

The Role of the Communication Discipline to Tackle COVID-19: Interrogating Positive Deviations and Critical Discourses

Singhal

Kim

2021

Journal of Creative Communications

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“…Positively deviant groups or individuals within health systems are high performers who do things differently. The positive deviance approach was first articulated within international public health literature 25‐27 during the 1990s, where it was applied toward a 74% reduction in severe childhood malnutrition over 3 years in Vietnam 25,28,29 . While quality improvement efforts tend to emphasize deficits and remediation of underperformance, a positive deviance approach focuses on the identification of high performers to analyze these performers and learn from their example 25 .…”

Section: Positive Deviance In the Age Of The Ehrmentioning

confidence: 99%

“…While quality improvement efforts tend to emphasize deficits and remediation of underperformance, a positive deviance approach focuses on the identification of high performers to analyze these performers and learn from their example 25 . Positive deviance approach can be an inward exercise where the wisdom to solve a problem is sought from within the organization, system, or network of units and is led by internal change agents 29 . It can also involve the sharing of that wisdom across similar institutions and settings, for an even broader impact.…”

Section: Positive Deviance In the Age Of The Ehrmentioning

confidence: 99%

Learning health system, positive deviance analysis, and electronic health records: Synergy for a learning health system

Azar

Pletcher

Greene

et al. 2022

Learning Health Systems

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Introduction: Over the past decade, numerous efforts have encouraged the realization of the learning health system (LHS) in the United States. Despite these efforts, and promising aims of the LHS, the full potential and value of research conducted within LHSs have yet to be realized. New technology coupled with a catalyzing global pandemic have spurred momentum. In addition, the LHS has lacked a consistent framework within which "best evidence" can be identified. Positive deviance analysis, itself reinvigorated by recent advances in health information technology (IT) and ubiquitous adoption of electronic health records (EHRs), may finally provide a framework through which LHSs can be operationalized and optimized. Methods:We describe the synergy between positive deviance and the LHS and how they may be integrated to achieve a continuous cycle of health system improvement.Results: As we describe below, the positive deviance approach focuses on learning from high-performing teams and organizations. Conclusion: Such learning can be enabled by EHRs and health IT, providing a lens into how digital clinical interventions are successfully developed and deployed.

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“…The positive deviance (PD) concept is an approach to behavioural and social change based on the observation that in any community there are people (positive deviants) whose uncommon but successful behaviours or strategies enable them to find better solutions to a problem than their peers, despite facing similar challenges and having no additional resources or knowledge than their peers [13,14]. It involves partnering with communities to develop case definitions and identify positive deviants who are engaged to identify potential enabling factors for outcomes of interest.…”

Section: Introductionmentioning

confidence: 99%

“Against all Odds”-Increasing Demand and Uptake of Immunization Services Among Non-Fully Immunized Children in Northern Nigeria Using a Positive Deviance Approach: Implementation Science Research

Azurunwa¹,

Yusuf²

2023

J Viro Res Rep

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Introduction: Children still die from vaccine-preventable diseases. Nigeria contributes 30% of unimmunized children <5 years globally. This study was conducted in 4 Local Government Areas (LGA) in Niger and Gombe States employing the positive deviance (PD) approach to increase vaccination demand in low child immunization coverage settings. Methodology: The was a quasi-experimental study, conducted between December 2019 and April 2021, comparing pre- and post- intervention vaccination uptake after 5 months of intervention among 400 caregivers of non-fully immunized children (CNFIC). We trained 40 caregivers of fully immunized children (CFIC) as mentors using a participatory learning and action tool. The CNFIC were matched in ratio 10:1 with CFIC and exposed to 8 impact meetings and 10 home-visits using communication materials to increase vaccination knowledge. Paired T-test and adjusted odd ratios from logistic regression models were used to determine change in immunization uptake and factors associated with full immunization for age, respectively. Result: A total of 343 CNFIC were successfully followed up during intervention. The age range of children in the study was 2 to 12 months with the female (178) slightly more than the male (165). The mean vaccine uptake rate increased from 43.7% to 85.9% (T= -29.3, P<0.005) with 55.4% fully vaccinated for age post-intervention. Safer LGA residence, being a housewife caregiver, and younger caregivers <30 years were positive determinants of full vaccination. Conclusion: Adopting the PD approach to low uptake vaccination settings can increase vaccination demand and coverage. This approach can be leveraged in other public health challenges.

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Endogenous wisdom in action - the positive deviance approach: an alternative conceptualization of communication and social change praxis

Cited by 4 publications

References 0 publications

The Role of the Communication Discipline to Tackle COVID-19: Interrogating Positive Deviations and Critical Discourses

The Role of the Communication Discipline to Tackle COVID-19: Interrogating Positive Deviations and Critical Discourses

Learning health system, positive deviance analysis, and electronic health records: Synergy for a learning health system

“Against all Odds”-Increasing Demand and Uptake of Immunization Services Among Non-Fully Immunized Children in Northern Nigeria Using a Positive Deviance Approach: Implementation Science Research

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