Qualitative System Dynamics Modeling to Support Community Planning in Opioid Overdose Prevention

Sabounchi, Nasim S.; Lounsbury, David W.; Iftikhar, Pulwasha; Lutete, Priscila; Trajkoska, Biljana; Estrada, Weanne Myrrh; El‐Bassel, Nabila; Rapkin, Bruce D.; Gilbert, Louisa; Hunt, Timothy; Goddard-Eckrich, Dawn; Feaster, Daniel J.; Huang, Terry T.‐K.

doi:10.1177/10497315221118109

Cited by 3 publications

(3 citation statements)

References 43 publications

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“…Group model building (GMB) is a participatory approach to SD modeling, which has been used to study a variety of complex social issues, including health disparities, structural racism, stigma, and opioid use [ 27 – 30 ]. Typical GMB programs bring together community members, experts, and other stakeholders to work together with modeling facilitators to build a shared understanding of the forces and feedback processes that explain a complex, dynamic problem [ 25 , 31 , 32 ].…”

Section: Methodsmentioning

confidence: 99%

Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options

Thompson,

Sabounchi,

Ali

et al. 2024

Harm Reduct J

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Background Good Samaritan Laws are a harm reduction policy intended to facilitate a reduction in fatal opioid overdoses by enabling bystanders, first responders, and health care providers to assist individuals experiencing an overdose without facing civil or criminal liability. However, Good Samaritan Laws may not be reaching their full impact in many communities due to a lack of knowledge of protections under these laws, distrust in law enforcement, and fear of legal consequences among potential bystanders. The purpose of this study was to develop a systems-level understanding of the factors influencing bystander responses to opioid overdose in the context of Connecticut’s Good Samaritan Laws and identify high-leverage policies for improving opioid-related outcomes and implementation of these laws in Connecticut (CT). Methods We conducted six group model building (GMB) workshops that engaged a diverse set of participants with medical and community expertise and lived bystander experience. Through an iterative, stakeholder-engaged process, we developed, refined, and validated a qualitative system dynamics (SD) model in the form of a causal loop diagram (CLD). Results Our resulting qualitative SD model captures our GMB participants’ collective understanding of the dynamics driving bystander behavior and other factors influencing the effectiveness of Good Samaritan Laws in the state of CT. In this model, we identified seven balancing (B) and eight reinforcing (R) feedback loops within four narrative domains: Narrative 1 - Overdose, Calling 911, and First Responder Burnout; Narrative 2 - Naloxone Use, Acceptability, and Linking Patients to Services; Narrative 3 - Drug Arrests, Belief in Good Samaritan Laws, and Community Trust in Police; and Narrative 4 - Bystander Naloxone Use, Community Participation in Harm Reduction, and Cultural Change Towards Carrying Naloxone. Conclusions Our qualitative SD model brings a nuanced systems perspective to the literature on bystander behavior in the context of Good Samaritan Laws. Our model, grounded in local knowledge and experience, shows how the hypothesized non-linear interdependencies of the social, structural, and policy determinants of bystander behavior collectively form endogenous feedback loops that can be leveraged to design policies to advance and sustain systems change.

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Section: Methodsmentioning

confidence: 99%

Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options

Thompson,

Sabounchi,

Ali

et al. 2024

Harm Reduct J

Self Cite

View full text Add to dashboard Cite

show abstract

“…The goals of participatory systems science approaches are to build a common vocabulary and agenda to describe a complex problem and its drivers, design potential solutions, and garner buy-in to implement the solutions that rise to the top after a range of options have been assessed with quantitative modeling approaches ( 40 ). For example, participatory systems science approaches have been applied to help community stakeholders in the HEALing Communities Study-New York State (HCS-NY) develop a shared understanding of the opioid crisis in order to inform local strategies for prevention and treatment ( 41 ). Community stakeholders who participated in the New York effort reported that the causal mapping approach helped them see the interconnectivity of complex factors, actors, and sectors and appreciate the need for multiple, mutually reinforcing strategies to avert opioid overdose and fatality.…”

Section: Addressing Complexity With Systems Sciencementioning

confidence: 99%

Section: Addressing Complexity With Systems Sciencementioning

confidence: 99%

Leveraging systems science and design thinking to advance implementation science: moving toward a solution-oriented paradigm

Huang,

Callahan,

Haines

et al. 2024

Front. Public Health

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Many public health challenges are characterized by complexity that reflects the dynamic systems in which they occur. Such systems involve multiple interdependent factors, actors, and sectors that influence health, and are a primary driver of challenges of insufficient implementation, sustainment, and scale of evidence-based public health interventions. Implementation science frameworks have been developed to help embed evidence-based interventions in diverse settings and identify key factors that facilitate or hinder implementation. These frameworks are largely static in that they do not explain the nature and dynamics of interrelationships among the identified determinants, nor how those determinants might change over time. Furthermore, most implementation science frameworks are top-down, deterministic, and linear, leaving critical gaps in understanding of both how to intervene on determinants of successful implementation and how to scale evidence-based solutions. Design thinking and systems science offer methods for transforming this problem-oriented paradigm into one that is solution-oriented. This article describes these two approaches and how they can be integrated into implementation science strategies to promote implementation, sustainment, and scaling of public health innovation, ultimately resulting in transformative systems changes that improve population health.

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Reframing the response to the opioid crisis: The critical role of resilience in public health

Roberts

2024

Open Health

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This analysis examines the opioid crisis in the United States as a significant public health challenge. It highlights the increasing prevalence of opioid misuse and overdose-related deaths over the past two decades, emphasizing the need for innovative and adaptive public health approaches to effectively address the crisis's root causes, mitigate its impacts, and support recovery for those affected. The inquiry focuses on resilience as a key concept in public health, exploring its relevance and application in responding to the opioid crisis. Resilience, understood as the capacity of individuals, communities, and systems to adapt and respond effectively to adversity, is presented as vital for enhancing public health preparedness, response, and recovery efforts. The goal of the article is to provide insights for policymakers, practitioners, and researchers on how to build resilience into public health systems and interventions to better confront the challenges posed by the opioid crisis.

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Qualitative System Dynamics Modeling to Support Community Planning in Opioid Overdose Prevention

Cited by 3 publications

References 43 publications

Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options

Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options

Leveraging systems science and design thinking to advance implementation science: moving toward a solution-oriented paradigm

Reframing the response to the opioid crisis: The critical role of resilience in public health

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