System Dynamics Approaches and Collective Action for Community Health: An Integrative Review

Abstract

System dynamics (SD) methods, from qualitative causal loop diagramming to quantitative simulation modeling, have the potential to be powerful tools for engaging community stakeholders interested in improving health. However, the extent to which SD drives collective action to improve community health is unclear. The objective of this review was to understand how often, why, and how SD has been used by cross‐sector community collectives. Of 409 identified manuscripts describing application of SD to community health, only 31 (7.6%) documented cross‐sector collective use of these tools. All 31 had as a purpose using SD to better understand community health problems, but only seven (22.6%) documented a collective action taken as the result. In nine of the 31 articles (29.0%), no learning, decisions, or action was documented. The most common form of collective participation in SD work among the seven collectives reporting resulting action was building the SD model, with implementing a new program or practice the most frequently mentioned collective action resulting. Cost and access were the most common system outcomes studied, and chronic diseases and prevention were commonly mentioned as the focal health outcomes. Overall, SD methods seem underutilized for engaging cross‐sector collectives in addressing complex community health problems.

County-level Correlates of Dental Service Utilization for Low Income Pregnant Women. Ecologic study of the North Carolina Medicaid for Pregnant Women (MPW) program.

“…Pilot interventions have proven successful for improving oral health care service delivery [27]. Additional, policy opportunities may arise if discussions can be framed around community-level bene ts though a systems dynamic approach [25].…”

County-level Correlates of Dental Service Utilization for Low Income Pregnant Women. Ecologic study of the North Carolina Medicaid for Pregnant Women (MPW) program.

“…Perhaps these communities are places where better support systems are in place for low income pregnant women and this is contributing to better utilization of dental services in the MPW program. Future research should examine the patient-level and provider-level system dynamics (Cilenti et al 2019) that are linked to services provided by CCNC care coordinators to leverage the Pregnancy Medical Home model to more explicitly address oral health for pregnant women. Further work can build on the progress has been initiated to help pregnant women get dental services using an academic, interprofessional approach (Byrd et al 2019).…”

Effectiveness of Social Measures against COVID-19 Outbreaks in Selected Japanese Regions Analyzed by System Dynamic Modeling

“…System dynamics have often been used in health systems, and in addressing health problems such as obesity, diabetes, hypertension, mental health, mortality, smoking, infectious diseases, injury by violence, respiratory diseases, substance abuse, disability, quality of life, and maternal and child birth complications [2]. As an infectious disease, human immunodeficiency virus (HIV) transmission has been studied.…”

“…(1) Is a modeling approach effective in overcoming the lack of information (actual number of infected patients)? (2) What are the most important measures to prevent the spread of infection? (3) What are the factors that influence infection among societal factors (in demography and behavior)?…”