We are Natalie Wilkins and Shakiyla Smith from the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
As public health scientists and evaluators, we are charged with achieving and measuring community and population level impact in injury and violence prevention. The public health model includes: (1) defining the problem, (2) identifying risk and protective factors, (3) developing and testing prevention strategies, and (4) ensuring widespread adoption. Steps 3 and 4 have proven to be particularly difficult to actualize in “real world” contexts. Interventions most likely to result in community level impact are often difficult to evaluate, replicate, and scale up in other communities and populations.[i]
A systems framework for injury and violence prevention supplements the public health model by framing injury within the community/societal context in which it occurs.[ii] Communities are complex systems- constantly changing, self-organizing, adaptive, and evolving. Thus, public health approaches to injury and violence prevention must focus more on changing systems, versus developing and testing isolated programs and interventions, and must build the capacity of communities to implement, evaluate, and sustain these changes.[iii] However, scientists and evaluators face challenges when trying to encourage, apply, and evaluate such approaches, particularly in collaboration with other stakeholders who may have conflicting perspectives. A systems framework requires new methods of discovery, collaboration, and facilitation that effectively support this type of work.
- Evaluators can use engagement and facilitation skills to help stakeholders identify their ultimate goals/outcomes and identify the systems within which these outcomes are nested (Goodman and Karash’s Six Steps to Thinking Systemically provides an overview for facilitating systems thinking processes).
- Evaluators must also address and communicate around high-stakes, conflictual issues that often undergird intractable community problems. “Conversational capacity”[iv] is an example of a skillset that enables stakeholders to be both candid and receptive in their interactions around challenging systems issues.
- Finding Leverage: This video by Chris Soderquist provides an introduction to systems thinking and how it can be applied to solve complex problems.
- The Systems Thinker: Includes articles, case studies, guides, blogs, webinars and quick reference “pocket guides” on systems thinking.
i Schorr, L., & Farrow, F. (2014, November). An evidence framework to improve results. In Harold Richman Public Policy Symposium, Washington, DC, Center for the Study of Social Policy.
ii McClure, R. J., Mack, K., Wilkins, N., & Davey, T. M. (2015). Injury prevention as social change. Injury prevention, injuryprev-2015.
iiiSchorr, L., & Farrow, F. (2014, November). An evidence framework to improve results. In Harold Richman Public Policy Symposium, Washington, DC, Center for the Study of Social Policy.
iv. Weber, C. (2013) Conversational capacity: The secret to building successful teams that perform when the pressure is on. McGraw Hill Education: New York, NY
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