The System exChange
The System exChange provides powerful tips and ideas for transforming your local community.
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The last issue of the System exChange introduced the idea of targeted universalism and provided a series of tools and resources to help embed equity into local efforts.
Click here
for this last issue.
This week's System exChange introduces how to bring a systems approach into your local work.
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What is a systems approach to community change?
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Organizations and communities have been working to reduce social problems affecting health and well-being for decades. Unfortunately, most efforts face big challenges and many have failed to achieve their goals. Why is this?
Over the years, communities have realized that social problems are far more complex than we used to think (some even refer to them as “wicked” problems!) and require a different problem-solving approach. Complex social problems:
- Have multiple, interacting causes in the community
EX: health is impacted by access to employment, healthy food, housing, transportation, and education (Davis et al., 2016).
- Show up differently across places and groups of people
EX: community health problems can have different causes in urban areas and rural areas (Kneebone & Holmes, 2015).
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What's a more powerful approach to tackle complex problems?
Many communities are adopting a
Systems Approach
to enhance their community change efforts. This approach helps to:
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Address Root Causes
Instead of symptoms
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Addressing the multiple, interacting "root cause" reasons for why health inequities are happening (e.g., social determinants of health like lack of access to employment, healthy food, housing, transportation, quality education, etc.) is more likely to improve long-term outcomes than only treating the symptoms of poor health (e.g., through hospital visits).
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Change the System
Instead of just changing people
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Shifting conditions like policies, practices, connections, decision-making processes, and shared goals across the community is more likely to create sustainable systems changes than only focusing on building individuals' skills and knowledge (this is because when residents move or staff turnover, their new skills and knowledge move with them leaving no lasting change in the community).
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Adapt to Local Context
Instead of using a one-size-fits-all approach
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Designing change efforts to address the needs and opportunities within your local community context - and adapting these efforts over time - is more likely to shift outcomes than using a static, "one-size-fits-all" recipe-like approach (which may only work for some people and settings, some of the time).
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Practical Tips:
Talking with Others
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How can you talk with others about using a systems change approach?
Use the following talking points and images to help talk with others about how a systems approach could increase the power of local change efforts.
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Talking Points Set 1: Why a Systems Approach to Community Change?
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Foster-Fishman, Nowell, & Yang, 2007
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A common community problem-solving approach is to launch different interventions or evidenced-based programs to improve outcomes related to health and wellbeing (refer to green and blue squares in image below).
For example, many communities try to improve outcomes related to obesity by launching health literacy classes and providing discounts on produce at farmers markets.
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While these interventions and programs are important, they often don't take into account other barriers getting in the way of health.
For example, we know that health outcomes are also affected by a person's access to affordable housing, livable employment, quality education, and transportation (i.e., the social determinants of health) as well as the coordination of local services and the use resident voice to guide decision-making. (refer to the interacting orange boxes in image below)
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So what is an alternative approach?
Many communities are using what's called a systems change approach to improve local health and wellbeing outcomes.
A systems change approach can help us to understand the interacting "root cause" barriers getting in the way of local outcomes (i.e., the orange boxes), design powerful strategies to address multiple root causes at the same time, and continually improve and adapt our efforts over time.
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Talking Points Set 2: Program Focus vs. a System Focus
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Program Focus
- Isolated, uncoordinated efforts
- Emphasis on addressing immediate needs, not solving entrenched problems
- Program improvement and expansion
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System Focus
- Interdependent and interconnected
- "Our Clients" and "Our Partner" mindset
- Emphasis on solving entrenched problems by targeting root causes
- Shared feedback and learning
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Check out the following resources to learn more about using a systems lens to guide your work.
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The ABLe Change Manual
Refer to the ABLe Change manual for more information on using a community systems change approach. In particular, see pages 4-26, 111-181, and 214-280.
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by David Stroh has some great tools for understanding how local community conditions (e.g., the orange boxes) interact to cause targeted problems
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Talk to your CHIR about using a Community Systems Approach! Reach our to your CHIR backbone agency to share ideas, discuss complex problems, and take action.
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Statewide CHIR Discussion Topic:
How is your community using a systems approach to guide your local change efforts?
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ABLe Q&A
Q:
There are so many different root causes for why health inequities are happening in our community, it can feel overwhelming...what should we do?
A
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Prioritize which root causes are the most important for your group
to start with
(e.g., because they have a big impact on local health inequities, affect lots of people and settings in the community, motivate local partners to act, etc.), and then expand your efforts over time to address a wider scope of root causes. Also consider what new community partners should be engaged in your efforts to address a more comprehensive array of root causes.
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If you find this publication useful, forward to your colleagues and encourage them to
subscribe
!
Want access to more information about community transformation? Check out the
Michigan CHIR Learning website
!! This website includes information, tools, and resources to help support local collaborative efforts.
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August 2019
Have an idea for a future update? Email us at:
ablechangeteam@gmail.com
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References
Davis, R. A., Savannah, S., Harding, M., Macaysa, A., Parks, L. F., Aboelata, M., ... & Haar, W. (2016). Countering the Production of Health Inequities: A Framework of Emerging Systems to Achieve an Equitable Culture of Health Extended Summary. Prevention Institute, September.
Foster-Fishman, P. G., Nowell, B., & Yang, H. (2007). Putting the system back into systems change: A framework for understanding and changing organizational and community systems. American Journal of Community Psychology, 39(3-4), 197-215.
Kneebone, E., & Holmes, N. (2015). The growing distance between people and jobs in metropolitan America. The Brookings Institution, March. Retrieved August 23, 2018, from http://kedc.com/wp-content/uploads/2015/04/Brookings_JobCommuteDistance2015.pdf
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