Community Level Strategic Planning Using System Dynamics Modeling

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Community Level Strategic Planning UsingSystem
Dynamics Modeling

• Javier Carrillo, MPH
• Area Health Promotion Specialist
• 2008 CDC Diabetes Translation Conference
• Orlando, FL
• Wednesday, May 7, 2008

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Learning Objectives

• Describe the use of System Dynamics Modeling
  (SDM) in facilitating community level strategic
  planning.
• Share lessons learned from the pilot project.

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California Community Pilot Hypothesis

• The diabetes model can facilitate development of
  a shared understanding of the diabetes system
  across diverse disciplines, leading to
  coordinated action among diverse stakeholders in
  a community setting.

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Conceptual Framework of SDM
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Unique Features of CA pilot

• Present the model in a community setting
• Regional Diabetes Collaborative of Monterey, San
  Benito, and Santa Cruz Counties
• Existing collaborative seeking reinvigoration
• Individual within collaborative interested in SDM
• Share model insights in a unique way
• Learning lab preview lessons learned
• Train community stakeholders to make the
  presentation
• Test facilitators guide
• Competencies needed

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San Benito, Santa Cruz and Monterey Counties
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RDC Workshop Planning Team
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Strategic Planning Workshop

• Morning Workshop Session
• Data on burden of diabetes in the 3 counties
• Population Flow Map and bathtub dynamics
• Resource mapping onto Population Flow Map
• Exploration of various what if scenarios using
  predetermined model runs (model calibrated to
  California data)
• Upstream only focus exclusively on obesity and
  pre-diabetes
• Downstream only focus exclusively on diabetes
  detection and management
• Balanced approach focus both upstream and
  downstream

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Diabetes System Dynamics Model Population Flow
Map
Burden of diabetes
Total Prevalence (People with diabetes)
Costs per person with diabetes
Unhealthy days per person with diabetes
Diabetes Onset
Deaths
Diagnosis
People with
People with
Diagnosed
Pre-diabetes
Diabetes
Deaths
Version used in CA Community Pilot
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Model Runs Taking a Balanced Approach
Unhealthy Days
Total Prevalence
700
175
D
B
B
150
600
Balanced
U
U
125
D
Monthly unhealthy days from diabetes per thousand
500
Balanced
People with diabetes per thousand adults
100
400
75
300
50
1980
1990
2000
2010
2020
2030
2040
2050
1980
1990
2000
2010
2020
2030
2040
2050
B Baseline U Upstream Only D Downstream
Only
Prevalence rises more slowly Unhealthy days
rises more slowly
Used in CA Community Pilot
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CA SDM Pilot Evaluation Plan

• Pre/post survey measures
• Length of membership/role in collaborative
• Previous exposure to SDM
• Collaborative functioning
• Perceptions of collaborative allocation of effort
• Obesity (reduction, pa, nutrition), pre-diabetes,
  diabetes detection, diabetes treatment
• Model learning outcomes
• Usefulness of morning session to strategic
  planning (post only)
• Key informant interviews
• Strategic planning consultants (n2)
• Community members trained to make SDM
  presentation (n2)
• Key members of RDC (n8)

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Pre-Post Survey

• Model Learning Outcomes
• After participating in the workshop, participants
  better understood
• Increase in diabetes prevalence coming from
  success with disease management
• Delay between obesity success and changes in
  prevalence
• Usefulness of morning session to strategic
  planning (successfully communicated/useful for
  strategic planning)
• What drives the burden (4.24/4.00)
• Identification of gaps, strengths, etc.
  (3.67/3.71)
• Realize interconnectedness of stakeholders
  (3.86/3.75)
• Understand importance of balanced approach
  (4.63/4.32)

Scale 1-5, means shown
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Value of SDM to Primary Prevention

• Breakthroughs from the CA experience
• SDM Community Workshop helped break down silos
  and level the playing field
• Population flow map and system thinking helped
  upstream and downstream stakeholders see how
  their work affects each other
• Resource mapping helped identify gaps and
  duplication

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More info available at www.caldiabetes.org Search
for SDM
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