Applying Systems Thinking to Understand Partnering for Hypertension Control

Wednesday, July 30, 2025, 6:25 AM

Session: Poster Session (Morning, 30th of July)

To better understand multisector partnerships for hypertension control from a complex systems perspective, we used a systems thinking approach to develop a causal loop diagram (CLD) capturing multisector collaboration for hypertension control. Drawing from a systematic literature review of 3,825 articles, content analysis of Cardiovascular Disease and Diabetes Network Leadership Team presentations, consultation with the Washington State Department of Health, a focus group, and 52 semi-structured interviews with stakeholders from five sectors—clinics, community pharmacies, community-based organizations, community health workers, and patients—we identified key factors and interrelationships influencing the success of these partnerships and their ability to promote hypertension control. The CLD depicts how social determinants of health, communication barriers, trust, role clarity, and access to resources interact with each other and with system feedback loops over time. Reinforcing and balancing feedback loops, along with delays, were visualized to better understand how system behavior emerges and where leverage points for intervention may exist. This process highlighted the value of applying a complex systems lens to public health research and offers a foundation for future simulation modeling to test and refine intervention strategies. Findings will inform efforts to improve hypertension control through coordinated, equitable, and sustainable multisector partnerships.