Poster: SOC Poster Session 3: Health on Sunday, July 23, 2023, 5:15 PM

Room: Exhibit Hall

Thread: Health

Duration: 90 minutes

Chairs: Christine Tang, Sandra Volken

Support: Martha Toy

Performance of Models of care for Diabetes and Hypertension in Low and Middle-Income Countries through Systems Thinking Lens

Presenter: Fatemeh Ehteshami

The burden of diabetes type II and hypertension has been increasing around the world over the past few decades, particularly in low and middle-income countries (LMICs). Hence, there is an underlying need for provision of effective health care services by health systems. Designing an effective healthcare delivery for diabetes and hypertension in a highly complex health system entails unpacking and examining how numerous components of the model of care interact with each other in a specific context. In this study, we want to combine a realist approach with Causal Loop Diagramming (CLD). We have developed an initial CLD based on a primary review of the evidence on models of care for diabetes and hypertension. We will conduct a realist review with the CLD as the a priori theory in LMICs. The gathered evidence may support, refute or reinterpret the initial CLD. Further, we will conduct semi-structured interviews and a co-creative participatory workshop in Iran as a case study to adapt the final CLD in this context.

A qualitative system dynamics model of overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws

Presenters: Rachel Thompson, Syed Shayan Ali, Robert Heimer, Gail DOnofrio, Rebekah Heckmann, Nasim Sabounchi

Good Samaritan Laws (GSLs) are a harm reduction policy intended to reduce fatal opioid overdose by enabling bystanders, first responders, and health care providers to assist individuals experiencing an overdose without facing civil or criminal liability. GSLs may not be reaching their full impact in many communities due to lack of knowledge of GSL protections among other poorly understood implementation barriers. The purpose of this study was to develop a systems understanding of the factors influencing bystander responses to opioid overdose in the context of Connecticut’s GSLs and to identify high-leverage policies for improving GSL implementation in Connecticut. We conducted six group model building workshops that engaged a diverse set of participants with medical and community expertise and lived bystander experience. Through an iterative, stakeholder-engaged process, we developed and refined a qualitative system dynamics model in the form of a causal loop diagram. Our model, grounded in local knowledge and experience, brings a nuanced systems perspective to the literature on bystander behavior in the context of GSLs, showing how non-linear interdependencies of the social, structural, and policy determinants of bystander behavior collectively form endogenous feedbacks which can be leveraged to design policies to advance systems change.

Understanding dynamic drivers of beef consumption in the U.S.

Presenter: Sydney Pryor

The U.S. is a top producer and consumer of beef globally. High rates of beef production and consumption are a leading cause of negative human and planetary health outcomes, including diet-related chronic diseases, climate change and environmental degradation. Despite substantial evidence indicating the benefits of healthy and sustainable diets and the urgency of reducing beef production and consumption in the U.S., few studies have compared strategies for accomplishing this shift. Several policy measures have been proposed to reduce beef consumption, yet most have not been implemented in the U.S. Their absence suggests that despite an array of policy options, the competing interests of agrifood system actors and their power imbalances contribute to a state of policy inertia surrounding beef in the U.S. The complex structure of the beef system, its many interested actors, and the resistance to significant changes in the system indicate the need for a systems approach to inform decision-making. Thus, the goal of this research is to employ qualitative and quantitative system dynamics model-building to identify dynamic structures driving policy resistance to actions that could reduce beef consumption in the U.S. and identify and compare points of leverage in the system that can contribute to a desirable reduction in consumption and related human and environmental health outcomes.

Mapping the Dynamics of Food and Nutrition Insecurity for College Students in the United States

Presenter: Candace Sapp

According to a national college health assessment, over 40% of students in the United States reported experiencing food insecurity during the 2021-2022 school year. College food and nutrition insecurity (FNIS) has been negatively associated with health outcomes, academic achievement, and overall well-being. Traditional college FNIS interventions adopt reductionist approaches and often provide overly simplistic solutions to a complex and dynamic issue. Causal loop diagrams (CLDs) can map the cyclical pathways between determinants, food and nutrition security status, and outcomes to better identify leverage points for impactful interventions. Developing a CLD that maps the unique attributes and needs of college students sets the foundation for developing systems models in the later aims of this dissertation.

Modeling A Comprehensive Approach to Gun Violence Prevention in New York State

Presenter: Turner Canty

This paper seeks to investigate the environment of firearm ownership in New York State, and trends in firearm deaths and suicides using a system dynamics model. The model covers 2011-2026, and uses susceptible, infected, and recovered framework. Several external factors such as stressors due to COVID-19, poverty, and the effect of violence interruption programs are also incorporated into the model and examined. The primary outcome data that this model is calibrated for are yearly firearm-related deaths. The goal of the paper is to investigate potential approaches for reducing the number of firearm violence deaths in the state, which have increased since 2020.