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Dissemination and Implementation Research in HealthTranslating Science to Practice$
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Ross C. Brownson, Graham A. Colditz, and Enola K. Proctor

Print publication date: 2012

Print ISBN-13: 9780199751877

Published to Oxford Scholarship Online: May 2012

DOI: 10.1093/acprof:oso/9780199751877.001.0001

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Systems Thinking in Dissemination and Implementation Research

Systems Thinking in Dissemination and Implementation Research

(p.175) 9 Systems Thinking in Dissemination and Implementation Research
Dissemination and Implementation Research in Health

Bev J. Holmes

Diane T. Finegood

Barbara L. Riley

Allan Best

Oxford University Press

The common response to the public health issues that plague society is to eliminate, or at least reduce, their complexity. This chapter suggests that a more productive response is to acknowledge complexity, and to design and study solutions that address it. In support of this view, it presents systems thinking as an approach to intervene in and study health issues such as obesity and chronic disease—complex problems in the sense that they are unpredictable and influenced by many interacting and multilevel variables. First, the chapter briefly reviews the evolution of dissemination and implementation (D&I) health research, revealing an increasing recognition of complexity. It then introduces the notion of “systems”—what they are, and why an understanding of them is critical to improved health and health care through dissemination and implementation. Systems thinking is then described and its implications explored, with two in particular expanded on: the need to rethink cause and effect, and the importance of considering different levels of intervention. Obesity is presented as an example of an issue whose complexity demands a systems approach in order to address it meaningfully. The final section of the chapter demonstrates systems thinking in action, using the examples of two new Canadian projects, funded by the Canadian Partnership Against Cancer, based on such an approach: Youth Excel and The CAPTURE Project.

Keywords:   public health, systems thinking, obesity, chronic disease, health research

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