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Community-Based System Dynamics User Guide Version 1.0

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 Community-Based
System Dynamics
User Guide Version 1.0
Brian J. Biroscak, PhD, MS, MA
Peter S. Hovmand, PhD
 Preface
• User guide to illustrate
doing system dynamics
in community settings
• Evolved over several
years working with a
community committee
• Designed to be used in
tandem with book:
“Community Based
System Dynamics”
 Acknowledgements (1)
• Colorectal Cancer Prevention Community
Committee (Tampa Bay area, Florida, USA)
• Florida Prevention Research Center, University
of South Florida (Tampa, Florida, USA)
• Brown School Social System Design Lab,
Washington University in St. Louis (St. Louis,
MO, USA)
 Acknowledgements (2)
• This user guide is a product of a Health
Promotion and Disease Prevention Research
Center supported by Cooperative Agreement
Number, U48DP005024-01(-02)(-03)(-04), from
the Centers for Disease Control and Prevention.
The findings and conclusions in this guide are
those of the author(s) and do not necessarily
represent the official position of the Centers for
Disease Control and Prevention.
 Contents
1. Introduction to CBSD 6. Group Model Building
2. Group Model Building Workshops and
and CBSD Process Facilitation
3. Engaging Communities 7. Model Refinement,
4. Problem Scoping and Integration,
Identification Formulation, Analysis
5. Core Modeling Team 8. Implementation and
Planning, Training Evaluation
 Chapter 1

“Introduction to Community-Based
System Dynamics”
 Why Community-Based System
Dynamics (CBSD)?
• CBSD is a participatory method for involving
communities in the process of understanding
and changing systems from the perspective of
system dynamics (Hovmand, 2014).
• System dynamics is the use of informal causal
maps and formal causal models with
computer simulation to uncover and
understand endogenous sources of system
behavior (Richardson, 2011).
 The basic element of system structure is the
feedback loop…

(R)

+
“CHICKENS”

…This one is a “positive” or

“reinforcing” feedback loop.
TIME
 Loops of effects interact with one another,
making traditional diagnosis quite difficult…

+ - FARM
SIZE
(R) (B)

+ +

“CHICKENS”
…Such as with this “negative” or
“balancing” feedback loop (B), which
may slow or reverse growth. TIME
 Why CBSD (cont.)?
“When well-meaning people can’t
see it the same way” (Seth Godin)
• Q: “What if I already
see the system and
recognize the actions
needed to better
manage the system?”
• A: You will have trouble
persuading others to
follow unless their
mental models change.
 Implicit models Explicit models
insights
Surface system

There is a system

The components of a system

How the components are related through feedback

Where one could intervene

What is the generic structure

Deep system

Where are the leverage points

insights

Why do things happen

Credit: P.S. Hovmand, WUSTL

 Implicit models Explicit models
insights
Surface system

There is a system

The components of a system

How the components are related through feedback

Mental
models Where one could intervene

What is the generic structure

Deep system

Where are the leverage points

insights

Why do things happen

 Implicit models Explicit models
insights
Surface system

There is a system

The components of a system

How the components are related through feedback

Mental
models Where one could intervene

What is the generic structure

Deep system

Where are the leverage points

insights

Why do things happen

 Implicit models Explicit models
insights
Surface system

There is a system

The components of a system

How the components are related through feedback

Mental
models Where one could intervene

What is the generic structure

Deep system

Where are the leverage points

insights

Why do things happen

 Implicit models Explicit models
insights
Surface system

There is a system

The components of a system

How the components are related through feedback

Mental
models Where one could intervene

What is the generic structure

Deep system

Where are the leverage points

insights

Why do things happen

 CBSD Is About:
• Building public
constituency to support
interventions that
address root causes of
dynamic problems
• Helping communities
co-create models that
lead to system insights
and recommendations
Credit: P.S. Hovmand, WUSTL
 Contents
1. Introduction to CBSD 6. Group Model Building
2. Group Model Building Workshops and
and CBSD Process Facilitation
3. Engaging Communities 7. Model Refinement,
4. Problem Scoping and Integration,
Identification Formulation, Analysis
5. Core Modeling Team 8. Implementation and
Planning, Training Evaluation
 Chapter 2

“Group Model Building and

CBSD Process”
 Group Model Building (GMB)
• Method of involving
participants and other
stakeholders in the modeling
process:
Problem conceptualization
Formulation
Intervention analysis
Implementation

• Reasons for using GMB

– Sharing of insights
– Developing consensus
– Design for implementation
– “Dignity of risk” Credit: P.S. Hovmand, WUSTL
 GMB Scripts
• Divergent activities
– e.g., “Graphs over Time”
• Convergent activities
– e.g., “Parameter
Estimation”
• Evaluative activities
– e.g., “Dots”
• Presentation activities
– e.g., “Concept Model”
https://en.wikibooks.org/wiki/Scriptapedia
 Three Phases of a CBSD Project
Phase*
Problem discovery or “scoping”
Core modeling team planning
Group model building with participants
* Each phase is described more specifically with its own chapter (Hovmand, 2014).
Activities
ID dynamic problem to be modeled
Assess suitability for system dynamics
Develop one-page project description
Design group model building process
Develop agenda, scripts for each session
Training, rehearsal
Qualitative modeling
Quantitative modeling (simulation)
Transfer of ownership
 Contents
1. Introduction to CBSD 6. Group Model Building
2. Group Model Building Workshops and
and CBSD Process Facilitation
3. Engaging 7. Model Refinement,
Communities Integration,
4. Problem Scoping and Formulation, Analysis
Identification 8. Implementation and
5. Core Modeling Team Evaluation
Planning, Training
 Chapter 3

“Engaging Communities”
 Engaging Communities
• Many ways to define “community” (e.g.,
neighborhoods, schools, organizations).
• Engagement fundamentally about building a
shared language around a model(s).
• Two basic approaches to demo GMB:
– Engaging with the “Graphs over Time” script
– Engaging with the “Concept Model” script
 “Graphs over Time” Script
1. Facilitator demo: how to
draw graphs over time
2. Participants draw one
variable over time per
piece of paper
3. Participants then share
graphs with group (round
robin)
4. Wall-builder clusters
graphs on wall/board
5. Participants talk about
clusters and problem
characterization https://en.wikibooks.org/wiki/Scriptapedia
Example: “Graphs over Time”
Example: “Graphs over Time”
Example: “Graphs over Time”
 Engaging Communities
• Both “Graphs over Time” and “Concept
Model” exercises provide ways to share:
– What a group model building exercise is;
– What we mean by a model; and
– How their participation can lead to a model.
 Contents
1. Introduction to CBSD 6. Group Model Building
2. Group Model Building Workshops and
and CBSD Process Facilitation
3. Engaging Communities 7. Model Refinement,
4. Problem Scoping and Integration,
Identification Formulation, Analysis
5. Core Modeling Team 8. Implementation and
Planning, Training Evaluation
 Chapter 4

“Problem Scoping and Identification”

 Critical Questions to Consider
Question
What is the problem? Is it dynamic?
What kind of problem is it?
Does the system involve feedback
mechanisms?
What kinds of insights would help solve
the problem?
What is the purpose of the model?
What value would the model add?
How This Is Answered
Drawing a reference mode with the
desired and feared behavior over time
Primary diagnosis as a learning,
coordination, analysis, or transformation
problem (or some combination thereof)
Drawing a diagram of the system that
involves one or more feedback loops
Identify types of model-based insights
that will help solve the problem
Write a model project description
Compare modeling to current tools
Credit: P.S. Hovmand, WUSTL
What Kind of Problem Is It?

Credit: P.S. Hovmand, WUSTL

What Kinds of Insights Would Help
Solve the Problem?
Modeling Project Description (1)
Modeling Project Description (2)
Modeling Project Description (3)
 Contents
1. Introduction to CBSD 6. Group Model Building
2. Group Model Building Workshops and
and CBSD Process Facilitation
3. Engaging Communities 7. Model Refinement,
4. Problem Scoping and Integration,
Identification Formulation, Analysis
5. Core Modeling Team 8. Implementation and
Planning, Training Evaluation
 Chapter 5

“Core Modeling Team Planning,

Training, and Capacity Building”
 CMT Meetings Description
1. Introducing CMT to Consists of introduction
Forming a Core Modeling
system dynamics and to system dynamics,
Team (CMT)
GMB process GMB, role of CMT, and
process for planning
CMT primary task: To design the GMB
GMB workshops
workshop or set of workshops over the
next four to five 2-hour meetings. 2. Developing process CMT focuses on
maps identifying stakeholder
Generally a small team of 5-7 people. groups and sequence of
GMB workshops
Desired CMT member features:
• Knowledge of community 3. Developing an agenda CMT develops a detailed
• Knowledge of stakeholders agenda for each GMB
• Know the local language/customs workshop
• Sense of meaningful deliverables
4. Adapting and CMT drafts a facilitation
• Understand local power dynamics
developing GMB scripts manual, GMB scripts
• Willing to ask tough questions
• Process tolerant 5. Training Planning
6. Rehearsal
Credit: P.S. Hovmand, WUSTL
Community-Based Prevention Marketing for Systems Change
Process Map: Modeling Project
Project Period: June 2015-August 2017

Months Planning and training Conceptual Model Model Model Policy Policy Transfer of
mapping formulation testing refinement analysis analysis cont. ownership

06/15-08/15 09/15-11/15 12/15-02/16 03/16-05/16 06/16-08/16 09/16-11/16 12/16-02/17 03/17-05/17 06/17-8/17

Stakeholders

Community members
(CCC) C D

Practitioners and
policymakers C F
(LT, ACS)

System dynamics modelers

(WUSTL) E G I

Core modeling planning team

B B B B J
(USF, CCC, WUSTL) A
B
B

Cross-stakeholder team
(TBD) C H

A. Problem discovery or “scoping” F. GMB: model formulation and refinement

B. Core modeling team planning and training G. Model refinement and initial policy analysis
C. Recruitment of group model-building (GMB) participants H. GMB: Policy analysis
D. GMB: dynamic hypothesis conceptualization I. Model revision and policy analysis
E. Model formulation J. Transfer of model ownership

Planning and training Participant recruitment Group model-building System dynamics modeling
Example: “Detailed Agenda”
Example: “Facilitation Manual”
 Contents
1. Introduction to CBSD 6. Group Model Building
2. Group Model Building Workshops and
and CBSD Process Facilitation
3. Engaging Communities 7. Model Refinement,
4. Problem Scoping and Integration,
Identification Formulation, Analysis
5. Core Modeling Team 8. Implementation and
Planning, Training Evaluation
 Chapter 6

“Group Model Building Workshops

and Facilitation”
Setting the Frame
Fundamentally, GMB planners are
offering people a different way to look
at things; and that can be a gift and
something terrific, but getting there
can be frustrating and disorienting.

The GMB workshop “frame” includes

everything from the physical layout of
the room to the authenticity of the
workshop facilitation team.

When it comes to GMB workshop

success, the most important factor,
more so than skill, is having the right
attitude.

Credit: P.S. Hovmand, WUSTL

Example: “Public GMB Agenda”
Example: “Facilitation Manual Scripts”
 GMB Facilitation Tips
• Connect with participants (e.g., learn names).
• Stay neutral and balanced.
• Use physical space (e.g., conversation flow).
• Work the room during small group exercises.
• Point and name objects (e.g., feedback loops).
• Don’t be in a rush to fill in silence.
• Know what you’re trying to do at each point.
Credit: P.S. Hovmand, WUSTL
 Contents
1. Introduction to CBSD 6. Group Model Building
2. Group Model Building Workshops and
and CBSD Process Facilitation
3. Engaging Communities 7. Model Refinement,
4. Problem Scoping and Integration,
Identification Formulation, Analysis
5. Core Modeling Team 8. Implementation and
Planning, Training Evaluation
 Chapter 7

“Model Refinement, Integration,

Formulation, and Analysis”
Why Model?
CBSD emphasizes educating and
building capacity over multiple
projects as a means to not only engage
and mobilize communities for change
during the early phases with informal
maps but also to build the motivation
and capacity for model specification,
testing, and analysis for rigorous
formal models and computer
simulations; and the ability to convey
insights to mobilize action.

In CBSD, the expert modeler is teacher

and guide, helping people see what
the modeler sees; succeeding here
means always being aware of how to
see and apply the principles of system
dynamics to gain the greatest insights.

Credit: P.S. Hovmand, WUSTL

Example: Colorectal Cancer Prevention
Community Committee (Tampa, FL)
• Understand colorectal
cancer (CRC) screening
challenges as a complex
adaptive system

• Use of participatory
group model building
with stakeholders and
system dynamics
modeling and
simulation
Overview of Group Model Building Workshops
for CRC Screening

Connection Causal Loop Stock and Flow Preliminary

Circles Diagrams Diagram Simulation Model

Session 1 Session 2 Session 3

Informal Causal Maps
Session 1: Connection Circles Session 1: Causal Loop Diagrams
Overview of Group Model Building Workshops
for CRC Screening

Connection Causal Loop Stock and Flow Preliminary

Circles Diagrams Diagram Simulation Model

<Positive
Social
Norms> +
Family
Support
-

Fear
-
+ - +
R
R
High-Risk -
+ (Family History)
- + People People
People Being Waiting for
Screened Positive Diagnostic Waiting for
Colonoscopy Diagnostics Treatment Treatment
Knowledge/ + Screening Screenings
Awareness -
+ +
- -
+ B
B +
B
+ Provider/Staff + +
+ Emphasis +
R + GI Specialists
+
+ Out-of-Pocket
<High-Risk
(Family Costs
Positive History)> R +
Social
+ Access to
Norms
Care
- Structural
+
+ Barriers
<Family
Support> Insurance

Session 1 Session 2 Session 3

 <Positive
Social
Norms>
+
Family
Support
-

Fear
-
+ - +
R
R
High-Risk -
+ (Family History)
- + People
Waiting for People
People Being
Diagnostic Waiting for
Screened Positive Colonoscopy Diagnostics Treatment Treatment
Knowledge/ + Screening Screenings
Awareness
-
+ +
- -
+ B B +
B
+ Provider/Staff + +
+ Emphasis +
R + GI Specialists
+ +
Out-of-Pocket
<High-Risk Costs
Positive (Family
History)> R +
Social
Access to
Norms + Care
- Structural
+
+ Barriers
<Family
Support> Insurance
 <Positive
Social
Norms> <Patient
+ Family Knowledge/Awareness>
Support
<Access to - -
Care> High-Risk
(Family History) +
Fear
<Out-of-Pocket +
Costs> + + <Out-of-Pocket
+ <GI Specialists, + <GI Specialists, -
Facilities, and Costs>
+ Facilities, and
+ Support Capacity> R Support
- + - Capacity> -
+ People
People People + Waiting for People
referred to Screened Diagnostic Waiting for
Pre-screening screening Positive Colonoscopy Diagnostics Treatment Treatment
Screening
and referral Screenings
+ -
+ + - + -
B B + + +
+ B -
- + + GI Specialists,
+
Out-of-Pocket Facilities, and <Access to
Provider/Staff Costs Support Capacity Care>
Patient Knowledge/ Emphasis
+ R
- Awareness
+ - -
+ -
+ +
R UDS and +
+ <High-Risk Access to + <Screening>
Positive HEDIS (Family
History)> Care
Social +
<High-Risk Norms Structural
+ -
(Family Barriers
History)> + -
+
National
<Family Screening
Support> Guidelines Insurance
Provider (private, ACA)
reluctance -
Overview of Group Model Building Workshops
for CRC Screening

Connection Causal Loop Stock and Flow Preliminary

Circles Diagrams Diagram Simulation Model

<Positive
Social
Norms> +
Family
Support
-

Fear
-
+ - +
R
R
High-Risk -
+ (Family History)
- + People People
People Being Waiting for
Screened Positive Diagnostic Waiting for
Colonoscopy Diagnostics Treatment Treatment
Knowledge/ + Screening Screenings
Awareness -
+ +
- -
+ B
B +
B
+ Provider/Staff + +
+ Emphasis +
R + GI Specialists
+
+ Out-of-Pocket
<High-Risk
(Family Costs
Positive History)> R +
Social
+ Access to
Norms
Care
- Structural
+
+ Barriers
<Family
Support> Insurance

Session 1 Session 2 Session 3

 Patient +
Knowledge - Fear Effect of Fear on Avg
and Delay to Diagnositc
Net Change in Awareness Effect of Patient Knowledge +
Patient Knowledge and Awareness on Avg Net Change
and Awareness Delay to Screening in Fear
+
Effect of Fear on Avg
- Delay to Screening Avg Delay to
Family +
Support + Effect of Family + Diagnostic
Net Change
Support on Avg Colonoscopy
+ in Family Avg Delay to B1
Support Delay to Screening
Screening Avg Delay to
-
+ - Treatment
- -
Effect of Patient
Knowledge and Positive People -
People Screenings People
Effect of Positive + Support on Waiting for
referred to Waiting for
Social Norms on Pre-Screening and Pre-screening screening
Diagnostic Diagnostics Treatment
Treatment
Patient Knowledge Referral and referral Colonoscopy -
and Awareness + +
No Negative No No
Effect of Proportion Screening Screenings Diagnostics Treatment
Positive Social pre-screened and +
Norms on referred - +
Family Support Total Population +
+ Needing to be -
Effect of Positive Screened
Social Norms on
Pre-Screening Prop
and Referral Prop Positive
Effect of Positive Screened
+ Social Nroms on Prop
+ -
+ Screened
+ + +
Effect of Fear on
Positive R1 Prop Screened
Social Norms Effect of Prop +
Net Change Screened on Social <Fear>
in Positive + Norms
Social Norms
 What kinds of questions can the CRCS
strategic model be used to answer?
Types of question Examples of questions that the CRCS model could answer
Retrospective • What were some of the key facilitators that made CRC
explanations of system screening increase early on?
behavior over time • What were some of the key barriers that made CRC
screening ‘level off‘ over time?

Prospective strategic • What are the plausible scenarios for achieving our
design and planning goals?
• Where are the leverage points for bringing about gains
in CRC screening?

Monitoring, evaluation, • What indicators should we be looking at to track

and learning progress, detect risks of failure, etc.?
 What kinds of questions CANNOT the
CRCS strategic model be used to answer?
Types of question Examples of questions that the model CANNOT answer
Predicting precise • How many people will be demanding CRC screening in 3
numeric estimates years?
• How much will we need to spend to achieve our goals?

Operational details • Which ‘marketing mix’ (product, price, place,

about implementation promotion) should we create?
tied to a leverage point • What skills should we train doctors, nurses, and
community health workers in?
 User Parameterized Models*
Key fact: dynamic equilibrium implies inflow = outflow

Given:
1. Value of inflow
2. Value of hazard rate
3. Outflow = Hazard rate x Stock

Find:
What is the stock when the system is in
dynamic equilibrium?

http://sfrc.ufl.edu/extension/ee/climate/wp-content/uploads/SEE_2a.pdf Solution:
Stock = Inflow/Hazard rate

*Winch, G. W., & Arthur, D. J. W. (2002). User-parameterized generic models: a solution to the conundrum of modelling
access for SMEs? System Dynamics Review, 18, 339-357.
Overview of Model
Overview of Model
Potential Leverage Points
Referrals and Screenings
Mapping of leverage points
Fear

Fear, patient knowledge,

family support, and
positive social norms
Distribution of
simulations combining
all interventions relative
to control

• All leverage points are

assumed to have the same
effect size (75%
improvement or strong
effect) for comparison
purposes

• Three basic clusters

Percent improvement
ranked from highest
(top) to lowest (bottom)

• Reducing fear has the

single largest overall
effect, followed by
improving positive social
norms

• Patient knowledge and

awareness and family
support have marginal
impacts on their own or in
combination
 Online interface

https://exchange.iseesystems.com/public/psh/prc-screening
 Contents
1. Introduction to CBSD 6. Group Model Building
2. Group Model Building Workshops and
and CBSD Process Facilitation
3. Engaging Communities 7. Model Refinement,
4. Problem Scoping and Integration,
Identification Formulation, Analysis
5. Core Modeling Team 8. Implementation and
Planning, Training Evaluation
 Chapter 8

“Implementation and
Evaluation”
Implementation
Implementation—putting some
innovation such as an intervention or
policy into actual use—is one of the
main motivations for doing CBSD.

An assumed consequence of CBSD is

that accumulated community capacity
leads not only to model-based insights
but also community mobilization to
implement the recommendations.

In CBSD, some insights derive from

less formal models (e.g., causal loop
diagrams) and are implemented
relatively quickly; other insights derive
from more formal computer
simulation models and require a
strategic planning approach for
implementation and evaluation. Image: Stuart Miles / FreeDigitalPhotos.net
Community Based-System Dynamics/-Social Marketing
“CBPM for Systems Change” framework represents one approach for
overcoming the implementation challenge in system dynamics modeling,
through the use of social marketing, which integrates marketing concepts with
other approaches to influence behaviors that benefit the greater social good.
 “Hopes”
Evaluation
Evaluation of CBSD workshops can
“Fears”
take many forms, from informal
assessments of “hopes and fears”
(right) to more formal pre-post follow-
up surveys of processes & outcomes.

Major evaluation challenge: GMB

workshops tend to be highly
customized, and a strong component is
tied to attitude and skills of facilitators.

CBSD is itself a dynamically complex

system. This book (Hovmand, 2014) is
an attempt to provide a more explicit
account of CBSD, underlying
philosophy, and potential outcomes;
and this user guide is an attempt to
provide a real-world example of CBSD.
 For More Information On:
Community-Based System Community-Based Prevention
Dynamics (CBSD) Marketing (CBPM)

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