1. Peter Hovmand, Ph.D. Director, Brown School of Social Work System Dynamics Lab Washington University in St. Louis Institute for Systems Science in Health Ann Arbor, MI May 3 - May 8 Work supported by Center for Mental Health Services Research, George Warren Brown School of Social Work, Washington University; through an award from the National Institute of Mental Health (P30 MH068579); National Science Foundation (SES-0724577), Substance Abuse Mental Health Services Administration Mental Health Transformation State Incentive Grant (SM57474-01), Center for New Institutional Social Sciences at Washington University in St. Louis; Save the Children UK Mongolia; and Foundation for Ecological Security

2. Research  Implementation of innovations  Evidence based practice (NSF, NIMH)  Domestic violence prevention (CDC, NIMH)  Cooking stoves in India (I-CARES, CNISS)  Mental health transformation (SAMHSA)  Diabetic retinopathy screening (VA, NIMH)  Infusing parenting training in child welfare (NIMH)  Simulation modeling  System dynamics  Group model building/participatory methods

3. Related publications  Hovmand, P. S., & O'Sullivan, J. (2008). Lessons from an interdisciplinary system dynamics course. System Dynamics Review, 24(4), 479-488.  Hovmand, P. S., Jonson-Reid, M., & Drake, B. (2007). Mapping service networks. Journal of Technology and Human Services, 25(4), 1-22.  Hovmand, P. S. (2008). Appendix C: Causal mapping. In Cooperative agreements for mental health transformation state incentive grants. Requests for applications no. SM-05-009. State of Missouri Comprehensive Mental Health Plan, April 2008. Rockville, MD: Substance Abuse and Mental Health Services Administration, U. S. Department of Health and Human Services.  Hovmand, P.S., Ford, D.N., Flom, I., & Kyriakakis, S. (in press). Victims arrested for domestic violence: unintended consequences of arrest policies. System Dynamics Review  Hovmand, P.S., & Ford, D.N. (in press). Sequence and timing of three community interventions to domestic violence. American Journal of Community Psychology.

4. Flexibility of SD practice across social theoretic paradigms (Figure from Lane, D.C. (1999). Social theory and system dynamics practice. European Journal of Operational Research 113, 501-527)

5. Modeling and simulation paradigms Radical Change Views of Society Regulation Views of Society Objective Views of Social Science Subjective Views of Social Science Learning problems: Working with people at risk and their families to help them learn through their own modeling Restructuring problems: Changing the structure of diabetes, e.g., a cure for a chronic disease System design problems: Identifying the key drivers of diabetes, resource allocation, policy analysis Coordination problems: Developing a shared vision of how to prevent diabetes

6. Flexibility of SD practice across social theoretic paradigms (Figure from Lane, D.C. (1999). Social theory and system dynamics practice. European Journal of Operational Research 113, 501-527)

7. Modeling and simulation paradigms Radical Change Views of Society Regulation Views of Society Objective Views of Social Science Subjective Views of Social Science

8. Triangulation CNH System Dynamics Model Plant demography Household survey Group model building

9. Group model building (GMB)  Motivations for GMB:  Modeling is theory building  Greatest insights come from modeling process  Participation increases likelihood of implementation  Participation is an intervention  Form of:  Action research (AR)  Participatory action research (PAR)  Method for group decision making/problem solving

10. Some key decisions in GMB  Modeler/research or participant initiated?  Defining or scoping the problem  Is it a system?  Is it dynamic?  Is SD the right tool?  Identification of stakeholders  Single session or multi-session  Where to do it  Qualitative or quantitative (simulation) model  Start with a “blank slate” or preliminary/concept model  Scripted or unscripted

11. Examples of scripts  Scheduling  Room setup  Hopes and fears icebreaker  Variable elicitation  Structure elicitation  Reference mode elicitation  Reflector feedback

12. GMB Scripts

13. Roles in GMB  Participants  Core modeling team  Facilitator/substantive expert (1)  Modeler/facilitator (1)  Gatekeepers/leaders (1-4)  Recorders (2-4)  Process coach (1)

14. Conditional cash transfers on poor households & schooling Mental health transformation Natural resource dependent communities Implementing EBP and organizational performance PartnersSave the Children UK Mongolia Department of Mental Health Foundation for Ecological Security 40 nonprofit organizations LocationUlaanbaatar, Mongolia Jefferson City, MOAndhra Pradesh, India St. Louis, MO Goal for GMB1) Conceptualize impact of CMP program; 2) develop household survey 1) Awareness of system; 2) identify potential leverage points 1) Conceptualize CNH; 2) combine GMB with PAR; 3) capacity building 1) Increase relevance; 2) capacity building Duration1 week modeling/1 week survey design 5 x 1.5 hour sessions1 week w/ staff, 1 day w/ villagers 3 x 2 hr planning; 2 x 4 hr modeling (ongoing) ParticipantsSCUK staff (N=20)Policy makers, researchers, consumers and family members, providers, industry (N=250) Community organizers, regional directors, staff scientists (N=30); rural villagers (N= Senior managers and program directors (N=50) Preliminary model used QuantitativeQualitative Quantitative ScriptedUnscriptedScripted

15. Save the Children UK Ulaanbaatar, Mongolia

16. Concept model

17. Research model

18. Research model in Mongolian

19. Measurement model

20. Household survey

22. Department of Mental Health Jefferson City, MO

23. Casual mapping exercises

24. Mental health transformation

25. Changing structure

26. Outcomes according to families and consumers Quality of life Consumer Empowerment Consumers and Families in Leadership Community preparation Natural supports + - R3 Populations losing appropriate services - ++ + + +- + Public awareness of mental illness Stigma R4 + - -

27. Statewide Mental Health Transformation

28. Foundation for Ecological Security, Andhra Pradesh, India

29. Reflecting model back

30. Models Built by Villagers in Local Language (Telugu)

31. Models built by Villagers in Local Language (Telugu) Villagers’ Model as Causal Loop Diagram in Vensim From Telugu to Vensim

32. Vensim version

33. Implementation of EBP and organizational performance

34. Preliminary simulation model

35. Structure elicitation for client buy in

36. Group model building as intervention

37. Modeling with Children

38. Wildebeests-Cats-Dogs System W = Wildebeests WB = Wildebeests births WD = Wildebeests deaths C = Cats CB = Cat births CD = Cat deaths D= Dogs CB = Dog births CD = Dog deaths

39. Things to keep in mind  It’s easier for participants to model their own problems than abstracted problems  The model is not a representation of their prior mental models, but a new socially constructed mental model  Generally increases perceived relevance, harder to maintain quality of analytic insights relative to simulation models, but greater likelihood of implementation*  Very useful for scoping

40. Readings related to GMB  Vennix, J. (1996). Group model building. New York: John Wiley & Sons.  Andersen, D. F., & Richardson, G. P. (1997). Scripts for group model building. System Dynamics Review, 13(2), 107-129.  Rouwette, E., Vennix, J. A. M., & Mullekom, T. v. (2006). Group model building effectiveness: A review of assessment studies. System Dynamics Review, 18(1), 5-45.  Luna-Reyes, L. F., Martinez-Moyano, I. J., Pardo, T. A., Cresswell, A. M., Andersen, D. F., & Richardson, G. P. (2006). Anatomy of a group model- building intervention: Building dynamic theory from case study research. System Dynamics Review, 22(4), 291-320.  Eden, C., Ackermann, F., Bryson, J. M., Richardson, W. S., Andersen, D., & Finn, C. B. (2009). Integrating modes of policy analysis and strategic management practice: requisite elements and dilemmas. Journal of the Operational Research Society, 60, 2-13.  Kumar, S. (2002). Methods for community participation: a complete guide for practitioners: Practical Action.