Social Media and Health: Leaders(hip) and Followers(hip)
Posted: May 18, 2012 Filed under: behaviour change, eHealth, health promotion, innovation, public health, Social media, systems thinking | Tags: complexity, creativity, design thinking, developmental design, developmental evaluation, eHealth, evaluation, Facebook, health, health promotion, healthcare, innovation, medicine, organizational change, organizational design, public health, Social media, systems thinking Leave a comment »
Social media is finally catching on with healthcare, public health, and health promotion. With a few recent articles published in the academic literature to rest on, academic health sciences has finally (and I might argue, begrudgingly) conceded that 900+ million users and $100B valuations (Facebook), and thousands of messages exchanged every milisecond (microblogs like Twitter and Sina Wiebo) might have some value for the public beyond entertainment.
If you note how long it took the health sector to start using the telephone as a serious means of engaging their patients or the public, this is lightning-quick adoption. Still, the barriers to adoption are high and the approach to using the technology is scattered. Indeed, just like the start of Internet-delivered telehealth (or cybermedicine (PDF), which has now evolved into eHealth), there is a mad rush to get liked, followed or some other metrics that most health professionals barely understand.
And that is part of the problem.
Meaningful Social Media Metrics
What is a meaningful metric for social media and health? A recently published article in Health Promotion Practice suggested four metrics that are taken from social marketing and applied to social media. These Key Performance Indicators (KPI’s) are:
- Insights (consumer feedback)
- Exposure (media impressions, visits, views, etc..)
- Reach (# people who connect to the social media application)
- Engagement (level of interaction with the content)
These are reasonable, but to to the uninitiated I would suggest a few words of caution and commentary to this list.
Firstly, the insights suggested by Neiger and colleagues “can be derived from practices such as sentiment analysis or data mining that uses algorithms to extract consumer attitudes and other perspectives on a particular topic” (p.162). While not incorrect, this makes the job sound relatively simple and it is not. Qualitative analysis + quantitative metrics such as those derived from data mining are key. Context counts immeasurably in social media use. It’s only in situations where social media is used as a broadcasting tool that gross measures of likes and sentiment analysis work with little qualification.
Even that is problematic. Counts of ‘likes’, ‘visits’, ‘follows’ and such are highly problematic and can be easily gamed. I am ‘followed’ on Twitter by people who have tens of thousands of followers, yet virtually no presence online. Most often they are from marketing fields where the standard practice is to always follow back those who follow you. Do this enough and pretty quickly you, too can have 23,000 followers and follow 20,000 more. This is meaningless from the perspective of developing relationships.
Engagement is the most meaningful of these metrics and the hardest to fully apply. This category gets us to consider the difference between “OMG! AWESOME!” and “That last post made me think of this situation [described here] and I suggest you read [reference] here for more” as comments. Without understanding the context in which these are made within the post, between posts (temporally and sequentially), and in relation to a larger social and informational context, simple text analysis won’t do.
Social Media Evidence: Problems and More Problems
One of the objections to the use of social media by some is that it is not evidence-based. To that extent I would largely agree that this is the case, but then we’ve been jumping out of airplanes with parachutes despite any randomized controlled trial to prove their worth.
Another article in Health Promotion Practice in 2011 highlights potential applications for social media and behaviour change without drawing on specific examples from the literature, but rather on theoretical and rhetorical arguments. An article published in the latest issue of Perspectives on Psychological Science highlights the current state of research on Facebook, which is timely given that its IPO is set for today. That review by Wilson and colleagues illustrates the largely descriptive nature of the field and offers some insight on to the motivation of Facebook users and their online activities, but rather little in what Facebook does to promote active change in individuals and communities when they leave the platform.
The answer to whether social media like platforms such as Facebook ‘work’ as methods of promoting change is simply: we don’t know.
Does social media provide support to people? Yes. Does it inform them? Yes to that too. Does that information produce something other than passive activity on the topic? We don’t know.
In order to answer these questions, health sciences professionals, evaluators, and tech developers need to consider not just followership, but leadership. In this respect, it means creating changes to the way we gather evidence, the tools and methods we use to analyse data, and the organizational structures necessary to support the kind of real-time, rapid cycle evaluation and developmental design work necessary to make programs and evidence relevant to a changing context.
As Facebook launches into its new role as a public company it is almost assured to be introducing new innovations at a rapid pace to ensure that investor expectations (which are enormous) are met. This means that today’s Facebook will not be next month’s. Having funding mechanisms, review and approval mechanisms, a staff trained and oriented to rapid response research, and an overall organizational support system for innovation is the key.
Right now, we are a long way from that. Hospitals are very large, risk averse organizations; public health units are not much different. They both operate in a command-and-control environment suited for complicated, not complex informational and social environments. Social media is largely within the latter.
Systems thinking, design thinking, developmental evaluation, creativity, networks and innovation: these are the keywords for health in the coming years. They are as author Eric Topol calls the dawning of the creative destruction of medicine.
The public is already using social media for health and now the time has come for health (care, promotion and protection) systems to get on board and make the changes necessary to join them.
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Have We Turned the Page on Social Science Research for Health?
Posted: May 15, 2012 Filed under: knowledge translation, Science & technology, social systems, Systems science | Tags: funding, health promotion, knowledge translation, public health, research, research funding, science policy, social science 2 Comments »
Turning the Page on Social Science and Health Research
Over the last two weeks social science researchers across Canada began receiving the decisions from last autumn’s competition for a Social Science and Humanities Research Council (SSHRC) funding award. SSHRC is the principal funder of social science research in Canada, although notably is not in the business of funding heath-related research, which is supposed to be funded by the Canadian Institutes for Health Research (CIHR). [Full disclosure: I currently hold grants from both of these organizations]. The problem is that CIHR was born from a policy and programming body and the former Medical Research Council and has a rather awkward relationship with social science research given its medical focus. It has funded some social science programs, but not in a manner that has enabled social scientists to comfortably explore the range of issues that they might have under traditional SSHRC funding programs, particularly when social issues are not always obviously health issues (e.g., poverty, education) and can easily be dismissed as not being relevant in spite of the evidence that they are. Yet, SSHRC has decided to forgo any funding of health-related projects due in part to the absence of funding to support it when there are presumably options through CIHR or the disease-specific health charities like the Canadian Cancer Society, the Lung Association and others.
Yet, these options are not suitable. In a manifesto entitled “The end of medical anthropology in Canada” a group of leading social scientists painted the picture of the situation in grim terms in University Affairs. Although medical anthropology is the focus of the piece, the authors might as well be speaking for social sciences in general:
Health is inherently social and cultural. SSHRC has always understood this; CIHR, we fear, does not. We face the possible extermination of one of the most vibrant, high-demand and policy-relevant health disciplines, the only scholarly field that places culture at the centre of the analysis of health and that characteristically does so in both national and international contexts. In a multicultural, settler society with a substantial aboriginal population, and in a world where health is at the core of developmental, political and social issues in so many countries, where Canada otherwise wishes to have an impact, does this make any sense?
This brings me back to the beginning of this post and the announcement of the results of the last competition. Looking at the funding numbers released by SSHRC, a discouraging picture emerges. In 2011-12, 37 per cent of all applications in the open competition were deemed fundable, yet only 22.5 per cent were funded. These numbers are similar t0 2010-11, when 36 per cent were deemed fundable and 22 per cent were funded. What is not mentioned in these numbers was the level at which these grants were funded in the first place. I am a 2010-11 recipient of funding from SSHRC — meaning my grant proposal was within the top 22 per cent of all applications for that year — and the amount I received was approximately half of what I requested. That means that I had to take half of my budget and throw it away. So yes, I was successful providing I did either half of the research or found money elsewhere. I did the latter and my pocketbook is none the better for it.
Consider the implications of this change in funding. With one in five projects funded and many of those that are funded at levels well below what was requested the motivation for researchers is one of the first casualties. Researchers know that funding is tight and that it is highly competitive, but few alternative sources for research grants that lay outside of specific disease-focused areas, social scientists young and old are faced with little option. This creates another set of affected parties: students and trainees. Research funding not only supports the scientists themselves in many cases (see my previous posts on this), but those seeking to become scientists themselves or those who seek to get better acquainted with research. In health sciences and policy, this means just about everyone enrolled in such programs.
Now consider all of this in light of a trend towards increasing graduate education numbers. At the academic institution I am affiliated with (like many of its peers), the enrolment numbers are set to nearly double across many of the professional programs associated with health practice and policy in the coming years. Increased demand for training opportunities from the public has created a means for universities to cash in. Of course, what these students will do when they get there is unclear (let alone when they graduate), but it cannot be much in the way of research — at least as it pertains to social science and health. The funding is simply not there to support the kind of broad-based inquiry into the social factors that influence health, illness and well-being anymore. We have, as I call it, reached ‘the Turn’.
The Turn is that point where the system changes irrevocably towards a new direction. It is like a ‘tipping point‘. Dwindling numbers of social scientists working from funding from an institutional budget (e.g., tenure-stream faculty positions) + a doubling of the student cohort * half of the research dollars makes for rather toxic math. The Turn will fundamentally shape the way social science inquiry is done and the kind of questions that get asked. As question foci change, the quality of the research shifts, and the depth of inquiry is reduced, so too will the real impact that social science has on our health.
The gap between what we know, what we do, and what we can do to prevent illness, treat sickness, and promote well-being will grow.
Anecdotally speaking, this trend is not unique to the social sciences, but it is amplified in this domain. Social sciences in Canada and abroad are consistently funded at lower levels than that of basic research (see here for a starting point). But what is interesting is that many of the problems that we face within health require social science knowledge and research to address and social science — from knowledge translation, social network studies, technology adoption, innovation, management, to policy implementation and beyond .
Prevention of disease and chronic illness is often a social phenomenon (e.g., hand washing). Even the act of taking the best of basic science and translating it into practice or policy options (or other scientific research) is a social act that draws on social science research to execute. Social determinants of health are social in nature and require social science to understand their impact. Designing the policy and programmatic interventions that support creating a healthier society also falls to social science research and practice.
What will our health landscape look like without the ability to take what we know and translate it into action? Worse yet, what if we simply are unable to even know what to do because the research and evidence isn’t there in the first place to translate into anything? Without another turn towards something more positive in our research support, we are about to find out.
* Photo Turn the Page by Miaboas used under Creative Commons License from Deviant Art.
Turning Thinking Talk to Action Walk (and a Trip to the Moon)
Posted: April 16, 2012 Filed under: knowledge translation, research, Social media, systems thinking | Tags: David Phipps, innovation, JFK, knowledge translation, moon, NASA, social innovation, Social media, systems thinking 7 Comments »
It’s much easier to talk innovation and creativity and far harder to turn that into something transformative that has social impact. Until we start acting on our conversation and creating the systems that support it, talk will become cheaper and the costs of converting that talk into something useful may grow beyond our means.
As the number and scope of information channels available to me grows, so too does my awareness of the conversations taking place on matters of personal interest. Where I once had to scour through material to find a place where I could learn about topics that interested me, I can now point to dozens of constantly updated spaces and tools where I can learn about social innovation, design, knowledge translation, systems thinking, evaluation and beyond. But this points to a problem as I’ll discuss later.
Two of my favourite tools are both optimized for the iPad and iPhone: Zite and Feeddler Pro. Zite creates a personalized magazine for you that is updated throughout the day drawing from various sources on the web from blogs to mainstream news through to academic articles. It’s a marvellous service and it ‘learns’ as you provide feedback on the selection it gives you, introducing you to new content from new sources all the time. Feeddler is a little less sophisticated as it is a RSS reader, but it provides a steady stream of content from the sites that I already know and trust. Mainstream sites like Fast Company (and its design and innovation derivatives such as Co.Design) and social media leader Mashable combine with some of my favourite blogs from folks like Seth Godin and KT blogs at Mobilize This! and KTExchange.
Indeed, it was a post on Mobilize This! from David Phipps that happened to crystalize something that was percolating in my head about taking action related to what I was reading. The focus was on the thinking about knowledge translation vs. its application.
In that post, Phipps comments:
It must be nice to be able to think about something and never have to do it.
But then that’s the role of researchers in many fields. Researchers think about things and study things without actually doing the things they study. Then there’s the role of practitioners. We do things without having incentives or rewards (ie the time) to sit back and think about and reflect upon what we do.
Referring to an earlier post on knowledge hypocrites, Phipps adds:
We need more mobilization of knowledge about knowledge mobilization. Researchers need to move beyond thinking about frameworks to working with practitioners who are putting those frameworks into practice. Practitioners likewise need to embed researchers in their practice.
I had found this post sandwiched between a number of other blogs or articles on innovation and creativity with similar calls to action and sometimes some tips or ‘lessons learned’. People (myself included) eat this up. Knowledge translation is a ‘sexy’ term in health sciences right now, particularly as people look to getting more bang for their research dollars. Innovation is seen as a big part of how to do it and what it is that should come from KT.
And creativity is the way to bring them both together. It makes for great reading and starts to give you the impression that you’re actually getting things done.
Get creative! Be innovative! Translate what we know into what we do! It’s just that easy…right?
As complicated as weaving these ideas together can be, they are not rocket science (even if the Apollo 13 rescue provides us of one of the best examples of them coming together, particularly when Hollywood sets it up). Yet, practically bringing action to the talk in health and human services may be a far greater challenge to address than putting humans on the moon. Indeed, it took a bold statement by President Kennedy and massive organizational commitment, research, creativity, innovation, and knowledge translation to go from rockets that could barely reach orbit to having multiple successful missions to our lunar neighbour. (For a remarkable recap of that journey I highly recommend seeing the documentary In the Shadow of the Moon).
Humans didn’t get to the moon because of one person or a small team, but organizational commitment and delivery. NASA didn’t just talk about going to the moon, write about innovation, or read creativity books — they (to draw on David Phipp’s blog) just did it.
Talking and writing about innovation is easy, doing it is hard. As Thomas Edison said:
Opportunity is missed by most people because it is dressed in overalls and looks like work
At the same time, the work needs to be done beyond a few. And the more we see something talked about, the easier it is to assume that others are doing it and that it is common practice. In the space race there was only one small community that could possibly get the job done (in the U.S. at least). If it wasn’t NASA, it wasn’t going to happen. A problem in health and human services is that most of society is implicated in the enterprise in some regard. Research comes from different disciplines (basic science to medicine to social work to education and beyond), it is practiced in health care institutions, daycares, schools, workplaces or individually at home, and it is highly contextual and oftentimes global in scope.
It’s not “Houston, we have a problem”, but the world.
This could be an advantage, but it isn’t for some reason. More knowledge, more talk about doing knowledge translation and innovation and creative work and more exposure to them all seems to be having an unclear effect. Having met many people from programs training people in design thinking and attended many an event that focused on knowledge translation I can say that there is only a modest correlation between those that study and those that do.
After nearly 20 years of scholarship and debate on knowledge translation and with tools like Twitter and YouTube and blogs we still have to ask questions (quite rightly and likely with much frustration) like this* :
We are still asking ourselves this question and will be for years to come if we don’t start walking instead of talking.
And change isn’t about convincing individuals alone to blog or Tweet, but to create that culture of innovation where we can share ideas, discuss concepts aloud and ideate together, prototype (and fail!), and experiment. It means acting on research as part of doing research and building partnerships rather than writing about them. It’s also about creating the systems that support change, not just inspiring a few individuals to do something different.
Writing about innovation is not the same as doing it. Thinking models — design thinking, systems thinking, knowledge-to-action thinking — are supposed to inspire action, not just thought.
We got the moon and back three times in the span of ten years from the call to action from President Kennedy. An entire country rallied around a very simple and challenging task of putting humans on the moon.
Could the time be now for us to do the same with social innovation and health?
* Thanks to Rob Fraser for consenting to having this tweet included in the post
** Speaking of walking the talk, it is good to be back after a few weeks’ unplanned sabbatical from CENSEmaking. More talk, and lots of walking to come. Thanks to all my readers for your continued interest.
The photo caption is Walk the Talk by Dangerous Truth used Creative Commons License from Deviant Art. Thanks Dangerous Truth!
Disruption by Design
Posted: March 13, 2012 Filed under: design thinking, Education & Learning, innovation, Social media | Tags: Andrea Yip, Clayton Christensen, design, disruptive innovation, education, graphic design, health, health promotion, human services, infographics, innovation, psychology, public health, social determinants of health, social innovation, social work, technology 1 Comment »
DISRUPT by Paul Woot
Innovation, new thinking, and a change in consciousness can upset the way we see our world and the manner in which we relate to it. This disruption can happen by happenstance or intention encouraging us to consider ways to design change before forces outside our influence change us.
disrupt |disˈrəpt|
verb [ with obj. ]
interrupt (an event, activity, or process) by causing a disturbance or problem: a rail strike that could disrupt both passenger and freight service.
• drastically alter or destroy the structure of (something): alcohol can disrupt the chromosomes of an unfertilized egg.
DERIVATIVES
disrupter (also disruptor |-tər|)noun
Observing the city I live in, the media I consume, and the way I learn, I can’t help but be amazed at how much of my life has been disrupted over the past few years. I can access nearly everything I need to run my business and do my research from my handheld or a tablet computer. I can hand that tablet or handheld to someone else and allow them to interact with the content on it by using gestural movements, not a keyboard.
If I am engaged in health communications or scholarly research, I look to places like Twitter and blogs as much if not more than I do academic databases. Many of the journals I respect and publish content that counts in fields like public health, such as the Journal of Medical Internet Research, are open access and free to anyone who wants to read them. And these open access publications are becoming leaders in their fields, not just cheap versions of “real” journals. This makes the content of my academic work and that of my many colleagues accessible and much more likely to be used.
If you’re a graphic designer your work has never been more important. Whether websites, infographics, high-quality interpretations of traditional media (for a great example see the re-imagined journal article by my colleague Andrea Yip) the world has become more visual and the weight of good graphic design is heavier than ever. At the same time, tools like easel.ly allow anyone to make an infographic, or WordPress for those who want websites (this one included), and even offers to do a $42 logo as reported in Creative Review.
Want to raise awareness of issues? Grab a film camera and put together a small film like Kony 2012, the most viral success story of any video to date.
Or write a book on an important, if somewhat arcane, topic like the meaning of making and get people from all over the world to invest in it on Kickstarter (that’s what Seung Chan Lim or Slim as he is known did and I invested in this venture with enthusiasm).
Or charge a mere $5 like comedian Louis C.K. did for a high-quality copy of his recent comedy show filmed at the Beacon Theatre in New York and let your buyers download up to five copies at once for one price.
Or write a book and let your customers determine its price (including free!) like Jon Kolko and his AC4D colleagues have done with Wicked Problems.
This couldn’t have happened five years ago. The production costs were too high, the distribution channels too primitive, and the bandwidth too low. Now, it’s all different and the disruptions are no longer happenstance, but designed.
Harvard professor Clayton Christensen coined the term ‘disruptive innovation‘ which ”describes a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves ‘up market’, eventually displacing established competitors.”
Christensen adds:
An innovation that is disruptive allows a whole new population of consumers access to a product or service that was historically only accessible to consumers with a lot of money or a lot of skill. Characteristics of disruptive businesses, at least in their initial stages, can include: lower gross margins, smaller target markets, and simpler products and services that may not appear as attractive as existing solutions when compared against traditional performance metrics.
Health promotion and public health are fields ripe for this kind of innovation, so is healthcare. Indeed, movements like those embodied in Patients Like Me, a social network portal aimed at supporting human empowerment in health care.
We are on the cusp of this taking place in health promotion and human services — whether they are governmental, non-profit or social enterprise based. Health promotion is largely about enabling individuals, groups and communities to better adapt to change, support themselves and gain greater control over the social determinants of health. At present, we teach students theory and research, but what about business dynamics or systems thinking or visual methods of presentation or social innovation? These are the tools and strategies that the abovementioned examples used. Many of them also used design.
The same challenge holds true for social work, psychology and education.
These are the fields that are key supports for promoting wellbeing in our community. It is perhaps not surprising that the concept of design is noticeably absent from all of these fields.
That doesn’t need to be the case.
This past week I had the privilege of spending an afternoon with Scott Conti and his staff at the New Design High School in New York City. There I saw students working through everyday problems using design, building business ideas to support themselves and their communities, and applying their various creativities to making a difference in their lives using design as the lens. This environment was where social work, education, psychology and health promotion intersect. Scott — who delivers a great talk on his work as part of TEDX Dumbo — is a health promoter and social innovator. So are his teachers.
None of them were trained for what they do. They have adapted, modified, created and innovated. They disrupted their own patterns of work and learning so that they could better disrupt those around them, for good. They did this by design.
If we are to expect that the fields most connected to social action and the promotion of wellbeing are to contribute to our betterment in the future, they need to change. Disruptive design for programs, services and the ways we fund such things is what is necessary if these fields are to have benefit beyond themselves. Long past are the days when doing good was something that belonged to those with a title (e.g., doctor, health promoter, social worker) or that what we called ourselves (e.g., teacher) meant we did something else unequivocally (e.g., educate). Now we are all teachers, all health promoters, all designers, and all entrepreneurs if we want to be. Some will be better than others and some will be more effective than others, but by disrupting these ideas we can design a better future.
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The Wicked Problem of Wicked Problems
Posted: February 13, 2012 Filed under: behaviour change, complexity, design thinking, innovation, Systems science, systems thinking | Tags: AC4D, complexity, design, Jon Kolko, planning, strategy, systems thinking, wicked problems 5 Comments »
All Knotted Up...Like a Wicked Problem
Wicked problems are receiving a lot of attention these days giving much excitement to systems thinkers and designers alike. Yet what these problems mean for planning and understanding social programs and policies is not clear and may be even more wicked that it first appears.
I was excited to learn that Jon Kolko and his creative band of learners at the Austin Center for Design (AC4D) are coming out with a book on wicked problems. As one who studies and helps others to intervene in addressing such problems, this was like being a Star Trek fan learning that Leonard Nimoy was coming to speak at the Trekkie convention in my hometown. It is refreshing to see that the concept of the wicked problem is gaining traction beyond the small band of scholars and practitioners working at the intersection of complexity, systems and design thinking (which, admittedly is where many AC4D folk inhabit, but hopefully their audience will not).
But it’s not just one book. We are seeing transformations in education and science — with calls for a ‘new breed of scientist’ being created at places like Massey University in New Zealand — or spread through the news or business stories in various forms.
The concept of the wicked problem was originally posed by management science scholar and systems thinker C. West Churchman with planners Horst Rittel and Melvin Webber. The Wikipedia entry on wicked problems provides some examples of what these things are:
Classic examples of wicked problems include economic, environmental, and political issues. A problem whose solution requires a great number of people to change their mindsets and behavior is likely to be a wicked problem. Therefore, many standard examples of wicked problems come from the areas of public planning and policy. These include global climate change[4], natural hazards, healthcare, the AIDS epidemic, pandemic influenza, international drug trafficking, homeland security, nuclear weapons, and nuclear energy and waste.
In recent years, problems in many areas have been identified as exhibiting elements of wickedness – examples range from aspects of design decision making and knowledge management[5] to business strategy.[6]
As our social lives become more interconnected through the Internet, globalization, and mass migration, the complexity of the situations we find ourselves in grows. More of anything in diverse forms interacting together is likely to create complexity as new properties emerge and those properties change the trajectory of actions and reactions of the parts dynamically.
As one who is interested in wicked problems and works with people to address them, I should be thrilled to see the term used so widely. I am, but cautiously so. There is a risk that in the enthusiasm to embrace the lexicon of complexity that the meaning gets lost, which is what one gets from the hype cycle (See below).
The Hype Cycle: Coming to a Wicked Problem Near You?
The hype cycle is described as phenomonena initiated by a technology (or idea) and, once caught on, spikes the expectations beyond reason leading to discouragement, mass abandonment of the idea, and then — hopefully — a return to a level of reasonable return.
While the “cycle” (it is not a cycle) has limitations, the analogy here is well suited to fads of various types and the rapid ascension of the concept “wicked problem” in past years is indicative of a trend. Below are two representations of the amount of citations of the work “wicked problem” and “wicked problems” from Google’s Ngram service:
Wicked Problem Citations: 1950-2008
Wicked Problem(s) Citations: 1973-2008
It appears that wicked problems (plural) are increasing and reference to a single problem is staying the same.
Regardless, an upward trend is evident. What it means is another matter…
If wicked problems are becoming talked about more often and by more people, it is appropriate to ask what kind of impact that this new thinking will have on not only the way the problems are posed, but how people seek to address them.
To that end, it is worth envisioning the future with caution. One of the reasons for this is that wicked problems are often not wholly wicked in their composition or the strategy required to address the problem — which ironically makes these types of problems even more wicked.
This has to do with the interconnected, multidimensional, and embedded nature of the problems themselves which contain within them many interconnected non-wicked problems. I’ve started to see difficulties with organizations developing strategy that fails to consider this. It is, as I’ve discussed before, an artefact of either-or thinking. Tackling the kind of wicked problems like poverty, chronic disease, and global finance require a meta-level strategy that recognizes, shapes and adapts to complexity, while accounting for micro-level issues that are indeed, very linear and simple.
Finding, training and retaining the right talent to work with diverse communities on problems that are poorly supported or funded from many sources is wicked. The human resource needs for payroll, supply management, and field support might be much less so. Yet, both are joined-up and require strategies that can extend beyond traditional management and strategy, but also embrace some of the very ‘best practices’ that seem at the outset to be antithetical to complexity.
Just as I shake my head in frustration at seeing complexity dealt with using amplified linear strategies that ‘do the wrong things righter‘, I have surprised myself by how much I’ve been twitching at hearing recent converts to systems thinking rail against the traditional ways of planning as if anything other than seeing problems as complex would be wrong.
At issue is that wicked problems are made more so by having both complex and non-complex elements working together, requiring a level of strategy development that is far more sophisticated than many first thought. Even a review of the better management texts using complexity give short shrift to the relationship between the complex, the simple and the complicated working simultaneously in environments and how we plan for that. The Cynefin Framework provides a start, but just a start.
Until we recognize this complexity — no pun intended — in the way we plan, there is great risk of replicating the hype cycle when our sole use complexity-based models yield poor results of a different nature than the poor results we are seeing from traditional linear, reductionist thinking models applied to many of the problems we deem as wicked today.
Picture credits: A Close Up on Knotted Rope by Sundariel used under Creative Commons License from DeviantArt
Graph: Gartner Hype Cycle by Jeremy Kemp used under licence from Wikipedia.
Knowledge Hypocrites: Take Two!
Posted: February 4, 2012 Filed under: knowledge translation, public health, systems thinking | Tags: beliefs, health promotion, hypocrisy, knowledge mobilization, knowledge translation, reflective practice, values 3 Comments »Knowledge Hypocrites: Take Two!.
The link above points to a great post by KMBeing that deserves some re-blogging here. It looks at the issue of hypocrisy in espousing the values of taking knowledge and putting it into practice, without practicing it. It’s worth a read.
There are a lot of professions and practices where we say one thing and mean another. This is something that can apply to health promotion, design, evaluation and social justice work in any guise.
What do the words and ideas mean and what do they mean in practice?
These two concepts are part of reflective practice and also require good communication, the kind that that allows people to find out what the meaning of their words are in the eyes and ears of another. Good communication requires speaking clearly, listening clearly, and clarifying clearly and doing so honestly and openly.
One of the issues with many of knowledge practitioners is that the rhetoric of knowledge translation/mobilization is so seductive. It is so common-sensical and even trendy. But the idea of sharing what we know, building relationships, and working together in true collaboration is much harder when viewed in reality where people have different resources, power structures, perceptions, reflective capacities, skills, knowledge, and time.
Knowledge mobilization is about not just strategy or tactics, but building up a system that supports it all. David Phipps, who wrote the original article looking at these hypocrisies was referring to this by commenting on the fact that there are too few incentives to change the way things are done and so without a top-level strategy to support change and no incentive from the bottom, the system remains the same.
Designing and living a system that works requires living and designing practices that support our values and communication now.
The PR Problem for Design, Evaluation,and Complexity
Posted: January 29, 2012 Filed under: complexity, design thinking, evaluation | Tags: complexity, design, design thinking, evaluation, George Miller, language, psychology, public relations, social change 2 Comments »
I (heart) PR
Complex concepts like evaluation, design and even complexity itself provide insight, strategies and applications that provide usable solutions to real-world problems, but also suffer from widespread misunderstandings, confusion and even derision. If they are to take hold beyond their initial communities of interest, they need to address their PR problem head on.
This past week was Design Week in Toronto. As one works extensively with design concepts and even has a health promotion-focused design studio, one couldn’t be faulted for thinking that this would be a big week for someone like me who lives and works in the city. Well, it came and went and I didn’t attend a single thing. The reason was partly due to timing and my schedule, but largely because the focus of the week was not really on design writ large, but rather interior design. Sure, there were a few events that focused on social issues (what I am interested in) like the Design With Dialogue session on Designing a Future for our Future, but mostly it was focused on one area of a large field.
And thus, interior design was left to represent all of design.
So why does this matter? It matters a lot because when people hear the term design, most of what was presented this week fits with that perception. The problem is that design is so much more than that. It is about making things, creative thinking and problem tackling (design thinking), social innovation, and responsive planning for complex situations. Architects, business leaders, military strategists, social service agencies and health promoters all engage in design. Indeed, Herbert Simon‘s oft-quoted and often contested definition fits nicely here:
Everyone designs who devises courses of action aimed at changing existing situations into preferred ones
If one accepts that we are all designers and all of what we create and use for change is design, than a week devoted to the topic should offer much more than innovative concepts in furniture or flooring. Yet, this high-concept style showcase is what most people think about when they first hear design. Give people a choice between a Philippe Stark Juicy Salif citrus juicer and creating a trades-based, social change curriculum for low-income kids such as the work by Emily Pilloton as the example of design and they will probably guess think Stark over Pilloton, when both are equally valid examples.
Evaluation (another area I focus my work on) is equally fraught with perception problems. If you want to raise someone’s blood pressure or heart rate, tell them that either they or their work will be the focus of an evaluation. Evaluation may be the longest four-letter word in the English language. Yet, tell someone that you have a strategy that can enable people to learn about what they do, its impact, and provide intelligence on ways to improve, adapt and outperform their competitors and you’ll find an inspired audience for evaluation services.
Lastly, complexity presents the same challenge. It’s very name — complexity — can make people shy away from it. As humans, we crave the simple in most things as it is easier to understand, manage and control. Complexity offers none of these things and, if anything, reveals how little control we have. Entire fields of inquiry have been established around complexity science and its related theories and practices. Complexity can help us make sense of why things don’t work as we think they ought to and allow us to better navigate through unpredictable terrain with greater resilience than if we tried to tackle such problems as if they were linear in their cause and consequence.
In all of these cases — design, evaluation and complexity — there exists a PR problem. The advantages that they pose are tremendous, yet these concepts are frequently misunderstood, dismissed, or inappropriately used . When this happens, it creates even greater distance between the potential benefits these concepts offer and their real-world application.
This distance is partly an artefact of poorly articulated definitions and examples, but also by design (no pun intended). There are those who relish having these concepts appear opaque to those outside of their social cluster. Thus, we have the ‘superstar designer’ who seeks to create products and personas that are built upon their rarity, rather than accessibility. There are evaluators who exploit the fear that people have of evaluation and lack the understanding of the methods and practices of evaluation (vs concepts like research or innovation consulting) to gain contracts and social influence within their field. Complexity, with its foundations in physics and systems biology, can appear to the layperson as otherworldly, making its practitioners and scientists seem all the more powerful and smart. These tactics benefit a small ‘elite’(?) number of professionals, while robbing a far larger audience of the potential benefits.
In 1969, then president of the American Psychological Association, George Miller, implored members to “give psychology away“. His message was that psychology was too important to be left just to the professional, graduate-trained practitioners to use. If psychology was to confer social benefits, it was necessary to ensure that everyone had access to it — it’s theories, methods, models and treatments. It is perhaps no surprise that psychology remains one of the most popular undergraduate degree programs in the arts and social sciences and the focus of television shows, magazines and and an array of services. Miller was commenting on the need to change a field that he perceived was becoming elitist and not serving the needs of society.
The same might be true of design, evaluation and complexity if we let it. It’s not a surprise that these three concepts are intimately tied together, as those training to apply design thinking and strategic foresight learn. Perhaps its time to start giving these ideas away, but to do so we first need to rehab their image and apply some design thinking and brand development strategy to all three ideas. As practitioners in any or all of these fields, giving away what we do by educating, reinforcing, and ensuring that the work we do is of the highest quality is a way to lead by example. None of us is likely to change things by ourselves, but together we can do wonders.
For those interested in evaluation, I suggest catching up on the AEA365 blog sponsored by the American Evaluation Association, where evaluation bloggers and practitioners share ideas about how to practice evaluation, but also how to communicate it to others. For those interested in design, I would encourage you to look at places like the Design Thinkers LinkedIn group, where practitioners from around the world discuss innovations and way to promote and apply design thinking. A similar group, and opportunity, exists with the Systems Thinking LinkedIn group or by joining the Plexus Institute, which does considerable work to promote complexity and systems thinking in North America.
Photo: I (Heart) PR by The Silfwer used under Creative Commons Licence from Flickr.
Common Sense, Complexity and Leadership
Posted: January 23, 2012 Filed under: complexity, social systems | Tags: common sense, complexity, decision making, developmental design, Duncan Watts, evaluation, leadership, social networks, strategy, systems thinking Leave a comment »
Bye, Bye Common Sense
Great leaders are often ascribed traits that include ample common sense. But what passes for common sense is often a grab bag of miscellaneous, inconsistent ideas that are context dependent and less useful in the complex environments where leadership is called for most.
common sense |ˌkɑmən ˈsɛns|
noun
good sense and sound judgment in practical matters: use your common sense | [ as modifier ] : a common-sense approach.
Today Research in Motion announced that its founder Mike Lazaridis and his co-CEO Jim Balsillie would be relinquishing their roles with the company. In their place, a ‘pragmatic, operational-type guy ‘was installed. Presumably, Thorsten Heins has the common sense to lead RIM after the founders lost theirs. Yet, the pragmatic, common sense that RIM is looking for might not be what they need given the complexity of the environment they are leading in.
Common sense is a false lure in complex systems. In his recent book, Everything is Obvious *Once You Know the Answer, social network researcher and Yahoo! Research scientist Duncan Watts eloquently critiques the concept of common sense, illustrating dozens of times over how “common sense” doesn’t fare so well in decisions that go beyond the routine and into the complex. Indeed. the very definition of the term implies that the problems that common sense works towards addressing are relatively simple and pragmatic.
Certainly, navigating daily social conventions might lend itself well to what we might call common sense. Watts refers to sociologist Harry Collins’ term ‘collective tacit knowledge‘ that is encoded in social norms, customs and practices of a particular world to describe common sense. However, what becomes common is a byproduct of many small decisions, dynamic and flexible changes to perspective, an accumulation of knowledge gained from small experiments over time, and the application of all of this knowledge to particular, context-dependent, situations. This constellation of factors and its interdependent, contextual overlap is why artificial intelligence systems have such a difficult time mimicking human thought and action. It is this attention to context that is most worth noting for it is this context that keeps common sense from being anything but common:
Common sense…is not so much a worldview as a grab bag of logically inconsistent, often contradictory beliefs, each of which seems right at the time but carries no guarantee of being right any other time.
Watts goes on to argue:
Commonsense reasoning, therefore, does not suffer from a single overriding limitation but rather from a combination of limitations, all of which reinforce and even disguise one another. The net result is that common sense is wonderful at making sense of the world, but not necessarily at understanding it.
Thus, we often concoct a narrative about the way something happens that sounds plausible, rational and be completely wrong. Throughout the book, Watts shows how often mistakes are made based on this common sense approach to solving problems.
When it comes to RIM, some have pointed to the late Steve Jobs’ assertion that they would have difficulty catching up to firms like Apple given that the consumer market is not their strength, the enterprise market is. Yet, Steve Jobs didn’t let the fact that Apple was a computer company stop him from making music players (the iPod), mobile phones (the iPhone) or becoming book, music and movie vendors (iTunes). A read of Steve Jobs’ biography by Walter Isaacson reveals a man who was able to lead and be successful through what appeared to be common sense, yet was decidedly uncommon among media and technology leaders. That is why Apple is where it is and why so many other technology companies lag behind them or simply disappeared.
The reason is that common sense in leadership looks as simple in hindsight only, not in foresight or even in the present moment. This is one of the big points that Watts makes. He uses the example of Sony’s MiniDisc system that, when introduced, had all of the hallmark features of the innovations that Apple introduced (novel, high quality, portable, smaller, visible advantages over the alternatives), yet it was a spectacular failure. Canadian management consultant Michael Raynor has called this the strategy paradox. When qualities such as vision, bold leadership, and focused execution — all the commonsensical aspects of great leaders — are applied to organizations it can lead to great success (Steve Jobs and Apple) or resounding failures (RIM?).
Strategic flexibility, making small adjustments consistently, and imaging scenarios for the future in an ongoing manner are some of the potential ways to limit the damage from common sense (or use its advantages more fully). This requires feedback mechanisms and close monitoring of program activities, developmental evaluation, and a willingness to tweak programs and design on the go (what I call: developmental design) . It’s not a surprise that this incremental approach to development is consistent with the way change is best produced in a complex adaptive system.
By recognizing that common sense is less than common and is certainly not consistent, program designers, developers, evaluators and other professionals will be better positioned to provide true leadership that addresses challenges and complexity rather than adds to the complexity and creates more problems.
Photo: Goodbye to Common Sense Space by Amulet Dream from Deviant Art
Does Solitude Enhance Creativity? A Critique of Susan Cain's Attack on Collaboration
Posted: January 22, 2012 Filed under: Uncategorized Leave a comment »
I’ve just read a New York Times article by Susan Cain, author of the forthcoming book Quiet: The Power of Introverts in a World That Can’t Stop Talking. It’s the frustrated cry of a true introvert. Cain is clearly tired of everyone touting the benefits of collaboration; some people, herself included, just want to be left alone. And, she argues, those are the people who really come up with all of the great ideas.
The Complexity of Planning and Design in Social Innovation
Posted: January 7, 2012 Filed under: complexity, design thinking, evaluation, Systems science, systems thinking | Tags: complexity, design, developmental design, developmental evaluation, evaluation, health, human services, Social media, systems thinking 2 Comments »
The Architecture of Complex Plans
Planning works well for linear systems, but often runs into difficulty when we encounter complexity. How do we make use of plans without putting too much faith in their anticipated outcome and still design for change and can developmental design and developmental evaluation be a solution?
It’s that time of year when most people are starting to feel the first pushback to their New Year’s Resolutions. That strict budget, the workout plan, the make-time-for-old-friends commitments are most likely encountering their first test. Part of the reasons is that most of us plan for linear activities, yet in reality most of these activities are complex and non-linear.
A couple interesting quotes about planning for complex environments:
No battle plan survives contact with the enemy – Colin Powell
In preparing for battle I have always found that plans are useless, but planning is indispensable – Dwight D. Eisenhower
Combat might be the quintessential complex system and both Gens Powell and Eisenhower knew about how to plan for it and what kind of limits planning had, yet it didn’t dissuade them from planning, acting and reacting. In war, the end result is what matters not whether the plan for battle went as outlined (although the costs and actions taken are not without scrutiny or concern). In human services, there is a disproportionate amount of concern about ‘getting it right’ and holding ourselves to account for how we got to our destination relative what happens at the destination itself.
Planning presents myriad challenges for those dealing with complex environments. Most of us, when we plan, expect things to go according to what we’ve set up. We develop programs to fit with this plan, set up evaluation models to assess the impact of this plan, and envisage entire strategies to support the delivery and full realization of this plan into action. For those working in social innovation, what is often realized falls short of what was outlined, which inevitably causes problems with funders and sponsors who expect a certain outcome.
Part of the problem is the mindset that shapes the planning process in the first place. Planning is designed largely around the cognitive rational approach to decision making (PDF), which is based on reductionist science and philosophy. Like the image above, a plan is often seen as a blueprint for laying out how a program or service is to unfold over time. Such models of outlining a strategy is quite suitable for building a physical structure like an office where everything from the materials to the machines used to put them together can be counted, measured and bound. This is much less relevant for services that involve interactions between autonomous agents who’s actions have influence on the outcome of that service and that result might vary from context to context as a consequence.
For evaluators, this is problematic because it reduces the control (and increases variance and ‘noise’) into models that are designed to reveal specific outcomes using particular tools. For program implementers, it is troublesome because rigid planning can drive actions away from where people are and for them into activities that might not be contextually appropriate due to some change in the system.
For this reason the twin concepts of developmental evaluation and developmental design require some attention. Developmental evaluation is a complexity-oriented approach to feedback generation and strategic learning that is intended for programs where there is a high degree of novelty and innovation. Programs where the evidence is low or non-existent, the context is shifting, and there are numerable strong and diverse influences are those where developmental evaluations are not only appropriate, but perhaps one of the only viable models of data collection and monitoring available.
Developmental design is a concept I’ve been working on as a reference to the need to incorporate ongoing design and re-design into programs even after they have been initially launched. Thus, a program evolves over time drawing in information from feedback gained through processes like evaluation to tweak its components to meet changing circumstances and needs. Rather than have a static program, a developmental design is one that systematically incorporates design thinking into the evolutionary fabric of the activities and decision making involved.
Both developmental design and evaluation work together to provide data required to allow program planners to constantly adapt their offerings to meet changing conditions, thus avoiding the problem of having outcomes becoming decoupled from program activities and working with complexity rather than against it. For example, developmental evaluation can determine what are the key attractors shaping program activities while developmental design can work with those attractors to amplify them or dampen them depending on the level of beneficial coherence they offer a program. In two joined processes we can acknowledge complexity while creating more realistic and responsive plans.
Such approaches to design and evaluation are not without contention to traditional practitioners, leaving questions about the integrity of the finished product (for design) and the robustness of the evaluation methods, but without alternative models that take complexity into account, we are simply left with bad planning instead of making it like Eisenhower wanted it to be: indispensable .
