Category: innovation

behaviour changecomplexityeHealthinnovationknowledge translation

The Face-to-Face Complexity of eHealth & Knowledge Exchange

The Public Health Agency of Canada‘s 2010 Knowledge Forum on Chronic Disease was held last night today in Ottawa with the focus on social media. The invitation-only affair was designed to bring together a diverse array of researchers, practitioners, policy developers, consultants and administrators who work with social media in some capacity. There were experts and non-experts alike gathered to learn about what the state of the art of social media is and how it can support public health. By state of the art, I refer not to the technological side of things, but rather the true art of public health, much like that discussed earlier this year at the University of Toronto.

Last night began with a presentation from Leanne Labelle that got us all thinking about how social media is radically different in the speed of its adoption and breadth of its social impact drawing inspiration from this video from Eric Qualman’s Socialnomics website.

Today we got down to business and started working through some of the issues that we face as a field when adopting social media. I would probably consider myself among the most experienced users in the audience, yet still gained so much from the day. Although I learned some things about how to use social media in new ways, what I learned most was how others use it and what struggles they have. This is always a useful reminder.

What stuck out was a presentation and related discussion from Christopher Wilson from the University of Ottawa’s Centre on Governance and a consultant on governance issues. In speaking about the challenges of doing collaboration, Christopher pointed to the problems of a ‘one-size fits all’ strategy using a diagram illustrating the fundamental differences between engagement at a small scale (under 25 people) and what is the mass collaboration that folks like Clay Shirky, Don Tapscott, and others write about. His diagram looks like this:

Technology Spectrum of Social Collaboration by Christopher Wilson

What Wilson stressed to the audience was the role that complexity plays in all of this. Specifically, he stated:

The more complex and interdependent things become, the more people need to be aware of the changing context and the changes in shared understanding.

As part of this, groups are required to engage in ways that enable them to deal with this complexity. In his experience, this can’t be done exclusively online. He further stated:

As complexity increases, the need for offline engagement increases.

I couldn’t agree more. In my work with community organizing and eHealth promotion, I’ve found the most effective means of fostering collaboration is to blend the two forms of knowledge generation and exchange together. The model that my research team and I developed is called the CoNEKTR (Complexity, Networks, EHealth, and Knowledge Translation Research Model).

This model combines both face-to-face methods of organizing and ideation, with a social media strategy that connects people together between events. The CoNEKTR model has been applied in many forms, but in each case the need to have ways to use the power of social media and rich media together with in-person dialogue has been front and centre. Using complexity science principles to guide the process and powered by social media and face-to-face engagement, the power to take what we know, contextualize it, and transform it into something we can act on seems to me the best way forward in dealing with problems of chronic disease that are so knotted and pervasive, yet demand rapid responses from public health.

design thinkingeducation & learningevaluationinnovation

More Design Thinking & Evaluation

Capturing Design in Evaluation (CameraNight by Dream Sky, Used under Creative Commons License)

On the last day of the American Evaluation Association conference, which wrapped up on Saturday, I participated in an interactive session on design thinking and evaluation by a group from the Savannah College of Art and Design.

One of the first things that was presented was some of the language of design thinking for those in the audience who are not accustomed to this way of approaching problems (which I suspect was most of those in attendance).

At the heart of this was the importance of praxis, which is the link between theory, design principles and practice (see below)

Design Thinking

As part of this perspective is the belief that design is less a field about the creation of things on their own, but rather a problem solving discipline.

Design is a problem solving discipline

When conceived of this way, it becomes easier to see why design thinking is so important and more than a passing fad. Inherent in this way of thinking are principles that demand inclusion of multiple perspectives on the problem, collaborative ideation, and purposeful wandering through a subject matter.

Another is to view design as serious play to support learning.

Imagine taking the perspective of design as serious play to support learning?

The presenters also introduced a quote from Bruce Mau, which I will inaccurately capture here, but is akin to this:

One of the revelations in the studio is that life is something that we create every single day. We create our space and place.

Within this approach is a shift from sympathy with others in the world, to empathy. It is less about evaluating the world, but rather engaging with it to come up with new insights that can inform its further development. This is really a nod (in my view) to developmental evaluation.

The audience was enthralled and engaged and, I hope, willing to take the concept of design and design thinking further in their work as evaluators. In doing so, I can only hope that evaluation becomes one of the homes for design thinking beyond the realm of business and industrial arts.

design thinkingeducation & learningevaluationinnovationresearch

Design Thinking & Evaluation

Design Thinking Meets Evaluation (by Lumaxart, Creative Commons Licence)

This morning at the American Evaluation Association meeting in San Antonio I attended a session very near and dear to my heart: design thinking and evaluation.

I have been a staunch believer that design thinking ought to be one of the most prominent tools for evaluators and that evaluation ought to be one of the principal components of any design thinking strategy. This morning, I was with my “peeps”.

Specifically, I was with Ching Ching Yap, Christine Miller and Robert Fee and about 35 other early risers hoping to learn about ways in which the Savannah College of Art and Design (SCAD) uses design thinking in support of their programs and evaluations.

The presenters went through a series of outlines for design thinking and what it is (more on that in a follow-up post), but what I wanted to focus on here was the way in which evaluation and design thinking fits together more broadly.

Design thinking is an approach that encourages participatory engagement in planning and setting out objectives, as well as in ideation, development, prototyping, testing, and refinement. In evaluation terms, it is akin to action research and utilization-focused evaluation (PDF). But perhaps its most close correlate is with Developmental evaluation (DE). DE is an approach that uses complexity-science concepts to inform an iterative approach to evaluation that is centred on innovation, the discovery of something new (or adaptation of something into something else) and the application of that knowledge to problem solving.

Indeed, the speakers today positioned design thinking as a means of problem solving.

Evaluation , at least DE, is about problem solving by collecting the data used as a form of feedback to inform the next iteration of decision making. It also is a form of evaluation that is intimately connected to program planning.

What design thinking offers is a way to extend that planning in new ways that optimizes opportunities for feedback, new information, participation, and creative interaction. Design thinking approaches, like the workshop today, also focuses on people’s felt needs and experiences, not just their ideas. In our session today, six audience members were recruited to play the role of either three facets of a store clerk or three facets of a customer — the rational, emotional and executive mind of each. A customer comes looking for a solution to a home improvement/repair problem, not sure of what she needs, while the store clerk tries to help.

What this design-oriented approach does is greatly enhance the participant’s sense of the whole, what the needs and desires and fears both parties are dealing with, not just the executive or rational elements. More importantly, this strategy looks at how these different components might interact by simulating a condition in which they might play out. Time didn’t allow us to explore what might have happened had we NOT done this and just designed an evaluation to capture the experience, but I can confidently say that this exercise got me thinking about all the different elements that could and indeed SHOULD be considered if trying to understand and evaluate an interaction is desired.

If design thinking isn’t a core competency of evaluation, perhaps we might want to consider it.



complexityinnovationknowledge translationpublic healthsocial systems

Restoring Sanity in Health Communications


Yesterday television commentators, satirists, comedians, provocateurs Jon Stewart and Stephen Colbert hosted the Rally to Restore Sanity on the Washington Mall. The event was described as a counter to what has been seen as a rising tide of hostility and incivility in the media.

We’re looking for the people who think shouting is annoying, counterproductive, and terrible for your throat; who feel that the loudest voices shouldn’t be the only ones that get heard; and who believe that the only time it’s appropriate to draw a Hitler mustache on someone is when that person is actually Hitler. Or Charlie Chaplin in certain roles.

The event, which I didn’t attend or see, has received a lot of news coverage that has, perhaps ironically and predictable, been all over the map choosing to focus on the “insane crowd” , the “lighthearted rally“, or the “comedic call for calm” (video).

But as the media grasps for their sound bites, the coverage ironically provides a perfect example of one of the central things  the Rally was intended to highlight: oversimplification and amplification of extreme perspectives that mislead and mis-represent reality.

If we amplify everything, we hear nothing.

These words from Jon Stewart point to the problem of lack of differentiation in signal strength when we communicate messages.

The press is our immune system. If it overreacts to everything we eventually get sicker.

When everything is important, nothing is important.

That is part of restoring sanity in any communication platform. Certainly when we consider innovation in health and social services. How often are recommendations for action large, unwieldy and full of detail? Everything is important and everything is critical. Attend a major public health conference and you’ll come away feeling that there are dozens of “top” priority items to tackle. This is not to suggest that there is lots of work to be done in lots of areas, but its easy to see why we’re having a hard time motivating policy makers, the public, and generalist health practitioners to action when they get these kinds of messages.

What results is that we wind up with gimmicks like football players wearing pink shoes to raise awareness for breast cancer. That might be a good idea, but it is also a costly one. Breast cancer is one of many areas that spends a lot of money to bring in a lot of money. Anecdotally, I’ve told by those in the know that many health charities in Canada send upwards of 80% of their charitable intake to the companies running the campaigns for the reason that they can’t run it themselves.

I agree that good campaigns require sophisticated talent (which requires investment), but as a donor I find the story behind these statistics reprehensible. But the bottom line in this case is around marketing and getting that message louder and bigger. As more distractions come in, more content is generated and people’s attentional resources get ever more taxed, being louder and bolder is seen as the viable strategy for getting messages — political or health — out.

But there are other ways.

Developing relationships, true relationships, with your intended audience might be a better way. It is not a simple* way like most of the loud-speaker marketing uses, rather it is a complex, more nuanced way of getting the word out. It’s also the way that most of us learn and develop trust networks. The difference is that these relationships and networks are far more robust and adaptive to complex conditions than the straightforward thrust of traditional simple marketing strategies. They will last much longer than the campaigns used to generate the messages in the first place.

When resources are tight and the number of people competing for those resources is greater than ever, a communication strategy that is cost-effective over the long-term, robust, adaptive and brings people and ideas closer together is a good bet. Time to restore not only sanity, but relationships in our work.

* simple does not equal easy or effortless.

behaviour changecomplexityeducation & learninginnovationpublic health

Time and Chance Doesn’t Happen to Us All


Again I saw that under the sun the race is not to the swift, nor the battle to the strong, nor bread to the wise, nor riches to the intelligent, nor favor to those with knowledge, but time and chance happen to them all. – Ecclesiastes 9:11

According to the bible, we are all subject to the randomness of life and the effects of time, regardless of our status, knowledge or skill. There are many days when that doesn’t seem true at all.

For those working in creative fields or knowledge working environments, time is something that is a critical ingredient for influencing the products that emerge from those settings. Time is needed to find information, process it, and make sense of it, particularly if that information is of a complex nature.

In the health sector, evidence-based decision-making is considered the gold standard. It stands to reason that using the best knowledge accumulated from what we’ve already done is a good idea when people’s health is at the centre of attention. But how often do we actually have the time to do actually get evidence, process it, and sense-make around it to apply it in a reasonable way? My informal read on my colleagues in the research and clinical practice fields is that the answer: none. Go to any meeting and nearly all the participants are at some point checking their Blackberry or iPhone in the meeting itself, or right before or immediately after. These are the times when we used to talk to each other, ask questions about each other, and build social relationships.

Now, its addressing the mountain of email that seems to be growing.

Chance, those opportunities to take advantage of spontaneous emergence of information, is also lost. By being so focused on the information coming in through mobile devices, or in one’s own memory, we lose opportunities for the sense-making that enables us to discover new things.

So we have this remarkable paradox where the demands for more, better, appropriate, timely knowledge is greater than ever on problems that are becoming ever-more complex with more tools to generate and sort this information, and no time to actually use it effectively.

In my health behaviour change course we look at literature on changing all kinds of behaviour from eating, physical fitness, smoking, sexual health promotion, and beyond, but not time. Perhaps it is time for that to change, for if that element changes, the chance that it will lead to improved health and innovation might increase along with it.

innovationsystems thinking

Over Educated and Under Developed For Innovation

This past week I had the true privilege of attending a High Table Dinner with some of the University of Toronto’s future leaders from Trinity College. The guests, some faculty, but mostly students, came from many different disciplines and ranged from first year undergrads to doctoral students who were well on their way in their dissertation studies.

Before, during and after the meal, we had the chance to mingle and chat, and in those discussions I was reminded of how out of sync much of the university system is with those seeking to innovate, but also how much promise there is in the future.

No more was this evident in the conversation that starts of with some variant on the topic “what do you study? teach? do?” As this was a very educated, enthusiastic and curious crowd, my simple answers were not sufficient. “I am a professor in the School of Public Health” was not going to cut it. So, I told people. And they listened. And they asked me a lot of questions. And as I was answering them, the absurdity of much of what I did, have done, and continue to do with my students became more readily apparent.

For example, I spoke of my education and the various degrees and certifications that I had when asked about my career track and background. As I tallied things from my undergraduate degree through to my post-doctoral training, the numbers started to add up, as did the designations, and soon I was faced with a fact that I graduated in GRADE 27.

Some students had no idea that there even were things like “post-docs” and the concept that someone would spend all these years getting a PhD and then feel the need to get further training beyond that seemed unreal. And yet, when I chose to get a post-doc, which I loved doing, I was told that it was soon to be the new standard for education. My colleagues in the basic sciences will often to two post-docs.

Consider that for a minute. We are advocating that young minds spend their most creative years, when they are enthusiastic, energetic, and ready to challenge the system getting entrained in the system, working for others, and being told that — no matter how bright they are — they are not qualified to contribute to the scholarly world in an official capacity. It reminds me of a TED talk by Sir Ken Robinson, where he quite rightly points to how we (the university system) create a model where everyone is measured against the PhD and basically how far away one becomes from one (more or less).

Once graduated, students have invested so much time, energy, money and opportunity costs into the system, they become beholden to anything that keeps them from losing this potential investment. It rewards them from keeping the status quo alive, even if they don’t like it.

On a personal note, I’ve spent the first few years post-post-doc imagining that, despite my best efforts to see through it, there had to be SOMETHING that I was missing about the way the system functions that, if I just stuck with it, would produce the results of change I wanted. I could really contribute to the greater good, while doing good work within the system that was academia in the form that I knew it to exist. At least, that’s what I thought.

A few years later, I realize much more about how the system is designed to perpetuate itself. As one who trained in complex systems and psychology, none of this should have been a surprise to me, but it was (and sadly, still is). Yet, what I saw in the youth that gathered around the room that night earlier this week was little evidence of this status quo. There were students — two in fact — that had the audacity to take Biochemisty and English. Some who were combining social sciences and the humanities, languages with applied sciences, and professional programs with non-professional-oriented studies. Why? Because they had the opportunity to learn provided through their education at the U of T.

My word to them was to embrace this. The world needs it. Here, as a professional scientist, I hear all the time that we need to innovate, that innovation and social innovation is the way forward. These are words I completely support, yet look beneath the surface and you’ll see that language couched in a way that doesn’t really challenge the system, but rather asks it to make a small change with the hopes that big things will happen. Maybe. But that is making the assumption that the system is designed for innovation in the first place, and the mere fact that in all those 27 years of education I was never once taught how to communicate with any audience other than my peers suggests that the system is more problematic than we think.

The school I teach at trains leaders in public health, yet there are no courses in leadership, which is on par with nearly every other school of its kind (some exceptions of course) in the country and continent. We are expected to engage in detailed, thoughtful knowledge translation when we’re not taught to do anything but our own discipline and taught no skills to communicate beyond it. Few schools offer this. As a faculty, team science or real transdisciplinary or applied or community-based research is considered novel as a side project , but not something that one gets rewarded for and certainly not something that suits a serious researcher.

These young learners have acquired much knowledge and will gain much more as they continue their studies. Hopefully they learn some other lessons along the way and maybe start working to solve these problems earlier, rather than grabbing more degrees towards making them stick.