Tag: new year’s resolutions

behaviour changesocial systemssystems thinkingUncategorized

Systems thinking and collective impact

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When we seek change the temptation is looking for ‘the key’ component of a problem or situation that, if changed, is expected to lead to profound transformation. Too frequently these type of solutions fail not because the change to the component is poor, but that the thinking is not aligned to the system that contributes to the problem in the first place and thus, changing thinking is what’s actually the key not the designed solution. 

If you’re one of the millions of people who made a New Years resolution there is a very good chance that your resolve has already wavered if not been completely abandoned. Research shows that New Years resolutions simply don’t hold up. This is not because of lack of will or even lack of effort or thought, but because we often confuse changes in a part of the system (e.g., exercise and better diet) with changes in the system itself (overall better health and weight loss).

Travel might be the ultimate example of systems and change. For the scenario pictured above, having a better automobile does nothing to help navigate the streetscape. No amount of fuel efficiency, top speed, safety rating or performance tires are going to make an ounce of difference in traversing this space. The reason is that the transportation system is broken, not that the units within it are. Indeed, cars, bikes, rickshaws and foot all perform perfectly well in this environment as designed, yet are rendered disabled in this context, which was designed to facilitate, not hinder their use.

Collective impact, systems change?

The model of collective impact is one that recognizes the fallacies of assuming that organizations seeking transformative social change will do so on their own, independently through wise thought and action. Collective impact is a model that has been widely supported by organizations such as Tamarack as a means of building capacity for systems change, not just change in the system.

The concept of collective impact was first popularized by John Kania and Mark Kramer in an article in the Stanford Social Innovation Review. Collective impact is a specific set of strategies that align the following five qualities and brief summaries that follow:

  • Common agenda (are organizations striving for the same things?)
  • Shared measurement systems (are partners measuring the same things in the same ways to enable comparisons and combine data?)
  • Mutually reinforcing activities (are initiatives building on one another, syncing up, and coherent?)
  • Continuous communication (are partners ‘in the know’ about what is happening across the system as activities unfold? )
  • Backbone support organizations (is there an organization or more that provides coordinating support and infrastructure to maintain the whole enterprise?)

The concept of coordinated action toward a common goal supported by shared means of assessment and feedback and ongoing communication is an enormous step forward in organizing actors involved in social change initiatives.

What is often missing from the discussion of collective impact is systems thinking. That is, explicit discussion of the way systems operate and not just discussion of the system itself that is to be changed. To be clear, there are many ways of doing collective impact and I mention Tamarack because they are among the few organizations that bring systems thinking into their work on systems change and collective impact. But it’s important to note that this is an exception, not the rule when reviewing what’s out there on collective impact. Many organizations do not (or may not) realize that thinking about systems change is not the same as systems thinking.

It is quite possible that we could see collective impact produce a larger-scale version of the flaws we see in initiatives aimed at changing components of the system if systems thinking isn’t considered integral to how its implemented. No amount of communication or shared measurement will help if we don’t measure the right things.

Systems thinking about collective impact

Social change is not doing the same thing that works at one scale (e.g. a person, family or team) and simply doing a lot more of it in more places. There are corollaries to be sure, but it’s not a linear pathway. Just as scaling a challenge and the response to it up produces potential for benefits, it also can scale harmful (or limiting) effects if the problem is not well-defined.

With that, let me pose some questions and challenges for those engaging in collective impact to help advance our shared understanding that are rooted in systems thinking?

  • What is the problem that is aimed to be solved (and is it the real problem?) Have alternative viewpoints from a diversity of actors throughout the system been considered in light of their position within the system and the values, goals and aspirations of those seeking systems change?
  • One of the ways that this diversity of perspectives is gained is through systems mapping. Systems mapping can be done through many different methods with each producing different looks at the dynamics, structures and relationships within the system. But what is shared is that it visualizes these qualities in a manner that makes it accessible to (almost) everyone. It allows for participants in the process to ask questions like: “why is [x] located so close to [y]?” or “where is [z] in all of this?” These create the kind of discussions that allow assumptions to emerge about the dynamics of the system itself.
  • An important follow-up to this is tracking these issues and framing them as evaluation questions. This grounds some of the metrics and measures in the system itself, not just the activities that the participants in collective impact initiatives seek to perform. It can also recognize the limits of the organizations at the table and either better account for them or provide guidance on how to overcome them (e.g., recruit more or different partners).
  • Systems maps are not only useful at the beginning, but can be an evaluative tool in itself. Maps developed at the start of an initiative and at different time points can enable partners to see what has changed and potentially find out how by examining how the structures, relationships and inclusion or exclusion of certain parts of the system shift over time. It may not allow for explicit causal attribution, but it can help understand and document what changed and initiate collective sense making about how that might have happened.

This is just a sample.

If we consider the traffic problem posed at the start of this post, one might find that the system problem isn’t even one related to the street, but to the larger community. One may find that the distances or locations of places to work, worship, shop and play are misaligned or that there are times of days when certain activities bring people into the street or perhaps its related to temperature (too hot, too cold) and the absence of climate control systems that work. More importantly however, systems thinking may enable us to account for all of these at the same time and avoid us focusing on one or two problems, but the system as a whole avoiding what is known as “a fix that fails”.

 

 

behaviour changecomplexityinnovationpublic healthsystems thinking

A Mindful New Year

Cutting through the swamp of information (CC by Mindfulness)

What is mindfulness and why should we be paying attention to it in our individual and organizational work in health systems? As the calendars change and we begin to reflect on the year past and what is to come, it seemed like a good time to ask that question.

Shifts in the calendar are always strange and wonderful events for me. On one hand, it seems that the world has changed with new possibilities, (literally) new calendars and date stamps on everything, and what seems to be a wave of renewal and energy among friends and family. It is the time when people make resolutions and aspirations to make the world and their part of it a better place. As I’ve written before, this is not unproblematic and often leads to failure, but the act of reflection is one of the consistent benefits regardless of whether goals are achieved or not.

Mindfulness, an intentional act of paying active attention to the present moment in a non-judgemental manner, has been found to produce benefits for individuals and organizations alike. University of Toronto professor and psychoanalyst Scott Bishop and others have sought to take the idea of mindfulness further by looking at what this act of paying attention really is and how it could benefit human wellbeing. In their 2006 paper, Bishop and his colleagues reviewed the state of the literature on mindfulness-based approaches to health and wellbeing and convened meetings with those doing research in this are with an aim to come up with a more specific definition of mindfulness suitable for research.

To that end, they came up with the following:

We propose a two-component model of mindfulness. The first component involves the self-regulation of attention so that it is maintained on immediate experience, thereby allowing for increased recognition of mental events in the present moment. The second component involves adopting a particular orientation toward one’s experiences in the present moment, an orientation that is characterized by curiosity, openness, and acceptance.

This model has some critical features worth expanding upon, particularly for those of us working on issues of health.

1. Self-regulation of attention. Unlike a traditional marketing approaches that seek to capture our attention and dictate things to us, self-regulation implies some sense of resistance to the messages that come or are thrown up at us (think: Times Square for the most extreme example of this) and control. It is tied in with self-determination theory and many other health behaviour change theories that stress the importance of having self-directed influence over our cognitions and emotions rather than having them unduly, mindlessly, influencing us. It sounds simple, but it isn’t easy when you’re bombarded by media messages.

2. Maintaining focus on the immediate experience and the present moment. Here I turn to sage wisdom of Yoda in his conversation with Luke Skywalker and Obi Wan Kenobi about the problems Luke has with sustained attention on the present, rather than fantasizing about the future.

A Jedi must have the deepest commitment, the most serious mind. This one a long time have I watched. All his life has he looked away… to the future, to the horizon. Never his mind on where he was. What he was doing. Adventure. Excitement. A Jedi craves not these things. You are reckless.

Jon Kabat Zinn has written and spoken extensively on this problem of sustained attention on problems and how our attentive resources tend to focus on almost anything but the present moment. Just spend a moment paying attention to where your mind is right now and it is probably not fully in the present.

3. Encourage curiosity, openness, and acceptance. These three points, joined together, are ones that are near and dear to my heart because they are so poorly done within my world of public health research and practice, despite what it may appear. Curiosity means supporting innovation — translating knowledge into actionable products that have transformative value (that is, it changes the way you see, act and engage with things – including ideas) — is something spoken of widely, but rarely achieved. Funders, researchers, policy makers and politicians alike are all becoming more risk averse it seems and that is almost antithetical to curiosity, which necessarily means going into the unknown.

Openness, a problem I have written about, is also something spoken of, but not acted on as often as words might appear.

And acceptance builds on the other two, drawing us to consider the value in new ideas and perspectives that differ from ours. It means attention to diversity and a welcoming of difference. That kind of thinking however, steers us into the realm of complexity, where the idea of best practice (a concept that seeks to reduce difference) is inappropriate in favour of good or appropriate practice.

Becoming mindful enables us to attend to the complexity of human systems and can guide our thoughts and actions in a manner more aligned with our purpose for doing what we do in the first place. It is that re-alignment of purpose and the desire to understand what we’ve done in light of what we desire that prompts such attention to New Year’s resolutions this time of year. A more mindful take on this suggests that we may wish to consider doing this much more than just at the end of December and beginning of January. Imagine what we might do then?

Happy Mindful New Year!

 

behaviour changecomplexitydesign thinkinghealth promotionpsychology

A Complex View of New Year’s Resolutions

A Happy, Simple New Year (CC- WilliamCho)

The end of the year is coming and, despite good advice and the warning about how they don’t work, you’re still determined to come up with a really good New Year’s Resolution and this year, dammit, you’re going to stick with it.

It’s simple, right? Make a commitment, come up with a plan to stick to it, and you’re ready to go.

Firstly, change in human systems is rarely a matter of simplicity, which is why New Year’s resolutions tend to benefit the diet industry and fitness clubs, but few others.

Another reason lays in the meaning of the term simple. Simplicity implies that there are relatively straightforward mechanisms that underlie a cause and consequence, that these can be predicted with reasonable certainty and consistency, and that we can derive “best practices” from such events given their reliability and efficiency. When we see something as simple, we usually have a high level of control.

Yet, it is the very nature of human systems that makes control such an elusive concept when wish to change something. Complexity science provides us with a different way to handle these problems. It provides a means of understanding complex situations — those where there are multiple causes and consequences that interact and change dynamically — that represent the lives of human beings. Rather than predict what is going to happen based on flawed assumptions of control, complexity science helps anticipate change and prepares people to adapt to these changes wisely.

Diet and exercise tend to be near the top of New Year’s Resolutions. Typically, people will make a resolution to start an exercise plan and reform their diet all in one swoop. The thinking is akin to “go hard or go home”. The problem with this is that what we eat, how we eat, and the activities that we do on any given day are part of a complex weave of activities that shape our lives. Few of us have jobs or lifestyles where everything is the same day to day. If you have children, you’ll know firsthand that even with the most regimented schedule for them and you, every day brings new surprises. But for the most part, these are little surprises that happen consistently and, consistent with a complex system, you adapt.

If your diet consists of a lot of take-out food, pre-prepared foods like frozen dinners or canned goods, the idea that you will suddenly start cooking at home, eating healthy meals and changing the portion sizes right away is setting yourself up for failure. This change alone requires shifts in your time (now you need to shop, cook, clean, and plan in advance), which suddenly changes how you use the rest of your time as it might impact upon work, play, social activities and so on. This isn’t to suggest that such investments in this new lifestyle are not worth it, but that simple shift will drastically change not just your diet, but your lifestyle as a whole all at the same time. That’s a lot of stress to put on the system that is your life.

An alternative is to make small shifts, ones that don’t upset things too much like perhaps making one meal on the weekends. Once that is in place, perhaps change the meal to allow for leftovers so that one day or two you pack a lunch instead of eating out. Maybe then shift towards changing the lunch options you choose when you do eat out one or two days per week. The key is to take one thing, do it and do it well and then build upon it by introducing another thing. Over time, your schedule will adapt and you’ll find the ways to make the changes without them feeling so big.

Exercise is the same way. Rather than sign up for a year’s membership at the gym and workout 2 hours a day for the first week only to find yourself so sore and tired that you can’t imagine going back, try upping the activity level you engage in with different strategies. If you don’t go to the gym at all, starting there might not be the best option. Try walking a little more around your neighbourhood or take the stairs when there is an escalator. Maybe get off the bus one or two stops early and walk the rest of the way home.  Once you start doing that, try a day pass a gym and do some very light weights or some simple cardio workouts like walking on a treadmill. As you build up over time, you will find what works and doesn’t work in terms of your likes and dislikes and what seems to be effective. This is called feedback, another critical component of complex systems.

By paying attention — being mindful — of what you’re doing and how it is working, you can start to build a longer-term strategy or pattern of activity that moves you along to where you want to go. It also prevents you from the let down at having not achieved your goals, but setting yourself up for success rather than failure. In doing so, you work with the complexity of human systems and our daily lives rather than against them.

behaviour changehealth promotionpsychologypublic health

New Year’s Resolutions: If You Must…

We Resolve To No More New Years Resolutions! (CC - Meddy Garnet)

The holiday season now takes a shift away from the goodies and rich foods that start with Hanukah and (almost) end with Christmas. There’s one last big day left*: New Years Eve/ Day.

* In Canada, Australia, New Zealand and the UK we have Boxing Day today, the day when all the unsold merchandise for Christmas goes on sale and people do silly things like camp out overnight on Christmas Night so they can get a deal the next morning. It’s just like Black Friday in the US.

People often wake from the sugar-induced near-comtose generated by all the treats on Boxing Day to realize that their new holiday pants fit tighter than expected, that the number of wine bottles in the recycling are hard to count, and that the return to everyday life that comes after the holidays might not be as jolly given the absence of any holidays to look forward to. Add to that the myriad “year in review” lists and recaps on television, print and the Internet and its quite natural to want to make a New Year’s Resolution.

The answer to that is: don’t do it. They don’t work and the whole thing is one big fallacy.

But evidence never stopped people from doing things before — even physicians and scientists — so if you must make them, here are some recommendations from a person that teaches a graduate level health behaviour change course on how to be a little smarter about goal setting:

1. Be specific. Declaring that you’re going to be healthier in 2011 isn’t providing much to go on. Does that mean that you’re going to eat better? And if so, what does that mean? A big mistake is that people keep their goals too general and thus, never really know if they’ve acheived them. One rubric to use is the S.M.A.R.T system for goals. S.M.A.R.T. refers to goals that are Specific, Measurable, Achievable, Realistic and Time Framed. The closer you can adhere to these, the more likely you are to achieve them.

2. Keep quiet. There is a school of thought that suggests that advertising your goals to the world (make them public) is a strong way to motivate change. The thinking here is based on theories of social norming and pressure that suggest that the fear of letting others down will motivate you to succeed. That might have some currency, but it paradoxically fails for reasons that have little to do with others and much to do with our brain. Research from NYU psychologist Peter M. Gollwitzer and his colleagues (PDF) found:

When other people take notice of one’s identity-relevant behavioral intentions, one’s performance of the intended behaviors is compromised. This effect occurs both when the intentions are experimenter supplied and when they are self-generated, and is observed in both immediate performance and performance measured over a period of 1 week. It does not emerge when people are not committed to the superordinate identity goal.(p.616)

Some other resources on this are available here. This isn’t to say that you can’t share aspirations with people, but when you declare you’re going to do something out loud ( following S.M.A.R.T) and get feedback from others, your brain starts to imagine that you’ve already accomplished the goal and is already diminishing your motivational fire.

3. Do it for yourself. Another reason these publicly stated goals might cause problems is that often we announce goals that we want to believe in (or believe others approve of), rather than those we want for ourselves. A large body of evidence suggests that we’re much more likely to do things that fit with our self-concept and values than those that challenge or complicate it. Self-determination theory is the foundation for this concept. Author Daniel Pink wrote an accessible piece on this in his recent book Drive. This can be applied broadly or more specifically. For example, with regards to weight loss, there are a lot of options to assist that from changing the food you eat and the way you eat (not dieting, which is a far larger fallacy than New Years Resolutions and persists even more) to exercise. Perhaps running on a treadmill is something that bores you to tears, so try a group dance class instead. If you’re not a fan of salads, try doing more with beans, oatmeal, nuts, fruit or smoothies. There are lots of ways to get the same place, but choose the things that you really like first.

4. Be social and connect. Even if you’re not announcing your goals to the world on YouTube or doing all the things you want to do first, it is still important to be social. Research on social networks and health show remarkable links (pun intended) between our social networks and our health behaviours. Smoking, obesity and mental health are all enhanced by having strong social networks (however you connect — this isn’t just about Facebook or Twitter). Building strong connections with people can offer so much benefit in terms of keeping you healthy, informed and “human”.

5. Help yourself by helping others. If you want to reach your goals, try helping others reach theirs. Working with your friends and family to support them in reaching their goals can actually strengthen your own resolve. Communities of practice are groups of individuals that are motivated to support each other in solving particular problems that often fall outside of traditional lines of work, discipline or problem domain. These collectives are often self-organized and volunteer-oriented and because of that, they capitalize on many of the aforementioned points. Find a community of people tackling the same problems and offer your assistance and wisdom. In doing so, you might find that you start to work through your own challenges and issues. Research on complex systems shows that small, incremental changes over a long time will produce much more stable change than radical upheavals at once.

New Year’s resolutions are problems because they often set us up for failure. Perhaps the one resolution that you will want to follow this year is to skip the resolution altogether and commit to doing something small often and enjoying yourself and those around you while you do it.