Guariguata L, Guell C, Samuels T A, Rouwette E A J A, Woodcock J, Hambleton I R, Unwin N
University of the West Indies, Cave Hill, Barbados.
MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
Health Res Policy Syst. 2016 Oct 26;14(1):79. doi: 10.1186/s12961-016-0150-z.
Diabetes is highly prevalent in the Caribbean, associated with a high morbidity and mortality and is a recognised threat to economic and social development. Heads of Government in the Caribbean Community came together in 2007 and declared their commitment to reducing the burden of non-communicable diseases (NCDs), including diabetes, by calling for a multi-sectoral, systemic response. To facilitate the development of effective policies, policymakers are being engaged in the development and use of a system dynamics (SD) model of diabetes for Caribbean countries.
Previous work on a diabetes SD model from the United States of America (USA) is being adapted to a local context for three countries in the region using input from stakeholders, a review of existing qualitative and quantitative data, and collection of new qualitative data. Three country models will be developed using one-on-one stakeholder engagement and iterative revision. An inter-country model will also be developed following a model-building workshop. Models will be compared to each other and to the USA model. The inter-country model will be used to simulate policies identified as priorities by stakeholders and to develop targets for prevention and control. The model and model-building process will be evaluated by stakeholders and a manual developed for use in other high-burden developing regions.
SD has been applied with success for health policy development in high-income country settings. The utility of SD in developing countries as an aid to policy decision-making related to NCDs has not been tested. This study represents the first of its kind.
糖尿病在加勒比地区极为普遍，与高发病率和高死亡率相关，是对经济和社会发展的公认威胁。2007年，加勒比共同体各国政府首脑齐聚一堂，宣布致力于通过呼吁采取多部门、系统性应对措施来减轻包括糖尿病在内的非传染性疾病（NCDs）负担。为推动有效政策的制定，政策制定者正参与为加勒比国家开发和使用糖尿病系统动力学（SD）模型。
利用利益相关者的意见、对现有定性和定量数据的审查以及新定性数据的收集，将美国先前关于糖尿病SD模型的工作适用于该地区三个国家的当地情况。将通过一对一的利益相关者参与和迭代修订来开发三个国家模型。在一次模型构建研讨会后还将开发一个国家间模型。将对这些模型相互之间以及与美国模型进行比较。国家间模型将用于模拟利益相关者确定为优先事项的政策，并制定预防和控制目标。利益相关者将对模型和模型构建过程进行评估，并编写一本手册供其他高负担发展中地区使用。
系统动力学已成功应用于高收入国家的卫生政策制定。系统动力学在发展中国家作为与非传染性疾病相关政策决策辅助工具的效用尚未得到检验。本研究属同类研究中的首例。
