Bensberg Monica, Allender Steven, Sacks Gary
Our Health Inc, Cheltenham, Victoria, Australia.
Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, Centre for Population Health Research, Deakin University, Victoria, Australia.
Health Promot J Austr. 2020 Sep;31(3):436-446. doi: 10.1002/hpja.325. Epub 2020 Feb 14.
Healthy Together Victoria (HTV) was a large-scale intervention that adopted a systems approach to prevention. It established the capability of an inexperienced workforce by cultivating their understanding of systems theories, tools and practice. This paper explores how this capacity was developed and what helped and hindered the process.
This qualitative research included 31 primary semi-structured interviews that focused on participants' understanding of systems thinking. Deductive thematic analysis was undertaken. A workforce development framework informed the coding that was used to create a causal loop diagram.
The findings display the multiple influencers on capacity-building. Practice change was enabled with training-although it lacked coordination and participation was limited. Yet, the systems approach was strengthened with governance arrangements, policies, funding, team support and leadership that empowered practitioners to trial systems methods. Capacity-building was hindered by HTV's unspecified theory that made it harder for novice practitioners to grasp. Funding cuts due to political changes reduced the initiative's duration and prompted resignations, causing the newfound experience to exit the workforce.
Capacity-building for systems practice requires a holistic approach of simultaneous, complimentary actions that address the individual and environmental influences of workforce development, especially the drivers of organisational culture that facilitate new practice. SO WHAT?: Effective training methods should specifically teach skills and knowledge that help practitioners to implement systems thinking. The workforce development requirements of other contributors also need to be considered, in addition to the policies, opportunities and resources that embed practice change.
维多利亚州共同健康计划(HTV)是一项大规模干预措施,采用系统方法进行预防。它通过培养缺乏经验的工作人员对系统理论、工具和实践的理解,来提升他们的能力。本文探讨了这种能力是如何培养的,以及哪些因素促进和阻碍了这一过程。
这项定性研究包括31次初步的半结构化访谈,重点是参与者对系统思维的理解。进行了演绎主题分析。一个劳动力发展框架为用于创建因果循环图的编码提供了信息。
研究结果显示了对能力建设的多种影响因素。培训促成了实践变革,尽管缺乏协调且参与有限。然而,治理安排、政策、资金、团队支持和领导力加强了系统方法,这些因素使从业者有能力尝试系统方法。HTV未明确阐述的理论阻碍了能力建设,这使得新手从业者更难理解。政治变革导致的资金削减缩短了该计划的持续时间并引发了辞职,导致新获得的经验从劳动力队伍中流失。
系统实践的能力建设需要一种整体方法,即同时采取互补行动,解决劳动力发展中的个人和环境影响因素,特别是促进新实践的组织文化驱动因素。那又如何?有效的培训方法应专门教授有助于从业者应用系统思维的技能和知识。除了推动实践变革的政策、机会和资源外,还需要考虑其他因素对劳动力发展的要求。