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将系统思维应用于公共卫生领域的知识传播。

Applying systems thinking to knowledge mobilisation in public health.

作者信息

Haynes Abby, Rychetnik Lucie, Finegood Diane, Irving Michelle, Freebairn Louise, Hawe Penelope

机构信息

The Australian Prevention Partnership Centre, Sydney, Australia.

University of Sydney, Menzies Centre for Health Policy, Sydney, Australia.

出版信息

Health Res Policy Syst. 2020 Nov 17;18(1):134. doi: 10.1186/s12961-020-00600-1.

Abstract

CONTEXT

Knowledge mobilisation (KM) is a vital strategy in efforts to improve public health policy and practice. Linear models describing knowledge transfer and translation have moved towards multi-directional and complexity-attuned approaches where knowledge is produced and becomes meaningful through social processes. There are calls for systems approaches to KM but little guidance on how this can be operationalised. This paper describes the contribution that systems thinking can make to KM and provides guidance about how to put it into action.

METHODS

We apply a model of systems thinking (which focuses on leveraging change in complex systems) to eight KM practices empirically identified by others. We describe how these models interact and draw out some key learnings for applying systems thinking practically to KM in public health policy and practice. Examples of empirical studies, tools and targeted strategies are provided.

FINDINGS

Systems thinking can enhance and fundamentally transform KM. It upholds a pluralistic view of knowledge as informed by multiple parts of the system and reconstituted through use. Mobilisation is conceived as a situated, non-prescriptive and potentially destabilising practice, no longer conceptualised as a discrete piece of work within wider efforts to strengthen public health but as integral to and in continual dialogue with those efforts. A systems approach to KM relies on contextual understanding, collaborative practices, addressing power imbalances and adaptive learning that responds to changing interactions between mobilisation activities and context.

CONCLUSION

Systems thinking offers valuable perspectives, tools and strategies to better understand complex problems in their settings and for strengthening KM practice. We make four suggestions for further developing empirical evidence and debate about how systems thinking can enhance our capacity to mobilise knowledge for solving complex problems - (1) be specific about what is meant by 'systems thinking', (2) describe counterfactual KM scenarios so the added value of systems thinking is clearer, (3) widen conceptualisations of impact when evaluating KM, and (4) use methods that can track how and where knowledge is mobilised in complex systems.

摘要

背景

知识动员是改善公共卫生政策与实践的一项重要策略。描述知识转移与转化的线性模型已朝着多向性且适应复杂性的方法发展,在这些方法中,知识通过社会过程得以产生并具有意义。人们呼吁采用系统方法进行知识动员,但对于如何将其付诸实践却鲜有指导。本文阐述了系统思维对知识动员的贡献,并提供了将其付诸行动的指导。

方法

我们将一个系统思维模型(该模型侧重于利用复杂系统中的变化)应用于其他人通过实证确定的八种知识动员实践。我们描述了这些模型如何相互作用,并提炼出一些将系统思维实际应用于公共卫生政策与实践中的知识动员的关键经验教训。文中提供了实证研究、工具和针对性策略的示例。

研究结果

系统思维可以增强并从根本上转变知识动员。它秉持一种多元的知识观,认为知识由系统的多个部分所塑造,并通过使用得以重构。动员被视为一种情境化、非规定性且可能具有颠覆性的实践,不再被概念化为在加强公共卫生的更广泛努力中的一项离散工作,而是这些努力的组成部分并与之一持续对话。知识动员的系统方法依赖于情境理解、协作实践、解决权力不平衡以及适应性学习,以应对动员活动与情境之间不断变化的相互作用。

结论

系统思维为更好地理解复杂问题所处的情境以及加强知识动员实践提供了有价值的观点、工具和策略。我们就进一步发展关于系统思维如何能够增强我们为解决复杂问题而动员知识的能力的实证证据和辩论提出了四点建议——(1)明确“系统思维”的含义,(2)描述反事实的知识动员情景,以便系统思维的附加值更清晰,(3)在评估知识动员时拓宽对影响的概念化,(4)使用能够追踪知识在复杂系统中如何以及在何处被动员的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8658/7670767/79eed429bc67/12961_2020_600_Fig1_HTML.jpg

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