Ti Kouka Consulting, Christchurch, New Zealand.
Institute of Environmental Science and Research, Wellington, New Zealand.
Health Promot Int. 2022 Feb 17;37(1). doi: 10.1093/heapro/daab075.
Public health problems are often complex and 'wicked' in nature. Wicked problems have multi-factorial causation, are dynamic and often understood and acted upon differently by different actors. Multi-sectoral collaboration is increasingly emphasized for tackling wicked problems through developing a strategic multi-sectoral plan and then taking collective action. Critical systems thinking can support the development of a shared perspective of the problem, strengthen participation in collective action and foster reflective practices to continuously improve both problem understanding and action. In this paper, we present a critical collaboration model, drawing together two complementary theoretical frameworks, as well as insights from three case studies from New Zealand, to offer a systematic approach to adopting a critical systems perspective in public health collaboration. The model provides six questions to make explicit individuals' understandings or assumptions about how others perceive an issue, problem or evidence, and the process of identifying answers strengthens the dialogical and reflective aspects of the collaboration. We indicate some potential areas for the application of the model to integrate critical systems thinking in collaborative practices.
公共卫生问题通常具有复杂性和“棘手性”。棘手问题具有多因素的因果关系,是动态的,并且往往被不同的行为者以不同的方式理解和采取行动。多部门协作越来越受到重视,通过制定战略性多部门计划并采取集体行动来解决棘手问题。批判性系统思维可以支持对问题的共同观点的发展,加强对集体行动的参与,并培养反思性实践,以不断提高对问题的理解和行动。在本文中,我们提出了一个批判性协作模型,将两个互补的理论框架以及来自新西兰的三个案例研究的见解结合在一起,为在公共卫生协作中采用批判性系统观点提供了一种系统方法。该模型提出了六个问题,以使个人对他人如何看待某个问题、问题或证据的理解或假设变得明确,并且确定答案的过程增强了协作的对话性和反思性。我们指出了该模型在整合批判性系统思维方面的一些潜在应用领域,以促进协作实践。