Applying influence for systems change in a large-scale community-based prevention intervention

Area of Science:

• Community Health Promotion
• Systems Thinking in Public Health
• Health Behavior Change

Background:

• Healthy Together Victoria (HTV) employs a systems approach for community-level health promotion.
• Practitioners within HTCs utilize 'self-in-the-system' tactics, viewing their relationships as integral to surrounding systems.
• This approach facilitates intervention by leveraging connections to foster change.

Purpose of the Study:

• To explore the understanding and application of the 'self-in-the-system' approach among HTC practitioners.
• To investigate how practitioners perceive and utilize their role within complex adaptive systems for health promotion.
• To identify the development of systems practice skills within community-level health initiatives.

Main Methods:

• Qualitative research design involving 31 primary semi-structured interviews.
• Purposive sampling followed by snowball recruitment to identify participants.
• Verbatim transcription of interviews and inductive thematic analysis using Braun and Clarke's framework.

Main Results:

• Some HTC practitioners conceptualize themselves as part of the prevention system, leveraging relationships for change.
• Development of trusted connections was crucial for engagement and cooperation.
• The concept of a 'prevention change agent' emerged, describing practitioners influencing HTC goals; this practical know-how is still developing.

Conclusions:

• A practitioner's ability to recognize their role in complex adaptive systems and influence others is key for facilitating community health promotion.
• 'Self-in-the-system' is an evolving skill for systems practice in prevention.
• This approach offers potentially more systemic ways of working compared to traditional programmatic methods.