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Rapid-cycle systems modeling to support evidence-informed decision-making during system-wide implementation.

R Christopher Sheldrick1, Gracelyn Cruden2, Ana J Schaefer3

  • 1Department of Health Law, Policy and Management, School of Public Health, Boston University, One Silber Way, Boston, MA, USA. rshldrck@bu.edu.

Implementation Science Communications
|October 10, 2021
PubMed
Summary

Rapid-cycle Systems Modeling (RCSM) enhances implementation science by integrating simulation models with stakeholder engagement. This approach helps decision-makers anticipate consequences and refine strategies for evidence-based interventions.

Keywords:
Computer simulationEpistemologyEvidence-based practiceImplementation sciencePsychological traumaScreening

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Area of Science:

  • Implementation Science
  • Systems Modeling
  • Health Services Research

Background:

  • Simulation models are underutilized in implementation science for scaling evidence-based interventions.
  • Stakeholders need methods to examine assumptions, consider alternatives, and anticipate consequences of implementation.
  • Rapid-cycle Systems Modeling (RCSM) is proposed as a group modeling approach to enhance engagement with evidence for implementation.

Purpose of the Study:

  • To demonstrate the utility of RCSM in a case study involving administrators implementing system-wide interventions for childhood trauma in foster care.
  • To illustrate how RCSM can assist stakeholders in using simulation models to inform implementation decisions.

Main Methods:

  • RCSM is an iterative method involving stakeholder question prioritization, simulation model development/refinement, and dialogue on model utility.
  • The case study engaged 31 key informants for question identification and 16 stakeholders in six member-checking interviews.
  • A prior simulation model was adapted to address implementation decisions.

Main Results:

  • Stakeholder questions focused on decisions for implementing trauma-informed screening.
  • Simulation model findings informed decisions on programmatic reach, screening thresholds, and treatment capacity.
  • Member-checking confirmed model relevance, identified system improvement opportunities, and informed discussions on implementation implications.

Conclusions:

  • RCSM embeds simulation modeling within stakeholder engagement, positioning it as both an analytic and implementation strategy.
  • This approach guides the effective use of modeling to support large-scale implementation of interventions.