Version 1
: Received: 26 July 2017 / Approved: 27 July 2017 / Online: 27 July 2017 (12:59:47 CEST)
Version 2
: Received: 27 July 2017 / Approved: 27 July 2017 / Online: 27 July 2017 (17:54:29 CEST)
Jalali, M.S.; Rahmandad, H.; Bullock, S.L.; Ammerman, A. Dynamics of Implementation and Maintenance of Organizational Health Interventions. Int. J. Environ. Res. Public Health2017, 14, 917.
Jalali, M.S.; Rahmandad, H.; Bullock, S.L.; Ammerman, A. Dynamics of Implementation and Maintenance of Organizational Health Interventions. Int. J. Environ. Res. Public Health 2017, 14, 917.
Jalali, M.S.; Rahmandad, H.; Bullock, S.L.; Ammerman, A. Dynamics of Implementation and Maintenance of Organizational Health Interventions. Int. J. Environ. Res. Public Health2017, 14, 917.
Jalali, M.S.; Rahmandad, H.; Bullock, S.L.; Ammerman, A. Dynamics of Implementation and Maintenance of Organizational Health Interventions. Int. J. Environ. Res. Public Health 2017, 14, 917.
Abstract
In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes.
Keywords
implementation; adoption; health interventions; community prevention; obesity prevention interventions; system dynamics; systems thinking; endogenous dynamics; qualitative modeling; case studies
Subject
Public Health and Healthcare, Health Policy and Services
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
