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Understanding social forces involved in diabetes outcomes: a systems science approach to quality-of-life research

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Abstract

Purpose

The field of quality-of-life (QOL) research would benefit from learning about and integrating systems science approaches that model how social forces interact dynamically with health and affect the course of chronic illnesses. Our purpose is to describe the systems science mindset and to illustrate the utility of a system dynamics approach to promoting QOL research in chronic disease, using diabetes as an example.

Methods

We build a series of causal loop diagrams incrementally, introducing new variables and their dynamic relationships at each stage.

Results

These causal loop diagrams demonstrate how a common set of relationships among these variables can generate different disease and QOL trajectories for people with diabetes and also lead to a consideration of non-clinical (psychosocial and behavioral) factors that can have implications for program design and policy formulation.

Conclusions

The policy implications of the causal loop diagrams are discussed, and empirical next steps to validate the diagrams and quantify the relationships are described.

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Acknowledgments

We gratefully acknowledge Joel Zonszein, M.D., and Judith Wylie-Rosett, Ed.D., for helpful discussions during the writing of this manuscript, and Brian Quaranto for assistance with manuscript preparation.

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Authors and Affiliations

  1. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

    David W. Lounsbury & Chawntel Vega

  2. Creator of Learning Environments, Wayland, MA, USA

    Gary B. Hirsch

  3. DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, 01742, USA

    Carolyn E. Schwartz

  4. Departments of Medicine and Orthopaedic Surgery, Tufts University School of Medicine, Boston, MA, USA

    Carolyn E. Schwartz

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  1. David W. Lounsbury
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  2. Gary B. Hirsch
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  3. Chawntel Vega
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  4. Carolyn E. Schwartz
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Correspondence to Carolyn E. Schwartz.

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Lounsbury, D.W., Hirsch, G.B., Vega, C. et al. Understanding social forces involved in diabetes outcomes: a systems science approach to quality-of-life research. Qual Life Res 23, 959–969 (2014). https://doi.org/10.1007/s11136-013-0532-4

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