Abstract
Measuring progress toward systems change, sustainable efforts that address root causes of an issue by changing policies and practices, is a difficult task for communities, evaluators, and foundations. Tracking and documenting changes in resources, power, policy, sustainable funding, structured relationships and roles, and underlying values require multi-level analyses. Systems change analysts must consider at least four “strata” at once: (1) events and trends, (2) patterns of interaction, (3) context and cultural or social models, and (4) the systems themselves. In this paper we provide a brief overview of systems change; a discussion of collaboratives as one “engine” of social change; a discussion of benchmarks and indicators of collaboratives focused on systems change; and suggestions for further research. The analysis draws upon several analytic frameworks described in the literature. We illustrate these concepts with examples from six systems change initiatives funded by The California Endowment. The need for further research is outlined.
Similar content being viewed by others
References
Ackoff, R. L. (1993). Benchmarking. Systemic Practice and Action Research, 6(6), 581.
Alford, R. R. (1975). Health care politics: Ideological and interest group barriers to reform. Chicago: University of Chicago Press.
Altman, D. G. (1995). Sustaining interventions in community systems: On the relationships between researchers and communities. Health Psychology, 14, 526–536.
Bell, J. D., Bell, J., Colmenar, R., Flournoy, R., McGehee, M., & Rubin, V., et al. (2002). Reducing health disparities through a focus on communities. Oakland, CA: PolicyLink.
Best, A., Stokols, D., Green, L. W., Leischow, S., Holmes, B., & Buchholz, K. (2003). An integrative framework for community partnering to translate theory into effective health promotion strategy. American Journal of Health Promotion, 18(2), 168–176.
Blum, H. L. (1976). Expanding health care horizons: From a general systems concept of health to a national health policy. San Francisco: Third Party Associates.
Blum, H. L. (1981). Planning for health: Development and application of social change theory (2nd ed.). New York: Human Sciences Press.
Brindis, C. D., & Wunsch, B. (1996). Finding common ground: Developing linkages between school-linked/school-based health programs and managed care health plans. Sacramento, CA: The Foundation Consortium for School-Linked Services.
Butterfoss, F. D. (2004). The coalition technical assistance and training framework: Helping community coalitions help themselves. Health Promotion Practice, 5(2), 118–126.
Butterfoss, F. D., Goodman, R. M., & Wandersman, A. (1993). Community coalitions for prevention and health promotion. Health Education Research, 8(3), 315–330.
Butterfoss, F. D., Goodman, R. M., & Wandersman, A. (1996). Community coalitions for prevention and health promotion: Factors predicting satisfaction, participation, and planning. Health Education Quarterly, 23(1), 65–79.
Butterfoss, F. D., & Kegler, M. C. (2002). Toward a comprehensive understanding of community coalitions: Moving from practice to theory. In R. J. DiClemente, R. Crosby, & M. C. Kegler (Eds.), Emerging theories in health promotion practice and research: Strategies for improving public health (pp. 157–193). San Francisco: Jossey-Bass.
Campbell, D. (1969). Reforms as experiments. American Psychologist, 24(4), 404–419.
Centers for Disease Control and Prevention. (2002). Physical activity evaluation handbook. Retrieved June 30, 2005, from http://www.cdc.gov/nccdphp/dnpa/physical/handbook/pdf/handbook.pdf
Churchman, C. W. (1971). The design of inquiring systems. New York: Basic Books, Inc.
Churchman, C. W. (1979). The systems approach and its enemies. New York: Basic Books, Inc.
Clayson, Z. (2006). Personal communication.
Davis, R., & Cohen, L. (2003). Health for all: California’s strategic approach to eliminating health disparities. Oakland, CA: Prevention Institute
Dunet, D. O., & Butterfoss, F. D. (2005). State plan index: A tool for assessing the quality of state public health plans. Prevention of Chronic Disease, 2(2), A15.
Fawcett, S. (2005). Our model of practice: Building capacity for community and systems change. Retrieved June 30, 2005, from http://ctb.ku.edu/tools/en/sub_section_tools_1002.htm
The Finance Project. (2002). Sustaining comprehensive community initiatives: Key elements for success. Retrieved June 30, 2005, from http://www.financeproject.org/Publications/sustaining.pdf
Foster-Fishman, P., Van Egeren, L., & Yang, H. (2005). Using a systems change approach to evaluate comprehensive community change initiatives. Paper presented at the American Evaluation Association and Canadian Evaluation Association Meetings. Toronto, Canada, October 24–30, 2005
Friedman, M. (1997). A guide to developing and using performance measures in results-based budgeting. Retrieved June 4, 2005, from http://www.financeproject.org/Publications/measures.html
Gray, B. (1989). Collaborating: finding common ground for multiparty problems. San Francisco: Jossey-Bass.
Green, L. W., & Ottoson, J. M. (1999). Community and population health. Boston: WCB/McGraw-Hill.
Greiff, D., Proscio, T., & Wilkins, C. (2003). Laying a new foundation: Changing the systems that create and sustain supportive housing. New York: Corporation for Supportive Housing.
Hart, M. (1999). Guide to sustainable community indicators (2nd ed.). North Andover: QLF/Atlantic Center for the Environment.
Healthy Cities. (2005). Retrieved July 19, 2005, from http://www.healthycities.org
Institute of Medicine. (2002). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, D.C.: The National Academies Press.
Kessel, F. S., Rosenfield, P. L., & Anderson, N. B. (Eds.), (2003). Expanding the boundaries of health and social science: Case studies in interdisciplinary innovation. New York: Oxford University Press.
Klein, J. T. (1996). Crossing boundaries: Knowledge, disciplines, and interdisciplinarities. Charlottesville, VA: University of Virginia Press.
Kramer, J. S., Philliber, S., Brindis, C. D., Kamin, S. L., Chadwick, A. E., & Revels, M. L., et al. (2005). Coalitions models: Lessons learned from the CDC’s community coalition partnership programs for the prevention of teen pregnancy. Journal of Adolescent Health, 37, S20–S30.
Kreuter, M. W., Lezin, N. A., Kreuter, M. W., & Green, L. W. (2003). Community health promotion ideas that work (2nd ed.). Sudbury: Jones and Bartlett Publishers.
Kubisch, A., Auspos, P., Brown, P., Chaskin, R., Fulbright-Anderson, K., & Hamilton, R. (2002). Voices from the field II: Reflections on comprehensive community change. Washington, DC: The Aspen Institute.
Lafferty, C. K., & Mahoney, C. A. (2003). A framework for evaluating comprehensive community initiatives. Health Promotion Practice, 4(1), 31–44.
Lasker, R. D., & Weiss, E. S. (2003). Broadening participation in community problem solving: A multidisciplinary model to support collaborative practice and research. Journal of Urban Health, 80(1), 14–47; discussion 48–60.
Lasker, R. D., Weiss, E. S., & Miller, R. (2001a). Partnership synergy: A practical framework for studying and strengthening the collaborative advantage. Milbank Quarterly, 79(2), 179–205, III–IV.
Lasker, R. D., Weiss, E. S., & Miller, R. (2001b). Promoting collaborations that improve health. Education for Health: Change in Learning and Practice, 13(2), 163–172 (CCPH Special Section).
McLaren, L., & Hawe, P. (2005). Ecological perspectives in health research. Journal of the Epidemiology of Community Health, 59(1), 6–14.
Mobilizing for Action through Planning and Partnerships. (2005). Community health status assessment core indicator lists. Retrieved June 4, 2005, from http://mapp.naccho.org/chsa/ChsaIndicatorListing.asp
Nicola, R. (2005). Turning Point’s national excellence collaboratives: Assessing a new model of policy and system capacity development. Journal of Public Health Management Practice, 11(2), 101–108.
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting Clinical Psychologist, 51(3), 390–395.
Prochaska, J. O., Redding, C., & Evers, K. (2002). The transtheoretical model and stages of change. In K. Glanz, B. Rimer, & F. Lewis (Eds.), Health behavior and health education: Theory, research and practice (3rd ed., pp. 99–120). San Francisco: Jossey-Bass.
Putnam, R. D. (2000). Bowling alone. New York: Simon and Schuster.
Putnam, R. D., & Feldstein, L. M. (2003). Better together: Restoring the American Community. Simon and Schuster: New York.
Rogers, E. M. (1995). Diffusion of innovations (4th ed.). New York: The Free Press.
Ross, J. (2004). Ways of approaching research qualitative designs, quantitative designs. Retrieved June 2005 from http:///www.fortunecity.com/greenfield/gr.22ly/432/rra2.htm
Rossi, P., Lipsey, M., & Freeman, H. (2004). Evaluation: A systematic approach (7th ed.). Thousand Oaks: SAGE Publications.
Samuel, S., & Stone-Francisco. S. (2006). Personal communication.
Senge, P. M. (1990). The fifth discipline: The art and practice of the learning organization. New York: Doubleday.
Stokols, D., Harvey, R., Gress, J., Fuqua, J., & Phillips, K. (2005). In vivo studies of transdisciplinary scientific collaboration: Lessons learned and implications for active living research. American Journal of Preventive Medicine, 28(2S2), 202–213.
Supovitz, J., & Taylor, B. S. (2005). Systemic education evaluation: evaluating the impact of systemwide reform in education. American Journal of Evaluation, 26(2), 204–230.
Syme, S. L. (2000). Community participation, empowerment, and health: Development of a wellness guide for California. In M. Schneider Jamner & D. Stokols (Eds.), Promoting human wellness: New frontiers for research, practice, and policy (pp. 78–98). Berkeley, CA: University of California Press.
Tseng, V., Chesir-Teran, D., Becker-Klein, R., Chan, M. L., Duran, V., & Roberts, A., et al. (2002). Promotion of social change: A conceptual framework. American Journal of Community Psychology, 30(3), 401–427.
W. K. Kellogg Foundation. (2004). W. K. Kellogg logic model development guide. Battle Creek, MI: W. K. Kellogg Foundation.
Acknowledgments
We would like to thank Rebecca Dorman for editorial and research assistance and the evaluators for the Initiatives cited, including Sarah Samuels, Zoe Clayson, and Michael Cousineau. This project was supported in part by a grant received from The California Endowment. The authors gratefully acknowledge the comments of the editors of this special issue and two anonymous reviewers of earlier drafts of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kreger, M., Brindis, C.D., Manuel, D.M. et al. Lessons learned in systems change initiatives: benchmarks and indicators. Am J Community Psychol 39, 301–320 (2007). https://doi.org/10.1007/s10464-007-9108-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10464-007-9108-1