Are child health information services a viable source of accurate vaccination data for clinicians working in paediatric emergency departments in England?

Vaccination is a global success story, yet UK coverage remains undertarget for a number of diseases. The paediatric emergency department (PED) offers the potential for opportunistic vaccination interventions.ObjectivesTo map the Greater Manchester (GM) Child Health Information System network to see if it was a viable source of vaccination data for clinicians working in the PED as a case study.MethodsPostprimary care vaccination management systems for GM were visualised using a systems mapping approach, with data obtained from the Office for National Statistics and commissioners in the GM Health and Social Care Partnership.ResultsOnce vaccination data left primary care, it passed through 1 of 10 local child health information services (CHISs), using an assortment of different information technology systems, after which it shed individual identifiers and was aggregated within national systems. None of the existing GM CHISs were accessible to PED practitioners.ConclusionMore work needs to be done to explore possible alternative sources of accurate vaccination data during a PED consultation.

Using complex systems mapping to build a strategic public health response to mental health in England

PurposeThis paper aims to use systems mapping as a tool to develop an organisation-wide approach to public mental health to inform strategic direction within a national public health agency. Design/methodology/approachTwo workshops were facilitated with internal staff from a wide range of public health policy teams working in small groups to produce paper-based maps. These were collated and refined by the project team and digitised. FindingsThe approach engaged a range of teams in forming a shared understanding and producing a complex system map of the influences on population mental health and well-being, where current policy initiatives were addressing them and what the gaps and priorities were. Participants valued the approach which led to further study and organisational commitment to the whole system working as part of national public mental health strategy. Research limitations/implicationsThe approach was limited to internal stakeholders and wider engagement with other sectors and community members would help further the application of complex system approaches to public mental health. Originality/valueIt was a valuable process for developing a whole-organisation approach and stimulating thinking and practice in complex system approaches. The paper provides a practical example of how to apply systems mapping and its benefits for organising public mental health practice.

Building Youth Infrastructure: Early Lessons From the Youth Systems Collaborative

In recent years the international youth development field has increasingly acknowledged that purposeful action at the systems level is critical for achieving positive outcomes for youth, sustainably, equitably, and at scale. In 2018 a group of international organizations formed the Youth Systems Collaborative, a community of practice whose aim is to promote international learning on youth systems change efforts. Building from the collective learning of this group, this paper offers a framework for understanding how widespread and sustained positive youth development outcomes can be achieved in low- and middle-income countries. Five enablers that advance systems change are presented: stakeholder collaboration; vision and goals; systems mapping; data, evaluation, and learning; and capacity development, as well as 4 domains within which system change occurs: policies, services and practices, norms and mindsets, and resource flows. Each of these 9 dimensions is illustrated with lessons learned from both U.S. and international youth systems change efforts. The paper concludes with a call to action for diverse system actors to apply these lessons as they support youth to reach their full potential.

Dynamics of Parental Opioid Use and Children's Health and Well-Being: An Integrative Systems Mapping Approach

The seemingly intractable opioid epidemic compels researchers, the media, and families to better understand the causes and effects of this complex and evolving public health crisis. The effects of this crisis on people using opioids, maternal prenatal opioid exposure, and neonatal abstinence syndrome are well-documented, but less is known about the impact of caregivers' opioid use on children's health and well-being. One challenge to understanding the effects of parental opioid use disorder (OUD) on child and adolescent outcomes is the numerous interrelated pathways in which a child's health and well-being can be impacted. To better understand these dynamic relationships, we applied a systems mapping approach to visualize complex patterns and interactions between pathways and potential leverage points for interventions. Specifically, we developed a causal loop diagram system map to elucidate the complex and interconnected relationships between parental OUD, social determinants of health at the family and socio-environmental levels, family strengths, social supports, and possible adverse impacts on children's physical and mental health and risks for future substance misuse. The goals of this research are to (1) identify factors and dynamics that contribute to the relationship between parental OUD and children's health and well-being and (2) illustrate how systems mapping as a tool can aid in understanding the complex factors and dynamics of the system(s) that influence the well-being of children and their parents or primary caregivers.

Undergraduate Research as System

This study examines the written and visual results of a participatory systems-mapping process used to explore undergraduate research at a large, public research university in the United States. With the university’s transition to a high-impact practice model, the institutional value of undergraduate research has increased, but challenges remain in implementing the practice equitably and inclusively, especially in the complex environment of higher education. The systems-mapping process reveals the subtle, often conflicting dynamics that underlie the undergraduate research enterprise, while simultaneously supporting the emergence of a shared vision, or story, of what the undergraduate research experience could be.

Emergent, Relational Revolution: What More Do We Have to Learn from Jane Addams?

What does Jane Addams's approach to social change offer to publicly engaged scholars and activists today? This essay explores several dimensions of Addams's work that have been misinterpreted and overlooked, putting these aspects of her work into conversation with research on endeavors to move higher education toward civic democratic engagement. The goal is to visualize opportunities and strategies for more inclusive and democratic engagement with issues across local, regional, and global communities. In particular, this essay explores how Addams's place-based, boundary-spanning methods of engagement provide strategies for more inclusive and collaborative philosophical activism, including (1) fostering and sustaining relationships across difference, (2) engaging with soft systems mapping, and (3) using synthetic imagination in crafting transdisciplinary engaged narratives. In conjunction with research on social change and creative innovation, Addams's work highlights the potential value of collaborative and democratic endeavors across difference as a means toward more radical imaginaries and relational revolution.