Diabetes Primary Prevention Initiatives System Dynamics Modeling Focus Area SDM FA

1
Diabetes Primary Prevention Initiatives System
Dynamics Modeling Focus Area (SDM FA)

• Rationale Outcomes
• Diabetes Translation Conference
• May 8, 2008
• Orlando, Florida

2
The Challenge

• Growing numbers of people with
• Diabetes
• Prediabetes
• Obesity
• How can we leverage and
• strategically invest limited resources?

Good news Evidence-based strategies exist
Bad news Resources are limited
3
Traditional Strategic Planningin Public Health

• Convene experts
• Assess burden and environment
• Brainstorm ideas
• Develop consensus
• Assess evidence
• Implement interventions

4
Another Approach
System-based conceptual framework
Best available science/expert consensus

5
Framework
6
Evidence

• Epidemiological studies
• Clinical trials
• Surveillance data
• Expert best guess estimates

7
Simulation Results
Status quo
Prediabetes only
Diabetes only
8
Tool is Part of a Larger Process
Improved Health Outcomes
9
Purpose of the SDM FA

• Test utility of the diabetes system dynamics
  model as decision-support/ strategic planning
  tool
• Main efforts to achieve purpose
• Groundwork and infrastructure (puzzle pieces)
• Model improvements/confidence building
• Model use/learning experiences
• Summarizing and marketing

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Puzzle Pieces
Build Implementation Capacity
Build Scientific Infrastructure
Market Tool Methods
Understand Audiences Applications
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Outcomes Scientific Infrastructure

• Real world experiences spurred iterative model
  improvements
• Sensitivity testing demonstrated stability of
  model conclusions
• Scientific review affirmed models usefulness for
  some purposes, not others
• State calibrations showed consistency in key
  insights but meaningful state variation

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Outcomes Implementation Capacity

• Technically oriented DPCP staff can create custom
  model tests in model software
• Various successful engagement approaches
• Full day, ½ day, 1-2 hours
• Written/briefing paper
• Learning lab format can be delivered by
• DPCP epi staff, program staff
• Community members
• Developed variety of evaluation methods
  questions

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Outcomes Audiences Applications

• Gathered information on key strategic questions,
  including those related to costs
• Identified important potential uses and audiences
• Developed approaches to better serve the needs of
  various audiences
• Epidemiologists/diabetes researchers
• Diabetes program managers/planners
• Community coalition members
• Chronic disease program planners
• Legislators and policymakers

14
Outcomes Tools Methods

• Website Clearinghouse?
• Over 2 dozen PowerPoint presentations
• 7 evaluation summaries
• White paper, including details on data sources,
  estimates and equations)
• Background paper for potential users
• Facilitators Guide, including FAQs
• Community Engagement Toolkit
• Prediabetes brief for policy makers
• Calibration data (50 states 13 calibrations)
• Published papers
• Bibliography

15
Number of Web of Science hits withSystem
Dynamics and Healthin the title, abstract or
keywords
AJPH Special Issue (March 1, v96, 3)
Start of DDTs diabetes SD modeling project
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SDM FA Participants/Contacts

• Centers for Disease Control Prevention
• Parul Nanavati pnanavati_at_cdc.gov
• Center for Public Health Practice, Rollins School
  of Public Health, Emory University
• Joyce Essien jessien_at_sph.emory.edu Drew
  Jones, Doc Klein
• California Diabetes Program
• Karen Black, Toshi Hayashi, Gary He
• Minnesota Diabetes Program
• Heather Devlin Heather.Devlin_at_state.mn.us Jay
  Desai Jay.Desai_at_state.mn.us