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Int. J. Environ. Res. Public Health 2017, 14(8), 917; doi:10.3390/ijerph14080917

Dynamics of Implementation and Maintenance of Organizational Health Interventions

1
Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
2
Department of Nutrition, Gillings School of Global Public Health, UNC Center for Health Promotion and Disease Prevention (a CDC Prevention Research Center), University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
*
Author to whom correspondence should be addressed.
Received: 23 June 2017 / Revised: 26 July 2017 / Accepted: 11 August 2017 / Published: 15 August 2017
(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)
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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. View Full-Text
Keywords: implementation; adoption; health interventions; community prevention; obesity prevention interventions; system dynamics; systems thinking; endogenous dynamics; qualitative modeling; case studies implementation; adoption; health interventions; community prevention; obesity prevention interventions; system dynamics; systems thinking; endogenous dynamics; qualitative modeling; case studies
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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. (CC BY 4.0).

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MDPI and ACS Style

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.

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