# 笔记 23 系统思维与公共健康

## 23.1 导论

• 选择健康干预方法
• 设定目标
• 资助
• 实施设计好的干预方法

• 干预不符合实情
• 很多策略无法重复
• 策略影响有限
• 策略结果不可预期
• 结果不好评价改善

CAS路径

• 反馈，可能是加强，可能是制衡
• 路径依赖，方向单一，不会盘根错节
• 无量纲网络，非线性，临界点
• 涌现
• 相变

• 利益相关者分析：按照兴趣与能力还有同意度等几个维度分析参与者，对不同参与者使用不同策略

• 网络分析：包括节点、边、属性及方向，探索节点人物、网络密度、分离程度、相似性及交互性

• 参与影响通路分析：项目设计管理评价方法，找到关键利益相关者，展示，找出属性关系并给出现在与未来的映射，找出阻断通路的地方

## 23.2 系统抽象与映射－因果环路图

• 因果关系 A -> B A导致了B
• 极性 ＋／－ 两者变化方向一致为正，反之为负
• 反馈环路 A 变化引起其它变化，最终又形成对A的增强或制衡
• 延迟 A对B的影响有延迟|| 制衡状态通常有延迟
• 环形符号 R表示增强 B表示制衡

group-based causal mapping workshop

• Elicit variables for a causal map from stakeholders
• Use these variables to build a causal map with stakeholders

Size of stakeholder group: - At least 3–5 people - A group size of 5–12 is ideal - Any group bigger than 20 people is best split up into separate workshops

The session is planned by the core modeling team that is made up of 3–5 staff members and stakeholders

The facilitator team may overlap with your core modeling team—for the causal mapping session we will need: - Head facilitator - Wall builder - Recorder

Steps:

Problem scoping - Identify problem and assess if problem is suitable for causal mapping - Develop one-pager that describes project, purpose, audience, and resources needed - Time necessary for this stage ranges from 1–3 hours to several meetings

Core modeling team planning and capacity building

• Design group model building workshop including the process and agenda
• Prepare recruitment and training of additional facilitation team members if needed
• Time necessary for this stage several 1- to 2-hour meetings

Actual group modeling workshop

• Session length varies from one or two 90 minute sessions to five-day workshops

Evaluation and reporting

Scripts: “playbooks” that outline the process of a particular group modeling activity step-by-step

## 23.4 系统思维与决策

Ecostructure 包括所有利益相关者

• 明智的决策者拯救世界
• 解决大问题
• 用复杂科学解释决策

• 设立规范自动转换的系统
• 使用agent-based models