Learning from local communities: Prevention Tracker expands
Project title: Prevention Tracker: Describing, guiding and monitoring system change efforts in local communities
Start date: January 2016
Estimated end date: June 2018
What is the issue?
Chronic diseases are Australia’s greatest health challenge. Lifestyle factors such as smoking, harmful alcohol use, poor nutrition and physical inactivity are causing a massive increase in chronic diseases including cardiovascular disease, respiratory disease, cancer and diabetes. Almost half of all Australians have a chronic disease and these diseases lead to eight in 10 premature deaths.
It is becomingly increasingly clear that we need to change the way we think about prevention if we are to buck these trends. Systems thinking has been used to understand and manage complex problems at a local and global level. It’s both a way of thinking and a practical tool to help tackle complex problems. It helps us to see the big picture – how the problem we’re trying to solve is made up of connected and inter-related components, so that a change in one part will influence other parts.
In cities and towns all over Australia, many different organisations, people and programs work to reduce the risk of chronic disease for the people in their communities. This work is not just happening in the health sector – people and organisations in education, transport and local government among others all make contributions that can improve their communities’ health.
However, little is known about how these people, activities and networks interconnect to shape a local prevention system. Understanding these interconnections, using systems thinking tools and methods, may be the first step to the design of new ways to intervene for chronic disease prevention.
How is the project addressing the issue?
Prevention Tracker is a national project that is exploring how local communities work to prevent chronic disease. Expanding a pilot project in Glenorchy, Tasmania, Prevention Tracker is working with a number of communities across diverse areas and populations of the country to help us to better understand local communities’ prevention systems and then guide and monitor communities’ work to prevent chronic disease. We will gather and learn from this knowledge to build a comprehensive picture of an effective prevention system for Australia.
By prevention system, we mean the people, processes, activities, settings and structures – and the changing relationships between them – that work together to try to improve the health of a community (see diagram). The idea is that if we can better understand the parts of a prevention system, and how they connect to make the whole, we can make better decisions about where and how to intervene to bring about improvements.
Prevention Tracker will attempt to describe each of these system parts and their interconnections by testing a range of methods in real life community settings. We will look at four main areas to understand a community’s prevention system and identify ways to improve it.
Describing the local prevention system
We will work closely with local communities to describe and understand their local prevention system.
This work will include:
- An inventory of health and well-being programs, policies and regulations that have the potential to reach community residents
- An atlas that maps key indicators of the liveability of a community
- A snapshot of the community – their health status and health risks
- Key informant interviews about partnerships for prevention, the prevention workforce, and what is working well and not so well in terms of health and wellbeing efforts in the community
- An organisational network analysis to measure connections with other organisations working across the community to improve the health of the community
- Community workshops to identify the complex causes of chronic diseases and opportunities for community-led actions for change.
Guiding system change within the local prevention system
Once we have described the local prevention system and begin to understand why things are the way they are, the next question is where and how to intervene in the prevention system.
Like all systems, prevention systems are dynamic and constantly adapting to changing circumstances. As a result, ‘action learning’ is a key part of Prevention Tracker. This means working closely with a team of local stakeholders who have the capacity and authority to implement strategies and assess their impact. With this team we will identify where and how to intervene to bring about systems change.
Monitoring system change within the local prevention system
An important part of describing and guiding system change efforts is knowing whether these efforts are making a difference. We will work with local teams and stakeholders to identify indicators of impact and progress towards achieving shared goals that strengthen the local prevention system.
Describing the model of Prevention Tracker
Each Prevention Tracker community will provide an opportunity for us to compare and contrast to identify a suite of common methods and inquiry processes best able to describe, guide and monitor system change in local prevention systems.
What are the expected outcomes?
Prevention Tracker is providing unique opportunities to work with a number of communities to identify a suite of methods and processes that other communities could use describe, guide and monitor their own efforts to prevent chronic disease.
We aim to pool and use what we learn from local communities to encourage action at local, state and national levels – actions such as better allocation of resources and stronger partnerships – to reduce the impact of chronic disease.
Prevention Tracker is also generating rich information about the strengths and challenges of this type of model in local communities. We are committed to sharing our learning through publication, presentations and social media.
Updated September 2016
- Dr Dan Chamberlain, La Trobe University
- Dr Seanna Davidson, Prevention Centre
- Maria Gomez, Prevention Centre
- Dr Liza Hopkins, Prevention Centre
- Pippy Barnett, Prevention Centre
- Katie Conte, Prevention Centre
- Jean Wang, Student Intern, McMaster University, Canada
International Advisory Committee:
- Professor Lesley Barclay, The University of Sydney
- Professor Pennie Foster-Fishman, Michigan State University, US
- Professor Terry Huang, City University of New York, US
- Professor Barbara Riley, University of Waterloo, Canada
- Professor Andrew Wilson, Prevention Centre and The University of Sydney
This initiative will develop methods for identifying and measuring local prevention systems. It will provide data that will allow us to make comparisons over time, both within communities as well as across different communities.
Our vision is that using and comparing local community information will help to guide action at both local and national levels – actions such as better allocation of resources and stronger partnerships – to reduce the impact of chronic disease.
Ultimately, we will pool and use what we learn from local communities to inform what is needed at a state and national level for an effective, efficient and equitable system for the prevention of lifestyle-related chronic disease in Australia.
What is Prevention Tracker?
Prevention Tracker is working with local communities to better understand their prevention system; how the people, processes, activities, settings and structures in that community all connect to influence the health of local populations.
Prevention Tracker in Glenorchy is a partnership between the Prevention Centre, Glenorchy City Council and the Tasmanian Government Department of Health and Human Services.
The Prevention Tracker proof-of-concept pilot study based in Glenorchy, Tasmania’s fourth largest city on the northern edge of Hobart, ran across 2015. We are currently discussing an expanded Prevention Tracker project in this community.
Prevention Tracker in Albany is a partnership between the Prevention Centre and WA Country Health Service (WACHS) Great Southern Population Health.
Currently, 68% of Albany adults are not at a healthy weight, 49% need to do more physical activity and nearly 90% do not eat enough vegetables. These people are at increased risk of chronic diseases such as heart disease, cancer and type 2 diabetes.
Prevention Tracker will work with local stakeholders in prevention to help create a better understanding of the local prevention system, identify possible points for effective intervention and monitor the effects of changes on the way prevention is carried out locally.
The vision is that the findings of the Prevention Tracker project in Albany will help to guide the City of Albany, WA Country Health Service and other organisations as they work together to improve health and prevent chronic diseases, with a particular focus on overweight and obesity.
Prevention Tracker in Broken Hill is a partnership between the Prevention Centre and the Broken Hill University Department of Rural Health (Sydney University).
Prevention Tracker is working with the Healthy Broken Hill initiative. Healthy Broken Hill embodies a whole-of-community approach to addressing obesity, diabetes and cardiovascular disease.
A Local Advisory Group has been formed in Broken Hill to provide local knowledge and insights to help the design, implementation and interpretation of Prevention Tracker.
Prevention Tracker in the Gold Coast is a collaboration between the Prevention Centre and Gold Coast Health.
The Local Advisory Group (Gold Coast) will have its inaugural meeting on 18 May.
The Gold Coast region stretches from Beenleigh in the north to Coolangatta in the south, and Springbrook and Ormeau in the western part of southeast Queensland. The estimated resident population is more than 560,000.
Roberts, N. Prevention Tracker: putting systems science to the test with local communities, World Congress on Public Health, Melbourne. April 2017.
Riley, T. World Leaders Dialogue: Exploring Systems approaches to chronic disease prevention, World Congress on Public Health, Melbourne. April 2017.
Riley, T. Living with uncertainty: behind the scenes of Prevention Tracker, World Congress on Public Health, Melbourne. April 2017.
- Prevention Centre news, April 2017: Prevention Tracker highlights key systems changes for communities
- Prevention Centre news, June 2016: Small wins in local communities make national change possible
- Prevention Centre news, October 2015: Prevention Tracker project learns from local wisdom