System Thinking and Action Research

System Theory and Action Research Susan M Ross Dr. Tyler Zerwekh September 15, 2012 Abstract Public health practices and policies are largely influenced by the population involved and seek to improve the overall health of the public. Achieving success in systems thinking requires making strategic decisions about what processes will best achieve the public health goals. Systems Theory Information Technology Systems Theory evaluates the relationship between information systems, and information technology, and people.

Action Research is used in the field of public health to alleviate adverse conditions in communities by addressing the determinants of health, community-wide interventions, and health promotion. Examples of Action Research evaluate the computer usage and health information technology and health collaboration groups as well as promotion of information health management techniques. An emphasis on relationship is the heart of systems orientation.

Systems thinking involving humans require an understanding of the nature of the system and its dynamics requires and an understanding of the people involved and the interaction with each other in the applicable network of the system. Action Research is a participatory, democratic process concerned with developing practical knowledge in the pursuit of worthwhile human purposes, theory and practice, in participation with others in the pursuit of practical solutions to issues of pressing concern to people, and more generally the flourishing of individual persons and communities. Reason & Bradbury, 2001). This paper will present a demonstration of a thorough analysis of a systems theory, action research, and an action research proposal to analyze the theory in relation to Caucasian socio-economic group. Systems Theory Fundamental systems-thinking perspectives and approaches that are shared across different fields are: (1) increased attention to how new knowledge is ained, managed, exchanged, interpreted, integrated, and disseminated; (2) emphasis on a network-centric approach that encourages relationship-building among and between individuals and organizations across traditional disciplines and fields in order to achieve relevant goals and objectives; (3) the development of models and projections, using a variety of analytic approaches in order to improve strategic decision making; and (4) systems organizing in order to foster improvements in organizational structures and functions (Leischow, et. al, 2008).

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Information Technology Systems Theory Information Systems (IS) theory is de? ned as concepts that speculate on social and technical relationships between Information Technology, Information Systems and social outcomes. Much IS theory originated in other disciplines and has been re? ned or applied to examine IT/IS issues. IS theory would also be classified as to include the technology acceptance model (TAM) and structuration theory and IT productivity models as applied to IS/IT phenomena (Chiasson, Davidson,2004) . Over the past years public health systems have evolved significantly.

As personal computers became more powerful and operating systems became more usable with the advent of Microsoft Windows, Computer information systems were updated to make use of more modern features, capabilities and software. Public health agencies began to recognize that information technology was a legitimate target for investment to improve their ability to perform core public health functions. As agencies began to upgrade replace or create new systems that were more robust and specialized using modern database management systems and tools on more reliable platforms, and the Internet began to come into its own.

The Center for Disease Control promoted its first System wide area communication and system integration projects through its Information Network for Public Health Officials (INPHO) initiative in 1993. (Artz, Salkowitz, 2007). Computer technology moved fairly quickly from the glass confines of the dedicated computer room to the general-purpose office. Over the past thirty years standards for technology have become an important fixture of organizational computing life.

Enforcement of standards also varies greatly depending on the political support for Information Technology (IT). As applications became more network-aware and network dependent, the need to leverage network investments became critical. Public health agencies became more ambitions as technology became more enabling. Computer Information Technology has a lot to offer Public Health agencies: existing data sets may be consolidated and population-based, including experiences negotiating data sharing agreements and memoranda of understanding.

With advancing technology national and international standards are being quickly developed to guide this functionality. (Artz, Salkowitz, 2007). Standards with compliance for patient information data sharing among different agencies, and back-up systems in the event of system failure and crisis are also among the concerns for globalizing Information Systems. Action Research Action research is a collaborative approach to research that provides people with the means to take systematic action in an effort to resolve specific problems.

Action research focuses on methods and techniques of investigation that take into account the study population’s history, culture, interactive activities and emotional lives. Although action research makes use of many traditional data-gathering strategies, its orientation and purpose are slightly different. The basic action research procedural routine involves four stages; (1) identifying the research question (s), (2) gathering the information to answer the questions (s), (3) analyzing and interpreting the information and (4) sharing the results with the participants (Berg, 2004).

Action Research is used in the field of public health to alleviate adverse conditions in communities by addressing the determinants of health, community-wide interventions, and health promotion. Indeed, action research is less a methodology and more a set of guidelines for the roles of the researcher and collaborators, interweaving theory and action and the function of the research knowledge.

There are many subtle variations and iterations of action research, but a gross distinction could be made between action research that is conducted by a researcher implementing an intervention at a community level for the dual purposes of change and knowledge outcomes versus community based participatory action research where those affected by the change and other important stakeholders participate in all stages of the research from design, implementation, and data gathering to analysis.

Participatory action research approaches often have the additional goal of promoting critical consciousness where through cyclical stages of dialogue participants attain a greater understanding of their situation, which in turn may result in political or major social change (Mullett, Fletcher, 20). Critics of Participatory Action Research (PAR) have questioned whether the reality of participatory research is ideal for promoting a healthy community.

The language of participation in health promotion research, and the inattention to gender, social and cultural (as in the use of universal terms like “the oppressed”) differences in participation in research processes do not always comport with the outcome values of PAR. Further, while participatory approaches can stimulate capacity building and community development, they can also bring unequal players to an uneven table to participate in difficult predetermined decision making (Minkler, 2000).

Action research also called participatory research is an alternative philosophy of social research. Three particular attributes are often used to distinguish participatory research from conventional research: shared ownership of research projects, community-based analysis of social problems, and an orientation toward community action. Critical action research expresses a commitment to bring together broad social analysis—the self-reflective collective self-study of practice, the way in which language is used, organization and power in a local situation, and action to improve things.

Critical action research is strongly represented in the literatures of educational action research, and there it emerges from dissatisfactions with classroom action research that typically does not take a broad view of the role of the relationship between education and social change. Critical action research has attempted to take account of disadvantage attributable to gender and ethnicity as well as to social class in its initial point of reference (Kimmis, McTaggart, 2007). Examples of Action Research Lau and Hayward (1997) used an action research approach in a study to explore the structure of Internet-based collaborative work groups.

Over a two-year period, the researchers participated as facilitators in three action research cycles of problem-solving among approximately 15 instructors and project staff, and 25 health professionals from various regions striving to make a transition to a more community-based health program. The aim was to explore how Internet-based communications would influence their evolution into a virtual collaborative workgroup. The first phase was taken up with defining expectations, providing the technology and developing the customized workgroup system.

The next phase saw the full deployment of the system, and the main lesson learned was that the steepness of the learning curve was severely underestimated, with frustrations only minimally satisfied by a great deal of technical support provided by telephone. The final cycle saw the stabilization of the system and the emergence of the virtual groups. The interpretations of the study suggest that role clarity, relationship building, information sharing, resource support, and experiential learning are important aspects in virtual group development.

There was also a sense that more research was needed on how group support systems can help groups interact with their external environment, as well as on how to enhance the process of learning by group members. Comstock and Fox (1995) have written about their experiences in integrating computer conferencing into a learning community for mid-career working adults attending a Graduate Management Program at Antioch University in Seattle. Their findings relate to establishing boundaries to interaction, creating a caring community, and building collaborative learning.

Students were expected to use the system for collaborative learning using three forms of conversation – dialogue, discussion and critical reflection. Dialogues were enjoined as a result of attempts to relate classroom lessons to personal situations at work, with a better understanding provided by multiple opinions. Discussions, distinguished by the goal of making a group decision or taking an action, required a fair degree of moderation, insofar as participants found it difficult to reach closure.

The process of reflecting critically on ideas was also difficult – participants rarely took the time to analyze postings, preferring a more immediate, and more superficial, conversational style. The authors conclude with four recommendations: 1) be clear about the purpose of the computer conference and expectations for use; 2) develop incentives for widespread and continuous participation; 3) pay attention to affects of the software on the way the system is used for learning; and 4) teach members of the community how to translate face-to-face collaborative processes to the on-line environment (Reason, & Bradbury, 2001).

Action Research Proposal The Affordable Care Act calls for a greater reliance on the internet as a means of communicating health and coverage information, yet variations in the current usage of the internet by some populations have important implications for implementation. Based on the results of The Washington Post, the Kaiser Family Foundation, and Harvard University Race and Recession Survey(2011), six in 10 adults overall say they have ever used the Internet to access health information, and access differs by race and income.

Forty-three percent of Hispanics report having ever used the Internet to access health information, while 56 percent of blacks and 65 percent of whites report doing so. The differences are even more striking among those with lower incomes. Just three in ten Hispanics with incomes under $40,000 say they have ever used the Internet to access health information, compared with 44 percent of blacks and half of whites with similar incomes. More than 70 000 websites disseminate health information; in excess of 50 million people seek health information online, with likely consequences for the health care system.

The Internet offers widespread access to health information, and the advantages of interactivity, information tailoring and anonymity. However, access is inequitable and use is hindered further by navigational challenges due to numerous design features (e. g. disorganization, technical language and lack of permanence). Increasingly, critics question the quality of online health information; limited research indicates that much is inaccurate. Meager information-evaluation skills add to consumers’ vulnerability, and reinforce the need for quality standards and widespread criteria for evaluating health information (Kline, Haynes, 2001).

An action research project evaluating the effects of the information technology theory on Caucasians over a period of time would be helpful in providing evidence based research for the Information Technology Systems Theory. The research project would review a group of Caucasian males and females in the same age range, the same level of computer skills and education. The focus of the research is to determine if the majority of access to healthcare was through the use of Information Technology would it create a healthier group then a group with minimal access to healthcare period.

The group would be evaluated for a year. During the time frame the group would have an in-person visit with a doctor once every six months except for an emergency. The visit would include a complete physical and required wellness checks. Follow-up visits would be via Skye or video-conferencing. The group would be deemed physically and mentally fit excluding family history of health issues. The group would be given a pass to a fitness center for a year to maintain their health, and would have to maintain contact with a nutritionist and their physician via the computer e-mail o a regular basis.

The group would also have access to the Internet anytime they want for the evaluation time. The rest of the environmental and social aspects would be determined by each participate of the research project, meaning that each participates could be local or global as long as there is consistent monitoring of the all of the participates. The evaluation would incorporate Action Research and Critical Action research as some instances would take into account the social economic status of the participants. Given that the largest percentage of whites used the computer and there is a large portion of people that lack access to healthcare in all races.

Minimizing variables, such as computer knowledge and education levels and providing all necessary tools to maintain a healthy lifestyle. Researchers would have options to focus the variable changes if there are any on the social economic condition of the individual participants. In conclusion Systems thinking involving humans require an understanding of the nature of the system and its dynamics requires and an understanding of the people involved and the interaction with each other in the applicable network of the system.

Public health agencies began to recognize that information technology was a legitimate target for investment to improve their ability to perform core public health functions. Computer Information Technology has a lot to offer Public Health agencies: existing data sets may be consolidated and population-based, including experiences negotiating data sharing agreements and memoranda of understanding. Action research approaches can stimulate capacity building and community development in designated social status groups if the focus is correctly designated. References Arzt, N. H. Salkowitz, S. M (2007), Evolution of public health information systems: Enterprise-wide approaches, p4-6, 11-13, 18-22. Berg, B. L. , (2004), Qualitative research methods for the social sciences, retrieved on August 23, 2012, from http://digilib. bc. edu/reserves/sc210/piat/sc21007. pdf Chaisson, M. W. , Davidson, E. , (2004), Pushing the contextual envelope: developing and diffusing IS theory for health information systems research, Elsevier Ltd. pg 157, retrieved on September 13, 2012, from http://www. butlercommonplace. org/thoughts/images/d/d0/Chiasson_et_al_2004__Info_and_Org. df Comstock, D. , ; Fox, S. , (1995),   Computer conferencing in a learning community: opportunities obstacles. ”   http://www. seattleantioch. edu/VirtualAntioch/DRAFT7HT. HTM (14/04/1998). Kemmis, S. , McTaggart, R, (2007), Participatory action research, Communicative action and the public sphere, retrieved on September 13, 2012, from http://www. corwin. com/upm-data/21157_Chapter_10. pdf Cline, R. J. W. , & Haynes, K. M. , (2001) Consumer health information seeking on the Internet: the state of the art, Oxford Journals, Volume, 16, Issue 6, pp671-692, etrieved on September 13, 2012, from http://her. oxfordjournals. org/content/16/6/671. long Lau, F. , and Hayward, F. (1997). “Structuration of Internet-based collaborative work groups through action research. Retrieved on September 13, 2012 from  http://search. ahfmr. ab. ca/tech_eval/gss. htm (11/4/1998). Leischow, S. J (2008), Systems thinking to improve the public’s health, American Journal of Preventive Medicine, retrieved on September 9, 2012, from http://dccps. nci. nih. gov/brp/scienceteam/ajpm/SystemsThinkingImprovePublicsHealth. pdf. Mullett, J. Fletcher, S. , (2011), Action research in public health, Oxford Index, retrieved on September 13, 2012, from http://oxfordindex. oup. com/view/10. 1093/obo/9780199756797-0018 Minkler, M. , (2000) Using participatory action research to build healthy communities, Public health reports, Focus on healthy communities. Retrieved on September 13, 2012, from http://www. ncbi. nlm. nih. gov/pmc/articles/PMC1308710/pdf/pubhealthrep00022-0089. pdf Reason, P. , ; Bradbury, H. (2001). Handbook of action research: participative inquiry and practice. London: SAGE. Retrieved on September 7, 2012

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