Abstract for: Making the Most of Simulation Modeling in Community Settings: A Conceptual Framework with Practical Value

The ReThink Health Dynamics model is a realistic, but simplified, portrait of a local health system. It was designed to support innovators leading collective efforts to improve health system performance over time. Here we present findings from a rapid, formative evaluation in five sites where the ReThink Health (RTH) model was piloted. We address several practical questions that are broadly relevant to those who use simulation modeling in diverse community settings: How does simulation modeling enhance collective efforts to transform local systems? In what ways? Using what methods? Under what conditions? An initial program theory was explicated using a table of domains, each grounded in the literatures on health system transformation and system dynamics modeling, then supplemented with insights from veteran practitioners. Preliminary hypotheses were tested and revised based on cross-case analyses, resulting in a robust framework that encompasses three major areas of interest in any modeling project: Contexts (i.e., settings and participant characteristics); Engagements (i.e., interactive experiences); and Effects (i.e., insights and consequences among individuals, groups, organizations/systems; and methodologies). Cross-site observations indicate that sites with certain pre-xisting collaborative characteristics and leadership capacities as well as internal motivation for the project were better able to use the model and harness its potential to catalyze change among individuals, groups, organizations, and methods.