MCHwork: Transforming Learning | MCH Navigator

MCHwork: Transforming Learning | MCH Navigator
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MCHwork: Transforming Learning
Session 3.3: The Hexagon Tool — Coming Full Circle with Systems Integration
Introduction
Throughout this season of MCHwork, we have looked at the
Hexagon Tool
as a way of determining the effectiveness of programs and policies in addressing some of the pressing needs for our MCH populations. This issue of MCHwork teases out how
Systems Integration
tools – specifically
Human Centered Design
Causal Loop Diagramming
, and
System Support Mapping
– augment the Hexagon Tool in this process.
ON YOUR MARK: Understand Needs with Human Centered Design
What is Human Centered Design (HCD)?
HCD is a problem-solving methodology that prioritizes user needs throughout the design process. By considering individual perspectives and employing iterative testing, HCD aims to create solutions that are not only functional but also resonate with populations of focus. HCD goes beyond simply considering user needs. It's an iterative process that revolves around understanding people, their contexts, and the challenges they face. HCD practitioners employ a variety of qualitative research methods, like user interviews and observations, to build empathy and gain a deep understanding of problems. This informs the brainstorming and prototyping of solutions, which are then rigorously tested with real users. This feedback loop allows for ongoing refinement until a program or practice is created that is truly user-centered and effective.
In public health, HCD can be used to develop educational materials that are culturally responsive and easy to understand for diverse communities.
This user-centric approach can be applied to any program or practice, ensuring that decisions are grounded in the lived experiences and preferences of the populations most impacted.
Why is HCD Important?
HCD is the foundation. It involves user research (the community in this case) to understand their experiences, needs, and perspectives regarding health concerns. Through interviews, focus groups, and observations, HCD identifies the most pressing public health issues impacting the community.
Watch this video to learn how a human-centered design perspective can bolster the Hexagon Tool to center decisions about new programs or practices in the experiences and preferences of the populations you serve.
Human-Centered Design Resources
Design Kit: The Human-Centered Design Toolkit
(ideo.org). This updated tool shares the practice and promise of human-centered design with the social sector. Online resources supplement a downloadable PDF, the Field Guide, that includes design methods, key mindsets that underpin how and why design impacts change, a set of worksheets, and case studies from projects that show human-centered design in action.
Introduction to Liberatory Design
(National Equality Project). This web portal explains an approach to addressing equity challenges and change efforts in complex systems. It is grounded in an integrated part of an evidence-informed equity framework that meshes human-centered design with complex systems theory, and deep equity practice.
Empathy Map
(Dave Gray, Game Storming 2009). The empathy map is a method for understanding audiences, including users, customers, and other players in any ecosystem. The purpose of the tool is to gain a deeper level of understanding of partners within that ecosystem.
GET READY: Explore the Issues with Causal Loop Diagramming
What is Causal Loop Diagramming (CLD)?
CLD is a visual tool used to map out the cause-and-effect relationships between different factors within a system.
By employing boxes and arrows, CLDs depict how changes in one variable can influence, and be influenced by, other variables over time.
In our MCH communities, a CLD might illustrate how increased access to healthy foods (variable) can lead to better dietary choices (variable), which in turn can reduce obesity rates (variable) and healthcare costs (variable), ultimately prompting further investment in healthy food initiatives (variable). This focus on interconnectedness allows CLDs to be instrumental in designing interventions that consider the perspectives of various populations. By incorporating the potential impacts on different groups within the CLD, decision-makers can ensure new programs or practices address the specific needs and preferences of each population.
Why is CLD Important?
Once a key issue is identified (e.g., high childhood obesity rates), CLD comes into play. This tool visually depicts the cause-and-effect relationships between factors contributing to the issue. Using arrows, CLDs show how factors like limited access to healthy food options (cause) can lead to higher obesity rates (effect). This helps identify the root causes for targeted intervention.
Watch this video about how a Causal-Loop Diagramming can combine with the Hexagon Tool to choose among options for a new program or policy.
Causal-Loop Diagramming Resources
Program Evaluation Portal
(CDC Office of Policy, Performance, and Evaluation). This resource provides CDC's approach to evaluation, materials and resources based on the CDC framework, and links to ongoing training events.
Causal Loop Diagramming in Five Minutes
(National MCH Workforce Development Center). This video provides the basics of CLD with examples related to MCH communities.
GET SET: Match Needs to Resources with System Support Mapping
What is System Support Mapping (SSM)?
SSM is a tool used to understand the needs and resources of individuals within a complex system.
It typically involves identifying an individual's role, responsibilities, the needs they have to fulfill those responsibilities, the resources available to them, and their needs for additional support.
System support mapping can be to
reveal gaps in resources or identify areas where workflows can be improved to better support professionals in their work. Ultimately, system support mapping allows decision-makers to consider the perspectives of different stakeholders, like healthcare workers and families, when developing new programs or practices, ensuring they are designed to address the actual needs and preferences of MCH populations.
Why is SSM Important?
Now that the root causes are clearer, system support mapping takes over. This tool focuses on existing resources and programs within the public health system. Following our example from above, it helps map out programs addressing healthy eating habits, nutrition education, or physical activity promotion within the community.
Watch this video about how system-support mapping can augment the Hexagon Tool to assess readiness for a new program or policy.
System-Support Mapping Resources
System Support Mapping in Five Minutes
(National MCH Workforce Development Center). This short video provides components of SSM, including ways to discover how roles and responsibilities relate to needs, resources, and wishes.
Whole System Mapping in Five Minutes
(National MCH Workforce Development Center). This short video provides the basics of system support mapping with examples related to MCH communities.
Asset Mapping
(National MCH Workforce Development Center). This extended video provides a detailed description of the role of asset mapping along with the process, case studies, and benefits of the process.
GO: Move from Assessment to Action
How Does the Hexagon Tool Fit In?
With both the problem (identified by HCD and CLD) and existing programs (mapped by SSM) on the table, the Hexagon Tool steps in. The
Hexagon Discussion and Analysis Tool
is an evidence-based resource to learn about now so you can use it when you're ready to move from
assessment to action
. This tool allows you to explore various combinations of existing programs to find the most effective solution. The Hexagon Tool helps analyze how different program combinations (e.g., combining nutrition education with after-school sports programs) might address the identified public health issue (e.g., high childhood obesity).
References
Digital.Gov.
Introduction to human-centered design: Everything you need to know to get started with our human-centered design series
Bartlett R, Boyle JA, Simons Smith J, Khan N, Robinson T, Ramaswamy R. Evaluating human-centred design for public health: a case study on developing a healthcare app with refugee communities. Res Involv Engagem. 2021 May 30;7(1):32. doi: 10.1186/s40900-021-00273-2. PMID: 34053451; PMCID: PMC8166144.
Lannon C.
Causal Loop Construction: The Basics
. Leverage Networks Inc. The System Thinker.
Sigma Six Training.
Causal Loop Diagram in Systems Thinking: Everything to Know
. 2024.
Systems Mapping Center at Policy Research Associates.
What Is Systems Mapping?
Calancie L, Margolis L, Chall SA, Mullenix A, Chaudhry A, Hassmiller Lich K. System Support Mapping: A Novel Systems Thinking Tool Applied to Assess the Needs of Maternal and Child Health Title V Professionals and Their Partners. J Public Health Manag Pract. 2020 Jul/Aug;26(4):E42-E53. doi: 10.1097/PHH.0000000000000941. PMID: 30807460.
This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UE8MC25742; MCH Navigator for $225,000/year. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.