High Leverage Interventions


In a hypothetical scenario, the establishment of school-based surveillance to document the prevalence of childhood obesity has been proposed as an intervention. The intention is that it would help inform the development of prevention and treatment policies.

(1) How does this strategy correspond to Meadows (1999) places to intervene in a system?(2) What are some of the unintended consequences that could result from this intervention?

Meadows, D 1999, Leverage Points: Places to Intervene in a System, The Academy for Systems Change, Vermont: http://donellameadows.org/archives/leverage-points-places-to-intervene-in-a-system/

Part – A: 200 words. This is your response to the assignment

Part – B: 50 words. I want you to develop a question from the assignment and discussion about it?

Part – C: 50 Words. I want you to develop another question from the assignment and discuss about it.


Finding leverage in the systemFinding leverage in the system, which is Stage 3 of the Systems Change in Public Health framework, is about clarifying what is not liked about the current system, exploring promising ways to improve the system and ‘stress testing’ these hypotheses. The Omidyar Group outline five steps to do this, which are:

Develop a systemic problem statement: Identify the disliked qualities of the system you would like to disrupt, mitigate or shiftFind opportunities for leverage: Look for areas of leverage in the system that promise large impact with relatively small engagementArticulate leverage hypothesis: Form connections between short-term impacts over time and long-term systems changeEvaluate feasibility and potential for impact: Analyse and assess the potential impact and feasibility of the leverage hypothesisEvaluate fit: Assess the extent to which these leverage hypotheses align with your organisations (or community) values, capacities and advantage.How we approach this stage, and more specifically how we find opportunities for leverage, will depend on what tools and processes have been used in our system inquiry. It’s likely (and hoped) that many tools have been used and layered upon one another to help refine our understanding of the system from multiple angles and diverse perspectives, and this process may have triggered many ideas about how to improve the system. Identifying leverage points is an iterative learning process, where information we’ve collected using one tool carries into the next which helps us to test ideas about appropriate interventions.

In more qualitative system inquiries, which might include for example carrying what we see in a systems map into a causal loop diagram, diagnostic questions that help identify fundamental system parts and system interactions, may then be used to find strategic leverage points. See Box 2 for an example of diagnostic questions from Foster-Fishman et al. (2007).

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