# Combining community-based system dynamics and design thinking to inform public health intervention: a case study optimizing community-clinical linkage design in Brooklyn, NY

**Authors:** K. Toney, E. Ballard, J. Duch, C. Zuniga, R. Gore, A. Castaneda, I. Dapkins, B. Roy

PMC · DOI: 10.3389/fpubh.2025.1585633 · 2025-06-04

## TL;DR

This paper explores a new method combining system dynamics and design thinking to improve public health interventions in Brooklyn by better understanding complex community and clinical interactions.

## Contribution

The novelty lies in integrating community-based system dynamics with design thinking to address public health challenges through multi-level insights.

## Key findings

- Integrating methods provides insights at multiple levels, linking system understanding to individual experiences.
- The approach helps translate insights into actionable strategies for intervention planning and sustaining change.

## Abstract

The underlying drivers and outcomes of social determinants of health are dynamically complex, making it difficult to design effective responses. This complexity has inspired a growing number of calls to move beyond mechanistic thinking and use systems science to engage directly with complexity and highlight opportunities for methodological innovation to enhance translation of insight into real world action. This case study describes a methodological innovation combining community-based system dynamics and design thinking to understand multi-level complexity of a public health challenge: optimizing the design of a community-clinical linkage in Brooklyn, New York. In-depth description of the case illustrates methods integration and resulting insights and recommendations. Results from the case demonstrate that integrating methods generates insight at multiple levels, including connecting holistic system understanding to individual experiences of system structure and operationalizing and translating insights into action. Combining community-based system dynamics and design thinking holds value for intervention planning, strategic implementation, and sustaining change.

## Full-text entities

- **Genes:** CRYGEP (crystallin gamma E, pseudogene) [NCBI Gene 200575] {aka CCL, CRYG5, CRYGEP1, D2S1472, G2}
- **Diseases:** diabetes (MESH:D003920), hypertension (MESH:D006973), noncommunicable disease (MESH:D000073296), FHC (MESH:D024741), food insecurity (MESH:D005517), disease (MESH:D004194), pain (MESH:D010146), SDoH (MESH:D003643), weight loss (MESH:D015431)
- **Chemicals:** alcohol (MESH:D000438)
- **Species:** Homo sapiens (human, species) [taxon 9606], Nicotiana tabacum (American tobacco, species) [taxon 4097]

## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12174143/full.md

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Source: https://tomesphere.com/paper/PMC12174143