Development and evaluation of system dynamics methods to engage with policy makers on the prevention and control of diabetes in a middle income region. (360G-Wellcome-110318_Z_15_Z)

The study will target English speaking middle-income countries in the Caribbean Community (CARICOM) who participated in the Heads of Government Port of Spain Declaration on NCDs (POSD). An on-going data analysis on mortality, morbidity and risk factor trends across the 20 CARICOM member states is underway, alongside detailed new data collection to define current policy responses to NCDs. This work will be used to inform which countries have sufficient data and strong stakeholder contacts for the development of a system dynamics model. Jamaica will be included as well as two other countries. The study will use mixed methods, gathering primary data through qualitative methods and secondary quantitative data. These data will then be applied to the design and implementation of a system dynamics model for policy evaluation. The qualitative phase will use in-depth semi-structured interviews with stakeholders identified through work with the on going POSD evaluation. The data will then be used to develop the first draft of a conceptual model using the Centers for Disease Control diabetes model as a basis. A quantitative data collection phase will collect evidence on diabetes prevalence, risk factors, determinants, outcomes, and health system response for the countries of interest. This review will provide the necessary information to quantify the relationships described by the conceptual model. Following the initial data collection phase, a model building workshop including all relevant stakeholders and investigators will work intensively to further refine the conceptual model until a consensus is reached. The final conceptual model will then be tested and validated. The final phase will involve a series of simulations evaluating policies for the prevention and management of diabetes. The results will be used engage policy makers and to evaluate the utility of the system dynamics methodology in adoption of policy.