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Systems Change for Health Introduction to the Systems Change Process
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Systems Change Health™ Training Courses

Introduction to the Systems Change Process
  1. Assessing and Framing the Problem
  2. Analyzing Potential Solutions
  3. Influencing the Systems Change Process
  4. Implementing Enacted Policies
  5. Evaluating Systems Change Interventions

Introduction to the Systems Change Process

Time frame: 1 day (see sample agenda below)

Learning Objectives: By the end of the course, participants will be able to:

  1. Recognize that a problem definition is socially constructed
  2. Recognize how policy analysis tools can help guide solution development
  3. Identify a range of advocacy strategies and tactics
  4. Identify implementation components
  5. Recognize how message framing is critical to the policy change process
  6. Recognize the utility of a project logic model for evaluation planning

Public health professionals are increasingly working on systems and environmental solutions to health problems.  For example, local or state organizations may plan to reduce childhood obesity by changing school district policies related to physical activity and nutrition.  To effectively work on policy change, however, these professionals need to know how to implement newly enacted policies and procedures.

Workshop Description: This course orients participants to the systems change process, including how a local or state coalition might influence both systems change and implementation.  Through interactive exercises, lecture, and group discussion, participants become familiar with five topics:   1) defining social/health problems; 2) analysis to identify solutions; 3) advocacy to influence the systems change process; 4) implementation of an enacted policy; and 5) evaluation of systems change.

The workshop will rely on multiple learning styles including experiential activities (e.g., role play, small group exercises, individual reflection), as well as PowerPoint slides and written materials.  Emphasis will be on exploring the concepts and practicing techniques.  Facilitators will guide the small group activities and ensure that participants learn from the collective skills and experience present at the training. 

Target Audience: Public health professionals from state and local agencies, including: directors; division managers; health promotion, health education and environmental health staff; clinical staff managing non-clinical programs; and key partners collaborating on policy, environmental, or systems change initiatives. 

Relevance and Usefulness: The session provides an introduction to the public health Essential Service of developing health-supportive policy.  Participants are introduced to 21 specialized competencies promoted by the Directors of Health Promotion and Education (DHPE). 

Gateway to Skills-Building: This course provides a gateway to a skills-building workshop series entitled, “Systems Change for Health,” sponsored by the Directors of Health Promotion and Education (DHPE). The workshop introduces learners to five of the 21 specialized competencies promoted by DHPE (, and provides information relevant to the CHES competency on advocacy.

DHPE is approved as a provider of continuing education contact hours (CECH), Category I in health education by the National Commission for Health Education Credentialing, Inc. (NCHEC). This course is approved for 4.5 CECH (1.5 of 4.5 are advanced-level MCHES).

Session Agenda




Registration and Networking



  • Welcome and introductory activities
  • Review agenda and materials

Background and Context

  • Changing policies, environments and systems
  • Competency curricula


Assessing and Framing the Problem
Health and social problems need defining and framing to encourage policy solutions. Root causes, evidence and framing in terms of stakeholder values are part of a successful definition.


BREAK (15 minutes)


Analyzing Potential Solutions

  • How to choose among potential solutions to a problem?
  • Stakeholder power analysis highlights acceptability and feasibility of solutions.
  • Policy analysis techniques compare estimated impact across itemized criteria which can help to identify the solution(s) to pursue.


Influencing the Systems Change Process

  • Advocacy techniques are key to influencing the policy process.
  • Successful planning uses both policy and media advocacy strategies/tactics.


LUNCH (60 minutes)



  • Brief orientation to message framing and media.


BREAK (15 minutes)


Implementing Enacted Policies
Once a policy is enacted, a government bureaucracy implements it (e.g., programs, regulations, rules, and budgets).


Evaluating Systems Change Interventions

  • Policy evaluation requires assessment of all campaign stages to provide rapid feedback.
  • Capacity, process and outcome measures are needed.



  • Additional concepts and tools in Skill-Building workshop series.
  • Review and feedback.
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