Identifying and Relating Factors Associated with a Community-Driven Approach to Place-Based Transformation using Group Model Building

Publication Date


Document Type



Public Health and Recreation


Maternal and Child Health | Public Health | Women's Health

Publication Title

American Public Health Association (APHA) 2018 Annual Meeting & Expo

Conference Location

San Diego, CA


Background: Inequities in birth outcomes are best understood as a “wicked problem” affected by challenges at the individual, interpersonal, community, and societal levels. In designing and implementing interventions, there is an increased recognition of the value of engaging residents to identify and drive solutions to challenges in their community. The Best Babies Zone Initiative prioritizes this resident-driven approach through place-based, community transformation efforts to improve birth outcomes. More research is needed on the mechanisms, facilitators, and barriers of community-driven work. The objective of this study was to create a model of these variables using group model building, a qualitative, participatory approach in the systems dynamics tradition. Methods: This study engaged individuals working in five Best Babies Zones (n=9) to identify factors associated with a community-driven approach, and connections among those factors. Participants went through a series of group model building steps to collaboratively generate a conceptual model of community-driven approaches. Results: The model reflects the complexity of engaging in community-driven work. Specific factors were identified related to: organizational collaborations, the relationship between organizations and funders, and direct work with community residents. A number of key leverage points were identified to facilitate community-driven work. Conclusion: Group model building provided an opportunity to learn from practitioners using a community-driven approach to develop and implement place-based initiatives. Future research is needed to further develop and refine the model. This model supports practitioners to inform their understanding of the complexities of community-driven approaches, plan for potential challenges, and leverage opportunities for full, meaningful engagement.


Community-Based Partnership & Collaboration, Community-Based Health