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William M. Trochim, PhD, Derek A. Cabrera, MA, Bobby Milstein, MPH, Richard S. Gallagher, BS and Scott J. Leischow, PhD

William M. Trochim is with the Department of Policy Analysis and Management, Cornell University, Ithaca, NY. Derek A. Cabrera is with the Department of Education, Cornell University. Bobby Milstein is with the Centers for Disease Control and Prevention, Atlanta, Ga. Richard S. Gallagher is with Gallagher and Associates, Ithaca, NY. At the time of the study, Scott J. Leischow was with the National Cancer Institute, Bethesda, Md.

Correspondence: Requests for reprints should be sent to William M. Trochim, PhD, Policy Analysis and Management, 249 MVR Hall, Cornell University, Ithaca, NY 14853 (e-mail: wmt1{at}cornell.edu).

Objectives. Awareness of and support for systems thinking and modeling in the public health field are growing, yet there are many practical challenges to implementation. We sought to identify and describe these challenges from the perspectives of practicing public health professionals.

Methods. A systems-based methodology, concept mapping, was used in a study of 133 participants from 2 systems-based public health initiatives (the Initiative for the Study and Implementation of Systems and the Syndemics Prevention Network). This method identified 100 key challenges to implementation of systems thinking and modeling in public health work.

Results. The project resulted in a map identifying 8 categories of challenges and the dynamic interactions among them.

Conclusions. Implementation by public health professionals of the 8 simple rules we derived from the clusters in the map identified here will help to address challenges and improve the organization of systems that protect the public’s health.

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