#6 But Seriously... How Do I Map a System?

In this follow-up to Episode #5 on diagnosing complexity, Matt and Tenille get tangible with a conversation on ways to think and approach systems mapping. The big focus is on two foundational ways to frame a system:

• through the actors that are involved or interacting
• through the determinants (barriers or enablers) to a topic area or point of focus

They unpack some of the tricks and tips - including second layer questions, boundary setting, and lateral thinking - as well as the role and importance of different perspectives being involved.

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Transcript

Matt Healey: [00:00:00] Hi Tennille. How's it going? 

Tenille Moselen: Hey Matt. I'm good. How are you? 

Matt Healey: Good. Thank you. how's your hay fever treating you today? 

Tenille Moselen: Much better. Although they say the allergies are the worst they've been this season in Melbourne. So I'm not surprised. 

Matt Healey: . Thank you for absorbing all of the hay fever on my behalf. Um, so last episode, I mentioned that I would bring you something, divided into two parts. So last time we talked about, more of a , thinking component where we were trying to really understand what is it that makes something complex and trying to unpack, uh, what complexity looks like and how it's, manifests or how it applies to different situations.

Matt Healey: This episode, I really wanted to take it a step further and start to get a little bit more practical. The way that we're going to do that, is we're actually going to, step through, how you develop systems maps. 

Matt Healey: What we're trying to do when we develop systems maps is develop a view or [00:01:00] picture of the complexity that we were discussing last time.

Matt Healey: Uh, and. The, the challenge often is that, we have to accept, and we talked about this last time with the discussion on complexity, that wrapping our heads around all of the different moving parts and all those relationships is quite challenging. 

Matt Healey: At the outset, we have to be really clear that the systems mapping processes are often, uh, quite. limited necessarily, but they're usually a version of, or only a piece of the picture that we're talking about. So we're almost taking these like abstracted views of the system that are quite bounded and quite limited in many ways.

Matt Healey: , but still meant to be kind of useful. So. I think the thing I want to reinforce to our listeners is, we're talking today about how to create systems maps, but they're not a silver bullet solution in terms of making sense of a complex problem. They're still going to have their limits to what they can tell you.

Matt Healey: So I thought what we start with is , we talk a little bit about the different types of systems maps, and then, after [00:02:00] that we'll get into, the practical parts of this, we'll actually talk about the issue from last time, can you remind me what your What issue was that we were talking about last time? 

Tenille Moselen: Yeah. Last episode, we were talking about vaping. 

Matt Healey: Vaping. That's right. , today we're going to keep going with that topic of vaping.

Matt Healey: but we're going to unpack it a little bit more in terms of, some different systems maps. I'll give you some time to, think about the different, components, of the complexity that is the vaping, system. Yep. While I kind of give our listeners a bit of a, a recap or a bit of an overview on, on what some of these structures of systems maps are, um, does that sound okay?

Matt Healey: You can prepare yourself. 

Tenille Moselen: Yeah, great. I'll start jotting down some notes while you, go through a bit of a recap. 

Matt Healey: Great. , we talk about systems maps as, a body of, techniques that you can use to make sense of complexity or complex situations. And I mean, there's lots of different ways you could interpret maps.

Matt Healey: In really broad terms, I would summarize them into either [00:03:00] maps that are reflecting the relationships between actors or maps that reflect the relationship between factors. , you could merge the two if you, if you so desired, but what I'm basically getting out there is that you have maps that reflect the different, Participants or actors or players in a, in a particular topic area or a geography , or you have the different sort of factors or drivers or determinants or whatever language you want to use, that relate to a particular issue.

Matt Healey: that usually is the issue that's defining the system that you're talking about. So, in this context, we could be talking about, the vaping system. So vaping would be like the central issue or topic that we're talking about. , there are other specifics within each of those sort of broad categories of, 

Matt Healey: systems map. I don't want to present those as the capitalized versions of what they are, but most maps would fall into one of those two categories. So that would include things like causal loop diagrams, which are a particular type of model that is reflecting how things are related, but it's including a plus [00:04:00] and minus on those relationships to show you how things feed back in on each other, how they reinforce or balance. changes in the system. So they're kind of a particular type of map. 

Matt Healey: usually one that's reflecting those, um, those factors for instance. So there are some really famous examples, out of the UK for instance, that speak to that. And if you, go to Google and search for causal loop diagrams, there's any number that you can find.

Matt Healey: But typically whenever I think about these in the sorts of work that we do, I would default to talking about them as either maps of. Actors or maps of factors. I think the thing that I would always suggest to people when they're thinking about how to develop a systems map as a first step is to actually give it a bit of a name.

Matt Healey: and when I say name, I don't mean like, you know, Matthew, but giving it a bit of a categorization or a label to help you refer to it, because one of the things that can trip people up is they'll want to develop a map of the system. And the risk there is you're presenting the [00:05:00] system as this objective thing.

Matt Healey: and the reality is that everyone experiences systemic issues or systemic, occurrences differently. And really it's better to talk about systems as a thing rather than the thing. So I would always say, try to give it a label or a reference. So you can say, this is a systems map of the public health system.

Matt Healey: And what you're trying to introduce to people there. Is the idea that this is an interpretation of that system. It's not an objective picture. it is, the accumulation of different perspectives or different evidence or different research on a particular topic area, but it's still just a view because oftentimes, by the time you've created it, dynamics have shifted, things have changed, As we talked about in the last episode, there's adaptation that's occurred because of different things that have changed.

Matt Healey: So, by the time you've made it, it could be out of date. So it's good to give yourself a bit of a, point in time reference and saying this is a systems map of the public health system, as of [00:06:00] December, 2022, it giving you a bit of a representation of a point in time.

Matt Healey: Set of dynamics and relationships and things like that, 

Matt Healey: but as a recap for our listeners, good way to think about it maps of actors, which is the organizations, the groups that the individuals that are involved or related to a particular area, whether it's a topic or geography or maps of factors, which are.

Matt Healey: The different drivers or determinants or things that are helping or hindering or driving an issue or a topic, whether it's something that's, you know, in inverted commas bad or something that you're aspiring to or trying to work towards, which is, you know, a good thing. Um, how does that sound as a recap to you?

Matt Healey: Make sense? Yeah, 

Tenille Moselen: I think that was good. particularly just focusing on the Fact that our maps that we create are a point in time and highlighting and reminding Alison is that I think is a a good point to drive home because [00:07:00] it's easy to forget sometimes after you put all the work in and walk away from it and think I've done it.

Tenille Moselen: There it is. But. Uh, as with the nature of all complex systems, it's constantly changing. 

Matt Healey: Yeah, absolutely. And the thing that can sometimes happen too, is that those outside influences that maybe aren't reflected in our systems maps can sometimes be the things that cause the biggest, uh, sort of upheavals or, or changes as well.

Matt Healey: So it can be really difficult to wrap our heads around everything that might influence the system that we've tried to map. , so giving yourself that, positive reinforcement that you can do a really good job with the systems map and it can do everything that you need it to do, but it will change and it will probably change in ways that either you haven't anticipated or can't predict, , and, and that's okay.

Matt Healey: And that's, you know, it's not like you haven't done everything that you could have done. , okay, so let's get into a bit of a practical, , Discussion now. , let's 

Tenille Moselen: do it. 

Matt Healey: Vaping was the topic or the sort of issue area.

Matt Healey: Keeping true to what we're [00:08:00] just talking about there. I think let's approach, this as though we're going to develop an actors map and a factors map. Okay. so we'll want to still keep it true to, some fairly sort of basic principles of good practice. So we'll want to think about what our boundaries are.

Matt Healey: We'll want to think about any, constraints or any sort of things that we want to define for ourselves, but I would typically say actors or all those sort of organizations or people or participants. It's usually a good 1 to start with when you're getting into your systems mapping journey, because it's quite tangible and it doesn't necessarily rely on the same level of insight or understanding of a particular issue as a determinants or factors map would because, you know, you can kind of see.

Matt Healey: The organizations, you can see the people in a particular, context or community. so it's, , a bit more of a straightforward starting point. So, if we take vaping, for instance, I mean, to Neil, do you think would be 1 of the 1st things that [00:09:00] you'd want to clarify for yourself when it comes to developing a systems map of vaping?

Tenille Moselen: so for our vaping, I think, firstly, we need to think about the boundaries, um, so that we can map the different actors that are in the system. 

Matt Healey: That's usually where I would try to start, because, we could be thinking about vaping, and the different actors, at a Commonwealth level or like whole of country level, but we could also be thinking about it and at an extremely localized level and what those dynamics look like and the different things that we might include or exclude, can vary quite a lot.

Matt Healey: You know, are we going to include at a, if we do an Australia wide map, are we going to include every retailer? Probably not because there's just far too many, but conversely, at a localized level, you could very easily include retailers and other providers and those sorts of things too.

Matt Healey: So, um, that's, that's really helpful to think about. are there other ways of thinking about boundaries that come to [00:10:00] mind for you, , or different ways of conceptualizing what a boundary is? I mean, geography is an obvious one in many ways, but are there other ones that come to mind for you?

Tenille Moselen: Yeah, absolutely. I think you're right. The first thing you think of is geographical boundaries because that's the most prominent in our mind, but there's other boundaries as well, particularly with vaping. And I think one of the important ones is probably cultural boundaries, uh, which is essentially that in different cultures vaping might be more or less acceptable and have more or less stigma around it, which could then influence whether or not there's a higher rate of vaping amongst different cultures as well.

Tenille Moselen: So there's geographical boundaries and cultural boundaries. Also, , boundaries that are set by laws and regulations as well around obviously the sales of vaping and age restrictions.

Matt Healey: Yeah, oh, absolutely. That's a good point too, because, , if you insert some of those, like, say, regulatory boundaries, for [00:11:00] instance, it might also, open up your system to other types of actors, that would otherwise not be included. for instance, crime, , sometimes those sorts of actors which maybe don't necessarily feature, could be more influential than they would otherwise be. 

Matt Healey: if you insert those kind of, either boundaries or sometimes maybe even like an overlay, or like a different way of looking at, that network, , Yeah, absolutely.

Matt Healey: Let's do a bit of a sort of verbal construction of this map. 

Matt Healey: So if you think of some different organizations or groups, who comes to mind for you when you think about, let's say, we're talking about . A vaping system in Victoria, for instance, who are the, who are the different groups be now in our map?

Tenille Moselen: Yeah, so I like to think about everything in a really logical way. It's how my brain works. So I usually would start, at the,, upper or higher end of influence, you could say. So there's regulators, which is. Essentially government, um, and different health departments in Victoria, then [00:12:00] there's the manufacturers.

Tenille Moselen: So the companies that are making the vaping devices, , and then I suppose there's the retailers whether that be online or actual brick and mortar stores, um, and then there's other ones that, , less obvious, which are things like, , law enforcement, ,

Tenille Moselen: , and then there's the advocacy groups as well. So there's environmental groups and health groups that advocate, uh, for, greater protections against vaping, or advocate for reduced waste that comes with vaping, um, and less obvious ones, like researchers, , who can be either researching the harms of vaping, or again, they could be, Doing the opposite, which is sort of researching how to reduce harm, but still have vapes available as well.

Matt Healey: that's, a very good point. And just thinking about like some of the groups in the way that you're framing some of their relationships there. We were talking about them in quite a. Like a positive way, as in, oh, they're here to have a good, I mean, not so much the, [00:13:00] um, maybe the sort of, uh, selling of the products, but like the framing of things like, oh, the researchers that are trying to study the health impacts of a being, you know, there are equally people like the work in market research where,, the role is to.

Matt Healey: Develop better campaigns, which includes for companies that are looking to sell,, particular products that may be harmful to people's health and things like that. And so this is where like some of that, maybe not even boundary setting, but some of those overlays start to creep in where we start to think about, well, what's the like role or function of the different players that we're trying to articulate?

Matt Healey: And do we include, say, researchers? Do we include two different, dots in our map researchers that are studying the health impacts that are trying to minimize or reduce harm? But do we also include organizations or groups that are, you know, studying consumer sentiment and trying to figure out how to. Advertise or market to new segments, or new customer bases and things like that. 

Matt Healey: but the other one that you actually mentioned there that I just want to touch on [00:14:00] is the environmental groups. Because I think that's quite interesting again, thinking about it in a boundary setting sense. So we've talked about, vaping as a health issue.

Matt Healey: , but what you were starting to introduce there, it sounds to me like was their sort of disposal. Um, and how that's managed and treating vaping as an environmental issue,

Matt Healey: so what that does is it actually starts to open up potentially a different sort of,, network map or, or map of organizations, because it would be those that have a role or an interest in vapes from an environmental perspective or like a waste management perspective, , which.

Matt Healey: All the ones that we've talked about are more related to the use of vapes and the health impacts of vapes,, as well, which I think is again, quite interesting and maybe partially reflects, um, the purpose of this podcast, talking about, um, public health and health promotion and those sorts of things.

Matt Healey: ,but also just, you know, people's backgrounds, like that can [00:15:00] influence how we think. Uh, about who is relevant as well. I mean, your background is in public health, so that makes a lot of sense to me. 

Tenille Moselen: Yeah, exactly. And I think you've highlighted the importance of setting the boundaries because like you just mentioned, , when we think of environmental groups in our participants map.

Tenille Moselen: , then we could open a whole can of worms of other participants or other actors that are involved if we look at it as an environmental issue. And, and that's why we do need to set these boundaries because the map would be never ending. 

Matt Healey: Yeah, absolutely. And I mean, the thing that we talked about last episode, one of our sort of, criteria or markers of complexity was that the, the sort of things you're taking a view of are kind of nested,, Within broader systems or networks, and I mean, this is also true here because again, we've taken a very health based view of this with a sort of light touch of some environmental topics, but also there's economic areas here too.

Matt Healey: And we've touched on them a little bit, but not [00:16:00] explicitly but also, you know, there's the. The, um, I guess we could call it justice or crime side to that can creep into it, that sort of educational view where we've actually taken a very, quite traditional public health view of this, but actually we could look at this from many different angles and that would actually quite strongly influence what this map ended up looking like.

Tenille Moselen: Yeah, absolutely. And there's also the, the mental health and wellbeing side of it as well around, . Absolutely. Social media platforms, , and peer pressure and influences, , whether they be social media influences or peer influences, , that we haven't considered as well. 

Matt Healey: Probably the one thing that is worth thinking about, I mean, there might be something that comes to mind for you is like the nature and the directionality of the relationship too. So in like, say in causal loop diagrams, you can have relationships that are. Sort of two way relationships or two way connections.

Matt Healey: You can also have one way [00:17:00] connections and they can have different effects depending on what the nature of that relationship is. And I think the same idea still applies here. If you look at this map, for instance, between say, um, Oh, I mean, let's just pick an obvious one, like retailers and consumers, , how would you define the nature of that relationship between those two?

Tenille Moselen: Retailers sell to consumers, essentially. So retailers are getting something out of their relationship with consumers. So it's directional that way. And consumers are also getting a product from retailers. So it's kind of bi directional because without one another. The product can't get to the consumer and the consumer can't get the product.

Matt Healey: Yeah, absolutely. And so what we're creating there is a bit of a feedback loop, which is like, basically retailers are selling to consumers and consumers are providing money, buying the product from retailers. There's a very close relationship there between the two. And, , obviously there are then other.

Matt Healey: Influences [00:18:00] or factors on whether retailers have the product to sell or whether consumers have the money to buy or the motivation to buy as well. , we're not sort of giving people answers as such, but I think just highlighting that there are lots of things to think about. 

Matt Healey: And for me, probably the takeaway messages with these sorts of maps with participants are to start with thinking about those boundaries, but maybe holding your boundaries a bit loosely.

Matt Healey: So trying to start with a bit of a, you know, maybe a geographic or like something that helps you define the limits a little bit. So whether it's like a health boundary or a broad topic area boundary or geographic boundary or something like that can be a good starting point. But then once you start to sort of, you know, think about who are all of the different players in our map, then you have to start to think about, what determines whether there's a line drawn between them.

Matt Healey: And is that line one way or two way? , and then importantly, as again, we talked about last episode, , what's the exchange, that occurs within that? And it doesn't have to be like for like. You know, in that example there, [00:19:00] consumers are providing money to retailers. They're buying a product. And so the exchange is, you know, literally for goods and services and that type of idea, but it doesn't always have to be in that in such a transactional way too.

Tenille Moselen: Yeah. Yeah, absolutely. And I think a lot of the relationships that are quite obvious and you immediately think of are transactional and are two ways. So I think it'd be interesting to highlight a relationship that is only one way. In this kind of vaping, , participant map that we've virtually or verbally created, I should say.

Tenille Moselen: Can you think of any that come to mind? Because all the ones I can think of immediately off the top of my head are two way, even between researchers and regulators. There's still the transaction of researchers being paid. Most of the time for their research. 

Matt Healey: Maybe in the context of advocacy, you could argue that maybe that's a bit more one way in the sense that [00:20:00] advocacy groups are, I guess, directing their advocacy efforts towards certain organizations or certain players.

Matt Healey: And there's not necessarily a direct return. I mean, there might be eventually, um, but it's not really sort of direct back to the advocacy groups. It's probably more in terms of there might be regulatory change or something, which has a broader sweeping effect, but it's not a transactional one where, you know, good job advocacy groups here is, you know, You know, a return for your efforts or, or anything like that.

Matt Healey: Um, or, you know, there's kind of steps in between as well. Like there could be a return, but it's kind of indirect in the sense that, you know, the return back to the advocacy groups is, uh, young people are vaping less and that is a indirect benefit or return from their direct efforts of advocating to the regulators, for instance.

Tenille Moselen: Yeah, absolutely. And typically, uh, a much longer term benefit. 

Matt Healey: Yeah. Oh, for sure. And I think this is where it kind of gets hard sometimes to think about. [00:21:00] The ideas of what we're trying to reflect here, which is, you know, this is kind of almost just like a, it's a messy conceptual reflection of the dynamics that are at play.

Matt Healey: the challenge here then is what do we do with this? And I think we have to go back to, well, these are not, it's not a silver bullet answer. This doesn't tell us What to do necessarily, but it can help prioritize. , so if we have to start thinking about, you and I were working on a project together and we had to think about who do we involve in our project or who do we try to reach out to, these sorts of processes can be useful as a way of thinking about, well, you know, I wouldn't normally have said.

Matt Healey: Environmental groups are someone that we, but based on what we can see and the different relationships, maybe they would be good to include in our project. It's also just a way of helping you think a bit laterally about the nature of what your. network or that the groups that you're involved with, are looking like.

Matt Healey: Okay. To wrap up this part of it. when you're thinking about your sort of participant maps, I think what we've tried to highlight here is setting boundaries or trying to think about what [00:22:00] your boundaries are to help limit your thinking are good, but maybe not sort of being too restrictive initially.

Matt Healey: So kind of loose boundaries, . Focusing initially on just who are the range of organizations or players,, and getting those down, whether it's on butcher's paper or, in a virtual whiteboard style platform, then looking at the relationships between them and trying to have a bit of a discussion or reflection on.

Matt Healey: What is the nature of that relationship? What's being exchanged? Is it 2 ways? And starting to think about, who's most central or who's likely to have the most, ability to influence or have the most ability to engage different groups . And I mean, it's again, not meant to be a silver bullet.

Matt Healey: It is very much. , just trying to make sense of who's, who's out there, who's interested or trying to work on this problem. But also, are they organizations that would work with you or potentially work against you, depending on what your aims are as well. All right, let's, take a break.

Matt Healey: And then when we come back, let's have a chat about determinants. 

Tenille Moselen: [00:23:00] Sounds good.

Matt Healey: Welcome back. 

Matt Healey: So before the break. We were talking about, , essentially actors maps or, you know, the, the ways in which you can think about how to start developing a bit of a, representation of the different organizations or groups that are involved or interested in a particular issue. It's a good 1 to start with. I would say that,, it's potentially a bit more straightforward than this next 1, which is, our factors maps or sometimes what I like to refer to as, determinants maps. 

Matt Healey: The reason I like to call them that is because I look at them in the view of, what are the different factors that help drive or determine whether an issue or a topic area is manifesting or not.

Matt Healey: And really what we're trying to get to is. It's almost like a form of root cause analysis,. So we're trying to get to the deeper drivers or determinants of an issue. So for those of you listening, who are very familiar with things like the determinants of health, like this will be very much in line with that way of thinking, as well.

Matt Healey: So we're going to keep [00:24:00] going with the topic of vaping. , yeah. But in this particular context, it's good to start off with a,, like a topic or something that kind of sits at the center. I would think about it like not so much vaping, , vaping is probably a bit too broad, but if we can define it as like a, , like a state or a current issue.

Matt Healey: That maybe has a bit of a, um, we'll call it a boundary, a bit of a boundary set around it in terms of like a geography or a demography or something like that. That can be quite useful to help focus our thinking. So, um, thinking about our vaping issue area, is there a statement or a phrase that you can develop, , that can maybe sit at the center of our conversation?

Tenille Moselen: Yeah. What about,, reducing rates of vaping among young people kind of aligns with what we've been chatting about. Yeah. 

Matt Healey: Yeah. So that's, that's really good. So there's kind of two ways that you can think about these things that sit in the center. Sometimes you can do it as what you've just described.

Matt Healey: So having that , that aim or that intent attached to it, which is reducing rates [00:25:00] of vaping among young people. So we want to see. we want to see that or we want to head towards that. You can also remove the, the reducing word and just have, the topic. So like rates of vaping among young people, both are correct.

Matt Healey: And I think what you'll find,, you've got to kind of find the technique that works best for you. There's no sort of right or wrong way to do it, but it's really just trying to give your, , participants or the people that are helping you develop these maps, something to focus on., so, you know, you can develop these by yourself.

Matt Healey: You don't have to have groups of people, but these are kind of good to do as a team or a group exercise. And you kind of have a, you know, almost imagine a piece of butcher's paper or something in the center of a table with this topic written in the center. And then each of you would have, a stack of sticky notes or whatever.

Matt Healey: And really what you're trying to unpack is, okay, well, what, um, what helps or hinders this particular issue, or if it doesn't have that reducing word in it, what drives this thing to happen or what influences it? So we've, you've called it here, [00:26:00] um, what was it again? Can you say it for me? for me. 

Tenille Moselen: Reducing rates of vaping among young people.

Matt Healey: So for this one, I'd say that maybe we want to start with thinking about, well, what are the barriers to, reducing rates of vaping among young people? Or what, what makes it hard to do that? 

Tenille Moselen: Um, 

Matt Healey: and it's kind of a brainstorming exercise. If you work in a topic area or on, a particular issue,, say, domestic and family violence, where lived experience is a really important, way of understanding what. Works or what doesn't work. this can be a good way of bringing in those different areas of expertise and insight and wisdom as well. , because you're basically saying to people like, well, what are all of the things from our different experiences or our different ways of knowing, , that, , that relate to this topic area or this issue.

Matt Healey: So obviously I'm putting you on the spot a little bit with this. , so people listening don't hold us to this. This is just an example of,, But if I said to you, for instance,, what are some of the things that, , make it hard for the rates of vaping amongst young people to [00:27:00] reduce, what are some of the things that come to mind for you that would,, be a driver or a cause of that?

Tenille Moselen: Yeah, I think some of the really easy ones that are at the front of everyone's mind is probably the accessibility of vaping products. So you can just walk into a store pretty much down the street in most. Towns and definitely cities and buy vaping products. And we have all seen the huge array of flavors that have also hit the market to make them even more appealing.

Tenille Moselen: Uh, and then I think that can change the perception of them as being harmful, , particularly compared to smoking, because they don't have a nasty smell. They don't light up like a cigarette. They smell like candy. , and they are targeting. Young people in social media, , and advertising and essentially glamorizing the use of vaping, , and then obviously that can lead to things like peer pressure as well, when young people's friends are doing it at, , school or after school as well, um, [00:28:00] Yeah, I guess they're like the really obvious ones.

Tenille Moselen: And then there's the more discrete ones. I guess you don't necessarily think of immediately, but that could be things around, um, you know, what programs do exist to help young people trying to quit, essentially what , cessation programs are out there. Are they effective? Are they accessible?

Tenille Moselen: Is there enough of them? Uh, and then. I suppose the long term health risks is still difficult to, um, provide evidence around because vaping is new. Uh, so that also can be a bit of a barrier in, you know, changing perceptions and reducing those rates. Uh, what about you? Any that you can think of that I haven't mentioned?

Matt Healey: I mean, you put me on the spot, which is probably quite fair of you., so if someone in your group says, okay, one of the things that prevents or reduces the, the likelihood that, , vaping rates will go down is the glamorization [00:29:00] or role of influencers on social media promoting vaping as something that's desirable.

Matt Healey: so the next question that you can ask yourself is why is that?, why is that a factor or a thing? And it can help you start to identify like the deeper drivers. So a part of this is you're kind of trying to develop your own, your own skillset in asking the right sorts of framing questions.

Matt Healey: So it's not always about,, what are the factors that drive the issue? Sometimes it's actually, , what are the factors that are driving the factors that drive the issue? So for instance, if we look at say, the role of influences in a particular topic area, one of the questions that we might want to ask is like, well, why, why are they promoting this, this topic?

Matt Healey: Product or, or this particular thing. , what's the benefit to them and, and how do we potentially influence or address that? , I think something there that's quite important is around, , like say, , affordability and devices. And because you might say, okay, well, why, [00:30:00] why are they so affordable?, and you might say, well, You know, they technically aren't meant to be, but, , maybe there's a lack of compliance amongst the retailers.

Matt Healey: Like, maybe they're not following the regulations, , or if we're thinking about things like, and you made this really good point,, the perception that vaping is less harmful than smoking. Well, why, why is that perception in existence? And I think that point that you made around, , the flavors of vaping products and the,, fact that they make them smell a particular way and they try to reduce the , effects like the smell and the, the smoke and all of those sorts of things .

Matt Healey: And so you can kind of ask these secondary or second layer questions to help you get to that. I mean, I've kind of not answered your question because partly I didn't know, but. I think what I want to try to focus in on is, yeah, like the second layer of why, like why is peer pressure to use vaping products such an important thing?

Matt Healey: Like what is the [00:31:00] driver of kids or young people promoting or peer pressuring others in their peer groups to, to vape as well? I wonder, even if a part of it is actually the perception of it being a, not coping mechanism, but like a stress reliever, like in that way, as well. But I think, you know, the fact that I don't necessarily have an answer maybe tells you that I'm not the right person to to develop such a thing, but also like, it's maybe a good.

Matt Healey: , signpost to say, well, some of these questions we don't have the answer to, but maybe if we did this with young people, for instance, like that would actually be a good mechanism for both engaging them, but also developing a very different view. Of what the issues are, because as we mentioned before the break with the map of the different players or actors, , we all have different views on what things look like we're developing maps that are kind of take on the issue or like their version of the issue.

Matt Healey: Uh, so, , a systems [00:32:00] map or a map of the different factors that influence rates of vaping that you and I develop would potentially be very different to something that a group of young people developed as well. 

Tenille Moselen: Yeah, absolutely. And I think it's just even a good example of how you said, uh, you gather in a room with the butcher's paper and the sticky notes and just asking that question of why and having these conversations, um, and going beyond just the sticky note, um, can be You know, a side outcome of having these sessions internally with different stakeholders and even better if you can have lived experience in the room with you.

Matt Healey: I think the thing that's also interesting about this is. You could almost do this in a two stage way where the first part of the process is doing those active maps and actually that could even help you identify who you then might want to include in a room to then develop these maps of the different determinants.

Matt Healey: Looking at, say, like the commercial determinants of health, uh, would give you a very different view of what this. Determinants map or this factor map looks like, , as [00:33:00] opposed to, , a young person's view, , as well. I mean, the thing that's important to acknowledge as well, like we're focused very much on the sort of barriers or like the deficit view of it.

Matt Healey: I mean, the reverse that we could take. Having looked at, like, the barriers is that we could look at the enablers, all the things that would help drive a reduction in the rates of vaping. So, like, what are the things that would help? , from your perspective, what, what do you think? Just offhand, what would be some of the things?

Tenille Moselen: I think the biggest one, um, is obviously the regulation of vaping products. So, um, having. Policies in place that make things legal and illegal is one of the strongest, um, enablers to reducing rates. So that can be around age restrictions to buying products. Um, there's also bans, I believe, uh, on certain flavored.

Tenille Moselen: Vaping products. , I don't know much about that. , and then there's other things that are just like the campaigns that wrap [00:34:00] around the policies. So the social media campaigns you see or advertising campaigns trying to highlight the risks of vaping. , and then there's education that rolls out in different areas, whether it be schools or in the community or targeting parents.

Tenille Moselen: , And things like vape free zones, whether that's making schools or universities or hospitals, , vape free, I think is a really interesting one. I know I've been on campus at a university looking at a vape free or no vaping zone sign and people are just walking around vaping and it's not necessarily enforced.

Tenille Moselen: However, you can do that. You wouldn't see people smoking in a smoke free zone as much. So I find that one a bit of an interesting one. And then,, there's also the opposite to peer pressure, which can be peer support as well to help quit vaping. Peers don't necessarily always, work for evil. Often if there's one person vaping in a [00:35:00] group of friends, those friends might You know, make them stand by themselves or walk away from them when they're vaping and it can work in the opposite way.

Tenille Moselen: Or they might just, , link them in with programs to help quit or just encourage them really. 

Matt Healey: The process with this works in a very similar way, you can still have that topic area in the center of your map. The prompt question there that's used is less about what's hindering. That's going to get you to more of the barriers or the deficit based view. , it's more taking that aspirational field. Like, well, what helps? Or what would help with this sort of thing.

Matt Healey: And again, you can think about it in terms of what are the things we need to see in order to have this outcome achieved? Versus, what are the factors that are preventing it from being achieved? Sometimes what you will find is that. If you develop , a map of the barriers, a map of the enablers will sometimes be the inverse or that the mirrored version of those things, which is absolutely fine and can, be a bit of a way of sense checking yourself as well.[00:36:00] 

Matt Healey: But again, what helps to you or me, or from our perspective. will be potentially very different to other people as well. , the other thing I do want to remind our listeners about is, uh, back in episode two of the podcast, I chatted with, um, Jocelyn Bignold from Macaulay. Um, and she was talking about the systems mapping work, um, that they had undertaken for safe at home.

Matt Healey: And the really interesting thing about that particular example is that it was actually a systems map that included both barriers and enablers to safe at home. Um, which, uh, as a quick refresher, is the, is the generally accepted policy response that women and children should be able to remain safe at home following experiences of, family violence.

Matt Healey: But the way in which that was approached was that the barriers and enablers were reflecting what currently happens. So what's currently in place that prevents that policy response from occurring as intended, but also what are the things that are in place that are working? So it was a map [00:37:00] that reflects both.

Matt Healey: Both elements together, , whereas what to Neil and I, what we were just talking about was , you could start to think about vaping amongst young people as a map of barriers or as a map of enablers. ,

Matt Healey: this has been a very wide ranging, discussion, which builds off what we talked about last episode, in terms of what is a complex problem. How do we understand what a complex problem is? And again, it's a challenge sometimes to describe how to tackle these things. But I think really the takeaway message that I would leave everyone with is think about things in terms of the actors.

Matt Healey: So who are the different organizations or groups or people that are within an area, whether it's a geographic area or a topic area, but then also what are the factors that are driving Particular outcomes or particular issues, either, , in terms of those helping or hindering factors, those barriers and enablers, , Tenille, is there a takeaway message that you would share with our listeners before we wrap up?

Tenille Moselen: Well, I really like actors and factors because [00:38:00] it rhymes and it's easy to remember, but I think just our last. It's very catchy. It's very good. , just our last message around, , when you're thinking about the determinants that you could approach it from barriers or enablers, or you could do both, but recognizing there's usually the inverse of that.

Tenille Moselen: Of the other that exists, whether it's a barrier or an enabler, because I think sometimes with issues, it's easy to just see barriers. 

Matt Healey: Yeah, I think,, humans are very deficit focused. We find it very easy to find problems, , in that particular way. 

Tenille Moselen: There's always problems to our problems.

Matt Healey: Yep. Absolutely. Thanks for your engagement yet again to Neil, this will be our last episode for 2024. , we hope everyone, who is listening or has listened to us over the course of this journey so far, has a nice break, and we'll catch you in the new year.

Tenille Moselen: Yeah, have a good Christmas everyone and keen for [00:39:00] 2025.