Participatory System Dynamics Modeling to Simulate HIV Test-and-Treat Improvements
This 2-year study is designed to build a computational and simulation model of the full HIV service system using a system dynamics (SD) modeling approach. We will use group model building (GMB) and multiple secondary data sources, supported by our recently funded in-depth study of the local T&T service system in Greater Hartford, CT (R01-MH103176), to build the SD computational and simulation model of that system. Using GMB, diverse community stakeholders will work with researchers to develop, validate, and test the model. The study aims are: (1) to engage a group of community stakeholders (N=20) in an iterative, participatory GMB process to develop, refine, and critique a computational SD model of Greater Hartford’s HIV T&T service system designed to simulate community viral load (CVL) over time in order to uncover system performance problems; (2) to combine GMB estimates, secondary data analysis, and relevant literature to calibrate/parameterize and formulate variables in the computational SD model and develop reference modes (epidemic trends) to validate the simulation model throughout the GMB process; (3) to demonstrate use of the SD computational model and web-based simulator app as a pilot analytical and practical tool that allows stakeholders, through simulation, to identify weaknesses and negative drivers of the system and project and compare impacts of different systems-level intervention options to reduce CVL at the city/population level. The SD computational model and simulator tool may be transferrable to other cities seeking to reduce HIV CVL with modifications using local data and stakeholder input.
Margaret R. Weeks, Ph.D.
Jianghong Li, MD, MSc.
Heather Mosher, Ph.D.
Marcie Berman, Ph.D.
Albert Einstein School of Medicine of Yeshiva University
David Lounsbury, Ph.D.
SD Modeling Task Force
St. Francis Hospital and Medical Center/Gengras Clinic
Ryan White Greater Hartford
HRA of New Britain
Rocin Deutsch, MD
Hartford Gay & Lesbian Health Collective
CT Children’s Medical Center (CCMC)
Seja Jackson, APRN
CT Department of Public Health (CT DPH)
Mauricio Montezuma, MD
Community Health Services
Latino Community Services (LCS)
Hartford Department of Health and Human Services (DHHS)
Hartford Gay & Lesbian Health Collective
Hartford DHHS, STI Clinic
LCS and Bergdorf Clinic
SD Modeling Facilitation Team
Margaret (Peg) Weeks
Weeks, M.R., Lounsbury, D.W., Li, J., Hirsch, G., Berman, M., Green, H.D., Rohena, L., Gonzalez, R., Montezuma-Rusca, J.M., Jackson, S. (2020). Simulating system dynamics of the HIV care continuum to achieve treatment as prevention. PLOS ONE. 2020 Mar 19;15(3):e0230568. doi: 10.1371/journal.pone.0230568. eCollection 2020. PMID: 32191771 [PubMed – in process] PMCID: PMC7082036.
Weeks, M.R., Lounsbury, D.W., Li, J., Green, H.D., Berman, M., Rohena, L., Gonzalez. R., Mosher, H.I., & Hirsch, G. System Dynamics (SD) Model of the HIV Care Continuum: Model Protocol (V.3). September 21, 2020.
Green, H.D., Weeks, M.R., Berman, M., Salvi, A., Gonzalez, R., Rohena, L., Ferguson, A., and Li, J. (2020) The impact of perceptions of community stigma on utilization of HIV care services. Journal of Racial and Ethnic Health Disparities, 7 (2): 383-391.
Green, H.D., Weeks, M.R., Berman, M., Mosher, H.I., Abbott, M., Garcia, N. Managing the risk of intimacy: accounts of disclosure and responsiveness among people with HIV and intimate partners of people with HIV. Culture, Health & Sexuality. 2018;20(10):1117-1129. PMID: 29944072;PMCID: PMC6399062.
Weeks, M.R., Li, J., Lounsbury, D., Green, H.D., Berman, M., Rohena, L., Gonzalez, R., Lang, S., Mosher, H.I. (2017). Using participatory system dynamics modeling to examine the local HIV test and treatment care continuum in order to reduce community viral load. American Journal of Community Psychology, 60 (3-4): 584-598. PMID: 29154393; PMCID: PMC5729085.
Click here for “HIV Care Continuum System Dynamics Model Overview Manual“.
Click here for “HIV Care Continuum System Dynamics Model User Interface”.
Click here for “Words Commonly Used in System Dynamics Modeling“.
Click here for “How to Use The Model“.
Click here for “HIV Care Continuum System Dynamics Model: Parameters Worksheets“
Click here for the “HIV Care Continuum System Dynamics Model website”.