Throughout my education and training in system dynamics modeling, I have developed solid skills in complex system modeling for health policy, population health intervention, and implementation science. My scholarly work has focused on using System Dynamics (SD) modeling and simulation methodology and related sets of tools, such as Group Model Building (GMB), to build simulation models to study complex problems in the health systems, identify effective intervention points, and design optimal intervention strategies to improve population health. Between 2011 and 2012, I assisted in GMB workshops to study nursing shortages in Singapore. Since 2020, I have applied the SD methodology to study the institutional delivery of marginalized women in Bihar, India. The modeling project identified multiple subsystems that contribute to the disparities in institutional delivery rates among marginalized women across parities. Multiple potential interventions were designed, tested, compared, and ranked based on model-based simulation analysis. I presented a poster of this work in the MCHRI Symposium 2020 and 2021 and received the "Honorable Mention" badge in the most recent symposium. I also presented this work to the Bill and Melinda Gates Foundation in India. In January 2022, I introduced this work at Western Medical Research Conference 2022. I have acquired the skills for simple statistical analysis skills with data management software, extensive data analysis, quantitative and qualitative analysis, synthesis, and integration. These skills and my previous training have prepared me for my existing research, which includes engaging stakeholders from multi-level and multi-sector to co-develop the model and analyze large and diverse datasets. This project focuses on developing an innovative approach that improves the conventional methodologies in the quality improvement field by implementing low-dose Aspirin intervention for pregnant women at risk of pre-eclampsia in California as a case study. I am leading the SD project under the close supervision of Professors David K. Stevenson and Gary Darmstadt. The collaborators of this project include Professor Jeffrey Gould, Chief Executive Officer of California Perinatal Quality Care Collaborative (CPQCC), Ms. Leslie Ann Kowalewski, Administrative Director of California Maternal Quality Care Collaborative (CMQCC), and Dr. Elliot Main, Medical Director of California Maternal Quality Care Collaborative. My long-term research goals involve becoming an independent researcher, broaden the application of GMB and SD in translational and implementation science, population health science, health policy planning, health services delivery, and healthcare management.
Gary Darmstadt, Postdoctoral Research Mentor
David Stevenson, Postdoctoral Faculty Sponsor
Current Research and Scholarly Interests
We will compare the processes of learning and intervention designs of two groups in the context of planning for a QI intervention. One group will utilize SD Group Model Building processes, and another will use the conventional KDD and RBA approaches. Qualitative and quantitative analytic approaches will be utilized to compare the learning processes and the intervention approach generated by these two groups. We anticipate that this study will lead to insights into new approaches to improving Q
Using System Dynamics Modelling and Simulation to Maximize Uptake of Aspirin by Women at-risk of Preeclampsia and Preterm Birth, Prematurity Research Group and California Maternal Quality Care Collaborative (CMQCC) (February 1, 2022 - Present)
•We will compare the processes of learning and intervention designs of two groups in the context of planning for a QI intervention. One group will utilize SD Group Model Building processes, and another will use the conventional KDD and RBA approaches. Qualitative and quantitative analytic approaches will be utilized to compare the learning processes and the intervention approach generated by these two groups. We anticipate that this study will lead to insights into new approaches to improving QI processes and outcomes.
California, United States
System Dynamics Modeling as an Intervention Planning Tool to Promote Institutional Delivery: learning from West Champaranin Bihar, India, Stanford University, University of Agder (Norway), and CARE India (August 1, 2019 - Present)
Women in India are encouraged to deliver in health facilities through the Janani Suraksha Yojana (JSY) conditional cash-transfer scheme provided to pregnant women and accompanying frontline health workers (Accredited Social Health Activists, ASHAs). Despite additional governmental efforts catalyzed by a statewide technical-support program led by CARE India and funded by the Bill and Melinda Gates Foundation, both institutional delivery rates (IDRs) in public and private facilities among Scheduled Caste and Tribe women in West Champaran district remained 10-15 percentage points lower for multiparous than primiparous women in 2014-19. The objectives of our study are to understand the major causal mechanism that gave rise to the disparities among the IDRs between marginalized women with increasing parities, identify high-impact intervention points in the system, and design a well-balanced intervention strategy to boost IDRs.
Community Group Model Building to Identify Systemic Barriers and Facilitators of Postpartum Depression Care Delivery for the Floating Population in Shanghai, Stanford Center for Innovation in Global Health (July 1, 2022 - December 31, 2023)
Our primary aim is to gather multiple-perspective information from female migrant workers with postpartum depression (PPD) in Shanghai, their caregivers, hospital staff, and community health workers to understand the system-level causal pathways that lead to a treatment gap in PPD for the migrant workers. Based on an understanding of system-level barriers and facilitators, our secondary aim is to formulate more context-specific and policy-relevant research questions and recommendations for intervention for further funding applications. We will adopt a participatory modeling approach called Group Model Building (GMB) to elicit tacit knowledge of community members to understand systemic barriers and facilitators that influence the treatment gap in PPD for migrant workers. We expect that the findings of this novel multidisciplinary research will shed light on the individual- to system-level factors that influence their care-seeking decisions. These findings will provide evidence for future research to design effective interventions that cater to this specific marginalized group to prevent and treat PPD. This research will also contribute to global knowledge on approaches to address PPD.
- Yuyang Cai, Associate Professor, Shanghai Jiaotong University
- Hong Li, Nursing Director, International Peace Maternity and Children Hospital