Systems-based Approach and Systems Thinking in School Health Promotion

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Systems-based Approach and Systems Thinking in School Health Promotion Powered By Docstoc
					       Health Promoting
Continuous Learning Sustainable
       Education System

                    Colleen M. Stanton
       Ph.D. Candidate, OISE, University of Toronto
            R.N., B.Sc.N., B.Ed., M.E.S., M.B.A.

                       Bob Harper
                       B.A., M.Ed.

                   November 22, 2011
       Overview of the Presentation

1. Introductions
2. An Ecological Approach to Health
3. Building on Questions and Findings from
   Previous International Research
4. Doctoral Research in Health Promoting
   Continuous Learning Sustainable Systems
5. What Can We Learn from this Research?
6. Conclusion
Colleen Stanton has 30 years of extensive experience as a:
• registered nurse; community health nurse in public health;
• teacher (children, youth, graduate students);
• health promotion consultant;
• researcher, evaluator, planner;
• teacher in graduate programs – (Masters in Nursing & Health Studies);
• senior health promotion manager in public health;
• initial management committee of the Ontario Healthy Communities
• member of the Ontario Healthy Schools Steering Committee.

Focus: Leadership towards healthy sustainable families, schools, workplaces,
       communities, cities and regions.

Bob Harper has 39 years of extensive experience as:
• Coordinating Superintendent of Education for a large school board
  in Ontario for ten years
• Member of the Senior Management Team for 15 years
• Worked in various roles in the education system for 39 years as a
  teacher, principal, superintendent, coordinating superintendent
• Most recent portfolio was as Coordinating Superintendent of
  Workplaces and Learning Environments
• Focus on healthy schools, eco-schools, plant services, international
  education, continuing education, transportation, etc.
• Expertise in secondary education
• Member of the Ontario Healthy Schools Steering Committee

Focus: Leadership Towards Healthy Sustainable Workplaces & Education

An ecological approach to health…..

• A key step would lie in understanding
  health as a pattern of relations rather than as
  a quantitative outcome.

• A pattern though is not a fixed matter but
  ‘primarily’ a dance of interacting parts…..

• This opens the possibility of understanding
  health as a process.
                           (Kickbusch, 1989).

A shift from a deficit model of disease to
an asset model of health potentials
inherent in social and institutional settings
of everyday life (Kickbusch, 1996)

  Is dynamic, interconnected, and
characterized by interrelationships,
 interdependencies, and synergies.

       (Capra, 1982; 1996)

Health promotion is the process
of enabling individuals and
communities to increase control
over the determinants of health
and thereby improve their health
(WHO, 1986).

       Moving Towards
  Open Design and Emergence
How can we begin to describe and
understand health as a process, as a
pattern of dynamic interrelationships, as
potential, as synergy? As a open living
system? As a pattern of open design and

 Building on Previous Research
• Completed an international research study
  entitled a Systems Approach to Health
  Promoting Schools, 2004;
• Summary published in the IUHPE Promotion
  and Education, Volume XII, No. 3-4, 2005;
• Interviewed 35 key informants – system leaders
  working to promote healthy schools around the

       Open Living Systems
         Evolve & Grow

• The previous research identified six core
  elements and a framework for a systems
  approach to health promoting schools;
• Identified key challenges and
  opportunities of creating a systems change
  process towards health promoting

                          Core Elements of a Systems Approach to
                              Health Promoting Schools, 2004
                                    Knowledge and Appreciation of
                                   Continuous Learning and

                                               Shared Vision

                                         Collaborative Culture
Interconnectedness                                                                       Interconnectedness
       with                                                                                     with
 Internal/External                          Referent Structure                            Internal/External
   Environments                                                                             Environments

                                         Overarching Strategy


                                     Evaluation and Monitoring

              Knowledge and Appreciation of                    Knowledge and Appreciation of
           Health & Health Promoting                               Systems Change
                    Systems                                    (Holistic, Integrated Approaches)
           Holistic, Ecological, Systems Approach)
                  Key Questions
• How and where is health created?
• What creates health in large organizations, workplaces, and
• How can a health promoting system support the core business of an
  organization (in this case a school board)?
• How can we link health promoting systems with learning systems?
• How can we work with others to build a common and shared vision
  and strategy that meets the needs of all stakeholders?
• What should we call this “entity”?
• A health promoting sustainable school? A Living School? An
  Effective School? A Learning School?
• What are the essential aspects of the system design and how can it
  remain open and flexible enough to grow and evolve?
               Key Questions
• How do we ensue the word “health” does not get in the
  way of developing a common and shared vision?
• What type of leadership would enable this large open
  systems change process?
• What type of ongoing evaluation, monitoring and
  scanning would be helpful but not limit our thinking,
  our learning and our ability to allow emergence?

              Key Questions
• How can we share our experiences locally,
  provincially, nationally and internationally?
• Is there a role for technology and international
  learning forums?
• How can we involve and engage people across
  the world in learning and sharing?

Quotes from Key Informants
“Working to create health promoting
schools involves a paradigm shift. We
need to recognize that this is an integral
process. It is a challenge to see the world
differently. Change is messy. We have to
embrace it and reorganize at a higher
level. It takes “big brains” to make this

  Quote from Key Informant
“It is not possible or desirable to create the
model of a health promoting school. Every
model is a result of dialogue and
consensus among its “constructors” and
has meaning within a certain value-
framework in a particular context. The
health promoting school is more of a
process of contextual interpretation than
an outcome of the implementation of
global principles.”                          17
  Quotes from Key Informants
HPS requires that people:
• can see the big picture; value a child and youth
  centred society;
• be comfortable with ambiguity and change and
  believe that by working together we can make a
  bigger difference – build synergy exponentially;
• believe that by working collaboratively we can
  get a greater return on our investment;
• appreciate that systems change requires ongoing
  dialogue and developing shared meanings.
                  Key Findings
The development of health promoting continuous
learning sustainable systems require that we focus on
developing the capacity to:
• authentically share power, distribute leadership and responsibility
  through empowering self-organizing processes;
• build authentic, open, honest relationships through collaborative
  partnerships, networks and communities
• increase our capacity to take risks, be creative and be comfortable
  with deep dialogue and diversity;
• learn to be comfortable with turbulence, non linearity and the
  messiness of change;
• move from top down, designed, approaches of management and
  control to more guided and emergent, creative approaches to
  learning and change.
            Key Findings

While the content and curriculum of a healthy
sustainable school system is important, it is
really about an ongoing systems change process
of relationship building, collaboration, ongoing
feedback looping, paying attention to
disturbances, distributing and sharing
leadership and power, appreciating diversity
and facilitating open environments that promote
deep learning and emergence.

            Research Questions

1. What are the top three system environments that have
   the most influence or enable the emergence of health,
   wellbeing, continuous learning and sustainability for
   individuals and for the organization as a whole?

2. What are the interrelationships, patterns and synergies
   between these top three (3) system environments?

3. Are there one or two system environments that might
   be considered the key synergy point(s) for this systems
   change process?

             System Environments That Promote Optimal Health,
             Wellbeing, Continuous Learning & Sustainability
                                        Knowledge and Appreciation of
                                        Living Systems,
                                   Change & Sustainability Lens
                                          (Holistic, Systems Approach)

                                           System Environments*

                                    1. Leadership (Shared and Distributed)

                                     2. Culture of Continuous Learning
                                         (Intellectual Environment)
Interconnectedness                                                                           Interconnectedness
       with                          3. Interrelatedness of Work & Life                             with
 Internal/External                                                                            Internal/External
   Environments                      4. Meaning/Purpose/Connectedness                           Environments

                                           5. Collaborative Culture

                                 6. Health Promoting Physical Environments

                                    7. Health Promoting Social/Emotional

                                  8. Work Organization/Design/Emergence

              Knowledge and Appreciation of                         Knowledge and Appreciation of
       Health & Health Promotion Lens                            Continuous Learning Lens
          (Holistic, Ecological, Systems Approach)                    (Holistic, Systems Approach)

  Different ways of
 understanding and
appreciating systems
3 Major Lenses of a HPCLSS

Health Promoting Systems
Continuous Learning Systems
Living/Sustainable Systems

         Health Promoting Systems
• Trevor Hancock, M.D., Ministry of Health, Public Health Consultant,
  Victoria, British Columbia, Canada
• Irv Rootman, Ph.D., Professor, University of British Columbia, Canada
• Lawry St. Leger, Ph.D., Deakin University, School of Health and Social
  Development, Australia
• Harvey Skinner, Ph.D., Dean, Faculty of Health, York University, Canada
• David Rivett, Previous Coordinator of ENHPS, World Health Organization
• Cameron Norman, Ph.D., University of Toronto, Canada
• Allan Best, Ph.D., University of British Columbia, Canada
• Michael Goodstadt, Ph.D., University of Toronto, Canada

  Continuous Learning Systems
• Carol Rolheiser, Ph.D., Previous Associate Dean, OISE, University
  of Toronto & Current Director, Centre for Teaching Excellence and
  Innovation, University of Toronto
• Blair Mascall, Ph.D., OISE, University of Toronto, Canada
• Stephen Anderson, Ph.D. OISE, University of Toronto, Canada
• Ken Leithwood, Ph.D., OISE, University of Toronto, Canada
• Lyn Sharratt, Ph.D., OISE, University of Toronto, Canada
• Marilyn Laiken, Ph.D. , OISE, University of Toronto, Canada
• Michael Fullan, Ph.D., OISE, University of Toronto, Canada
• Andy Hargreaves, PhD., Lynch School of Education, Boston
  College, MA
• Bryan Smith, Ph.D., President, Broad Reach Innovations, Markham,
  Ontario, Canada

  Continuous Learning Systems

• Cristina D’Arce, Ph.D., President, Society for Organizational
  Learning, (SOL), Brazil
• Doug Reeves, Ph.D. & Elle Allison, Ph.D., Renewal Coaching for
  Sustainable Change for Individuals and Organizations
• Jack Miller, Ph.D., Professor, OISE, University of Toronto, Holistic
  Curriculum & Holistic Learning;
• Alma Harris, Ph.D., Professor, University of London, UK
• James Spillane, Ph.D., Professor, Northwestern University
• Mary Anne Archer, Ph.D., Professor, OISE, University of Toronto

    Living Sustainable Systems
• Fritjof Capra, Ph.D., Berkley California, United States of
• Margaret Wheatley, Ph.D. , Berkana Institute, United
  States of America
• Michael Fullan, Ph.D., Previous Dean, OISE, University
  of Toronto
• Andy Hargreaves, Ph.D., Lynch School of Education,
  Boston College, M.A.
• Gareth Morgan, Ph.D. , York University, Schulich School
  of Business, Ontario, Canada
• Glenda Eoyang, Ph.D., President, Human System
  Dynamics                                                  28
 Data Collection Methods and
Criteria for Sampling/Selection

  • Preliminary Interviews (10)
  • Semi-Structured Interviews (60)
     – District Level (14)
     – School Level (46)
  • Review of Key System Patterns with Systems
    Thinkers and Change Leaders (Internal/External)


            System Environment #1:
            Leadership (key enabler)
1.   Appreciation of human qualities, relationships, respect for life;
2.   Authentic sharing of power, control, empowering forms of
     distributed/shared leadership;
3.   Promotes meaningful and authentic input into decision-making;
4.   Creates a culture of continuous learning, deep dialogue, risk taking
     and innovation;
5.   An appreciation of diversity - diverse opinions, ideas, cultures,
     worldviews, mental models;
6.   Creates a culture of collaboration, networking and community

        System Environment #2:
     Culture of Continuous Learning
1.   Capacity to adapt to change and generate/co-create
     new knowledge, wisdom, and ways of knowing;
2.   Capacity to take risks, be creative and learn from
3.   Capacity to access and synergize resources to address
     complex issues in personal and organizational lives;
4.   Appreciation of diversity – diverse cultures, opinions,
     worldviews, ideas, ways of learning etc.
5.   Meaning, purpose, coherence and consciousness

      System Environment #3:
  Interrelatedness of Work & Life
Individual and Organizational Levels:
1. Increased awareness that we are interrelated and
   interconnected to each other and to the whole;
2. Appreciation that we are open systems nested within
   broader open systems (individuals, family,
   organization, community, planet);
3. Increased awareness that we are all part of something
   bigger than ourselves and working towards common
   good, moral purpose, collective purpose
4. Capacity to address specific issues related to
   interrelatedness of work and life (quality of life) – e.g.
   generational issues, more flexible work hours, life
   stages, opportunities to return to school, time off with
   family, caregiver support, mentoring and support
   during difficult and stressful times, etc.
    System Environment #3
Interrelatedness of Work & Life
5. Increased awareness and appreciation of the need for
   renewal, regeneration, and rejuvenation;
6. The capacity to deal with loss, change and growth;
   letting go and moving on;
7. Increased emergent properties of compassion, caring,
   empathy, forgiveness, global awareness, ecological

               System Patterns

Leadership was identified as the major enabler of a
healthy sustainable learning system for individuals and
for the organization as a whole.

Guided and emergent forms of distributed leadership
(DL) were reported as promoting the highest levels of
optimal health, wellbeing, continuous learning and
sustainability for individuals and for the organization as
a whole.

          Hargreaves’ Ladder of
          Distributed Leadership
• Anarchy
• Emergent distribution
• Guided distribution
• Progressive delegation
• Traditional delegation
• Autocracy
                  (Hargreaves & Fink, 2006)

                      Schools with
                  Guided to Emergent
           Patterns of Distributed Leadership
Exhibit characteristics and conditions of a HPCLSS such as:
• increased sense of empowerment;
• increased ownership and commitment;
• positive continuous learning environments;
• sense of meaning, purpose and connectedness;
• patterns of flow, appreciation of diversity;
• sharing of power and control; sense of “voice”;
• ability to cope; be resilient with increased workload and change;
• increased capacity to support each other socially, emotionally,
  intellectually, physically, and spiritually;
• increased creativity, use of technology;
• increased capacity to integrate multiple initiatives and programs;
• Increased awareness of interrelatedness with emergent properties
  of compassion, caring, empathy, forgiveness, global awareness and
  environmental awareness.
    Schools with Emergent Patterns of
         Distributed Leadership

• There is an increased sense of aliveness, awareness and
  consciousness…. capacity to grow and evolved …the
  individual and collective systems are becoming more
• There is a growing appreciation of interrelatedness as
  individuals, as organizations, communities and the
  global environment/planet;

      Diverse Leadership Patterns
There are two very different leadership patterns across this

• Leadership in one large area of the system is more open,
  emergent and self-organizing;

• Leadership in another large area of the system is top
  down, very directed, with pre-determined goals and

• These can be termed “organized” & “self- organizing”
  systems. (G. Eoyang; M. Wheatley; F. Capra);

               Patterns of
          Continuous Learning
• There is a strong culture of continuous learning in this
  organization. The majority of the key informants
  reported this to be health promoting for them as
  individuals and for the organization as a whole.

• Staff (superintendents, principals and teachers) who are
  nested under more closed top-down leadership
  environments reported their learning environments
  were not health promoting or sustainable because the
  learning agenda was pre-determined, not personalized
  and meaningful to them.

    Patterns of Interrelatedness

• While health and wellbeing is being created in this
  organization/school district through the leadership,
  culture of collaboration and culture of continuous
  learning, there is a need for greater appreciation of
  individual health and wellbeing in key areas: increased
  flexibility re personal needs; time off; more attention to
  generational issues; more attention on ensuring balanced
  work and family life; opportunities for rejuvenation and

    Patterns of Interrelatedness
• Key informants (teachers and principals in particular)
  would like to see the continued expansion of
  international networks, exchanges, volunteer work
  opportunities, teacher training programs that promote
  their continuous learning and growth.
• At the organizational level, there is a need to consider
  how principal and vice principal leadership is
  encouraged, developed and sustained on an ongoing
  basis – paying more attention to various forms of
  distributed leadership, the selection process, how and
  when principals are recruited and transferred,
  opportunities inside and outside the system for renewal,
  rejuvenation, continuous learning.                       42
              Striking Patterns:
                 A Summary
• Throughout this system one of the striking patterns is
  the creation of health, wellbeing and sustainability in the
  areas of the system where the leadership is more open,
  draws on guided to emergent leadership patterns and
  facilitates emergence, creativity and innovation.
• In these school and system environments, individuals
  report higher levels of health, wellbeing & sustainability.
• They describe feeling alive, a sense of wellbeing, support
  from their colleagues and supervisor, openness to new
  ideas and creative approaches, and a true sense of
  respect for life, caring and appreciation of diversity.
• They describe many examples of emergence or co-
  creation of new ideas, programs, structures, and ways of
  seeing the world.                                           43
               Striking Patterns
• Another striking pattern is the emergence of empathy,
  caring, compassion, forgiveness, and increase global and
  environmental awareness in schools exhibiting higher
  forms of DL, deeper learning environments and
  increased interrelatedness. This pattern was identified in
  more open caring, emergent leadership environments.

• When emergent leaders (supervisory officers, principals
  and teachers) are nested under more autocratic and top
  down leadership they reported feelings of stress, ill
  health, inability to grow and learn deeply, a lack voice,
  choice and a lack of empowerment. They also reported
  increased absences from work.                             44
             Blockages of Flow
               in the System
There are a few major “blockages” of flow in this
system that are influencing health, wellbeing and
sustainability and that need to be addressed
related to:
• different leadership philosophies, values and forms
   (sharing of power/control; empowerment);
• different attitudes related to control, flexibility,
   empowerment in some key areas/departments;
• a need for more openness to deeper learning – allowing
   deeper learning to take hold through dialogue, taking
   risks, sharing of knowledge and control etc.
• lack of flexibility in relation to human resource policies,
   job design, flexible work hours, elementary union
   management and relations.
What are the underlying
principles of a HPCLSS?

       12 Principles of HPCLSS
           1. Holistic, ecological living systems *
            (systems are nested within systems)

                   2. Interrelatedness *
(interdependence, ecological awareness, meaning/purpose)

                      3. Relationships
   (trust, cooperation, reciprocity, honesty, authenticity)

                         4. Diversity *
   (resilience, culture, conflict, gender differences, etc)

5. Sharing and distribution of power, control and leadership
    (empowerment, trust, distributed, shared leadership)

        6. Collaboration, Networks, Communities *
  (social networks, collaboration, sharing of knowledge)
                Principles of HPCLSS
                                 7. Learning*
 (double & triple loop learning, feedback loops, adaptability, generativity,
                   creativity, social support, innovation)

                          8. Growth, Loss & Change
(generativity, adaptability, openness, flexibility, willingness to be disturbed)

           9. Balance/Equilibrium/Disequilibrium/Homeostasis *
               (integrity, balance, awareness, consciousness)

              10. Meaning/Purpose/Coherence/Consciousness
 (interrelatedness, integrity, ability to think towards the future, ecological
                       awareness/sensitivity, aliveness)

  Principles of a HPCLSS
                     11. Flow*
 (energy, interrelationships, dynamics, synergy,
ideas, resources, generative learning, knowledge,

            12. Emergence* & Design
  (creativity, novelty, innovation, risk taking,
          new and flexible structures)

      Health, Wellbeing, & Sustainability
    (health, wellbeing, continuous learning,
      “aliveness”, “spirit”, future, energy,
             ecological awareness)

 * These are the principles of all living systems
•What can we learn from this
 research? What further research
 can be done in this area?
    Open Design & Emergence
Health promoting continuous learning sustainable systems
are moving from:

• traditional planned systems to a growing understanding of
  complex adaptive learning systems;
• organized, designed systems to self organizing, emergent,
  creative systems.

This involves an ongoing process of growth and development
and increasing complexity.

 What can we learn from this research about integrating
health, wellbeing and sustainability into school districts?

• Health is created in our everyday work and home lives.
• Educators are beginning to more fully understand and
  appreciate how health is created and co-created in their
  own work environments.
• A growing number of educators are developing an
  increased appreciation of the interrelationships between
  individual, organizational, community, and global
  health, wellbeing and sustainability.
• Higher more evolved forms of distributed leadership
  (DL) can be enablers of health, wellbeing, continuous
  learning and sustainability; while less evolved forms can
  be disablers of health, wellbeing and sustainability.
 What can we learn from this research about integrating
health, wellbeing and sustainability into school districts?

• Cultures of collaboration, continuous learning and
  distributed leadership are generally health promoting,
  but in order to be sustainable they need to be supported
  by sufficient flexible resources and attention to ensure
  balance, renewal, regeneration and resilience of staff;
  learning has to be personalized, relevant and meaningful
  to each individual.
• People need to be supported socially and emotionally
  through difficult change and life processes; and the
  challenges of loss, change and growth – individually and

 What can we learn from this research about integrating
health, wellbeing and sustainability into school districts?

•In human/social systems, meaning, purpose, coherence
and consciousness are integral to health, wellbeing and

•Key informants reported that shared meaning, purpose
and coherence, and their awareness and consciousness of
this shared purpose was “ensuring the aliveness, health,
wellbeing and sustainability of their individual lives and
the life of the organization”.

•Meaning, purpose, coherence and consciousness is the
synergy point of this system.
 What can we learn from this research about integrating
health, wellbeing and sustainability into school districts?

• It was important to create flexible, open, adaptive
  structures to begin to dialogue and think about how to
  fully integrate curriculum and portfolio areas across this
• This began the process of building deep understanding
  and ongoing commitment and ownership by all staff
  throughout the system. Staff were beginning to come to
  a deeper understanding of their own health, wellbeing
  and sustainability and the interrelatedness to the whole.

 What can we learn from this research about integrating
health, wellbeing and sustainability into school districts?
• Research that is currently underway in the education
  system needs to be shared and understood.
• For example this particular research was built on the
  research of key educational leaders in the areas of:
  distributed leadership; organizational learning; learning
  organizations; systems change; and collaborative
  learning environments.
• This requires having researchers and professionals
  working across a number of diverse fields including
  education and health.

 What can we learn from this research about integrating
health, wellbeing and sustainability into school districts?

As members of professional learning communities,
communities of inquiry and practice – teachers,
principals, superintendents, senior leaders,
parents, trustees, students have extensive
knowledge, skills and capacities to design and
work towards creating a vision of healthy
sustainable learning systems in collaboration with
community partners.
            New Portfolio and
          Open & Flexible Learning
             Structure Created
• New Portfolio was created to address Healthy
  Workplaces and Learning Environments;
• Linking and Integrating Healthy Schools, Eco-Schools,
  Safe Schools, Outdoor Education, Positive Climates for
• Wanted to give workplace wellbeing a key focus in the
• Wanted the process to be owned by the everyone;
• Wanted to increase overall understanding and
  appreciation of leadership, learning and interrelatedness
  in health, wellbeing & sustainability.                  58
           Towards Health Promoting, Continuous Learning Sustainable Systems
         Ongoing growth patterns of increasing complexity, non linearity, openness,
          health promoting relationships, empowered shared distributed leadership,
         shared meaning & purpose, diversity, voice, choice, collaboration, coherence
                        and deeper adaptive and generative learning
Closed System                 Designed/Planned, Fairly             More Open, Guided/Facilitative          Emergent/Assertive
Autocratic, Top-Down,         Closed, Aligned, Linear              Approach                                Non-Linear Approach
Structured, Linear            Approach
Approach                                                           Facilitates emergence, creativity,
                              People reported that the overall     openness within the agreed upon         Clear on shared purposes and
Structured, aligned, little   framework, goals and outcomes        framework and purpose.                  values, while promoting
choice, voice, input and      are pre-determined and               Becoming more complex and               shared creativity, emergence,
ownership                     established by a few; They have      non-linear; has developed their         openness, innovation, risk
Work is delegated and         little or minimal input into         own structures for collaboration        taking, increased flow, voice,
learning is organized at      important decisions affecting        and community building and              empowerment, increased
the top; people are           their work and life. This leads to   does not stop emergence; still          choice, involvement, increased
frustrated and reported       frustration, dis-connect with        fairly structured and people work       growth, learning, double and
feeling stressed, lack of     individual and organization          collaboratively. People reported        triple loop learning etc.
opportunities to grow and     meaning and purpose; little          feeling healthy, enjoying ongoing       Very high levels of health,
learn, and be themselves      input; feelings of                   collaboration and community             wellbeing and sustainability
and contribute tot the        disempowerment, lack of voice,       building; learning with others;         reported. Very high levels of
whole. Detailed planning      lack of choice. There is very        and there is flexibility in work life   empowerment, self knowledge,
and analysis is used to       superficial learning as the          balance, and wellbeing.                 deep sense of contribution to
ensure predictability and     outcomes and goals are already       Data requirements are developed         the whole; able to question
people feel they have no      pre-determined and they have         together by a team and they are         authority and ask difficult
input, voice, or choice.      limited input. Use of                monitored and changed on an             questions – deep dialogue etc.
They feel like “pawns” in     quantitative data is very            ongoing basis. Synergizes               There is a strong sense of
the system. A few             frustrating, lacks meaning and is    existing resources and may access       interrelatedness with
reported having to take       time consuming and not helpful.      some new resources.                     environmental and global
sleeping pills and taking     Does not access or synergize         There is a culture of honouring         activities – locally and globally.
time off work.                resources, talents, capacities.      and respecting each individual’s        Utilize both qualitative and
                              Feedback looping is used to          strengths and the need for self         quantitative data and involved
                              regulate and keep the “status        determination, empowerment,             in research
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