Setting objectives for community and systems change: an application of concept mapping for planning a statewide health improvement initiative

Health Promot Pract. 2004 Jan;5(1):8-19; discussion 10. doi: 10.1177/1524839903258020.


The Hawaii Department of Health (HDOH) used concept mapping techniques to engage local stakeholders and national subject area experts in defining the community and system factors that affect individuals' behaviors related to tobacco, nutrition, and physical activity. Over eight working days, project participants brainstormed 496 statements (edited to a final set of 90), which were then sorted and rated for their importance and feasibility. A sequence of multivariate statistical analyses, including multidimensional scaling and hierarchical cluster analysis, generated maps and figures that were then interpreted by project stakeholders. The results were immediately incorporated into an official plan, approved by the governor and state legislature, recommending how Hawaii's tobacco settlement resources could be used to create sustainable changes in population health. The results also provide empirical support for the premise that both community and systems factors ought to be considered when planning comprehensive health improvement initiatives.

MeSH terms

  • Cluster Analysis
  • Community Participation*
  • Decision Support Systems, Management*
  • Hawaii
  • Health Promotion / organization & administration*
  • Humans
  • Models, Organizational
  • Multivariate Analysis
  • Organizational Objectives*
  • Planning Techniques
  • Program Development
  • Public Health Administration*