Leadership Research Summary:
- Strengthening systems for chronic disease prevention is essential. Leadership for systems change is an important key to strengthening systems. Leadership in prevention research for supporting systems change remains a relatively abstract concept and there is limited empirical information about the leadership practices of prevention research teams when viewed through a complexity lens. In this paper we examine and describe some systems leadership practices for creating change through prevention research, as identified in a series of six case studies.
- A qualitative approach incorporating semi-structured interviews, participant observation, and document review was used to facilitate an in-depth investigation of the research topic.
- Several researcher practices for enhancing research impact in the prevention of chronic disease were distilled from the data pertaining to how they sought to create change. These included persuasive communication, compassion and deep listening, reflective practice, and embedding themselves within the systems they sought to change.
- The findings provide insights that may assist prevention researchers and other practitioners dedicated to creating change in chronic disease prevention
Leadership Research Implications and Findings:
- The need to communicate in a persuasive manner was emphasized within the study’s sample. This meant learning the language of key stakeholders, adjusting communication styles to meet the needs of diverse groups be they senior government officials or community members, and avoiding jargon unless it was considered beneficial regarding technical use of terms and to ensure stakeholders were all on the same page. This aligns with the literature noting the importance of being able to adapt communication styles and formats to ensure relevance and comprehension (23). Something that was not however emphasized as much in our sample was the importance of storytelling for influencing policy, despite this being a well-documented necessity within the literature (32, 33). This omission is likely the result of our data collection tools not being specifically designed to explore leadership practices in depth.
- Being able to situate research work within the policy and practice landscape was a key practice observed among participants. Instead of being focused first and foremost on situating research within an academic context, participants were primarily concerned with asking for, understanding, and then addressing the needs of communities and policymakers to ensure their work was impactful. Thus, demonstrating a keen awareness of policy processes, contexts, and stakeholder goals [as per (23)]. Being able to step into the shoes of key stakeholders, be they patients, community members, or policymakers, was an essential part of this process and was facilitated by compassion and deep listening practices. Being humble, approachable, and accessible to stakeholders involved in change processes served to build rapport and trust, which contributed to ongoing fruitful engagement and relationships [(as per (34, 35))], and enabled them to become embedded within the systems they sought to change. Self-awareness appears to be an important antecedent to the development of these important change making skills (36), along with the guidance of a trusted mentor who has already embodied these practices across their career and can provide honest feedback for reflection.
- Oliver and Cairney (23) recommend that researchers should be clear on whether they are an advocate for particular topics or knowledge brokers presenting a more neutral position. Researchers do note however that this may not always be a choice available for researchers due to funding agreement rules and restrictions. The study observed a strong lean toward advocacy and activism within our sample, especially given their change making focus when it came to chronic disease prevention. Moreover, to be effective as change makers, participants spoke at length about the need to establish legitimacy and authority in their focus areas. When they were early in their careers or branching into new fields, they strategically teamed up with respected personnel or sought out mentors to help them achieve their goals. Oliver and Cairney (23) note the importance of being entrepreneurial or collaborating with someone who is able to act on their behalf. Owing to the benefit of having been mentored themselves, participants mentioned choosing to act as mentors for others to pass on skills and foster networks for those new to their field. They also emphasized the importance of capacity building both within their research teams and their stakeholder groups.
- When it comes to addressing complex and systemic problems there are calls for leaders to cultivate practices that interact to create systems of leadership; these have been referred to as “collective’ (7, 37), “shared” (38), “collaborative” (39), “emergent” (40), “co-leadership”, and “distributed” (11) leadership. Central to these concepts of leadership is the notion that leadership is a social process that is not reliant upon a single heroic leader but rather relies upon a systemic perspective of leadership whereby multiple actors take responsibility for change (10, 11). Distributed leadership, for example, calls for an emphasis on the attributes and behaviors of teams as opposed to individual leaders, while traditional forms of leadership typically focus on single leaders within organizations and systems (11). The topic of distributed leadership was not identified within our discussions with participants, however, this was likely a result of the interview guide not being geared toward this specific topic. This may be a fruitful area for further exploration in future prevention research studies exploring leadership and change making.