title: Systems Science for Caribbean Health: the development and piloting of a model for guiding policy on diabetes in the Caribbean.
abstract: BACKGROUND
  Diabetes is highly prevalent in the Caribbean, associated with a high morbidity and mortality and is a recognised threat to economic and social development. Heads of Government in the Caribbean Community came together in 2007 and declared their commitment to reducing the burden of non-communicable diseases (NCDs), including diabetes, by calling for a multi-sectoral, systemic response. To facilitate the development of effective policies, policymakers are being engaged in the development and use of a system dynamics (SD) model of diabetes for Caribbean countries.
  
  
  METHODS
  Previous work on a diabetes SD model from the United States of America (USA) is being adapted to a local context for three countries in the region using input from stakeholders, a review of existing qualitative and quantitative data, and collection of new qualitative data. Three country models will be developed using one-on-one stakeholder engagement and iterative revision. An inter-country model will also be developed following a model-building workshop. Models will be compared to each other and to the USA model. The inter-country model will be used to simulate policies identified as priorities by stakeholders and to develop targets for prevention and control. The model and model-building process will be evaluated by stakeholders and a manual developed for use in other high-burden developing regions.
  
  
  CONCLUSIONS
  SD has been applied with success for health policy development in high-income country settings. The utility of SD in developing countries as an aid to policy decision-making related to NCDs has not been tested. This study represents the first of its kind.
authors: University of the West Indies, Cave Hill, Barbados. leonor.guariguata@mycavehill.uwi.edu.
authors: L
authors: http://orcid.org/0000-0003-1682-7160
authors: L
authors: Guariguata
authors: MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
authors: C
authors: C
authors: Guell
authors: University of the West Indies, Cave Hill, Barbados.
authors: T A
authors: TA
authors: Samuels
authors: Nijmegen School of Management, Radboud University, Nijmegen, The Netherlands.
authors: E A J A
authors: EA
authors: Rouwette
authors: MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
authors: J
authors: J
authors: Woodcock
authors: University of the West Indies, Cave Hill, Barbados.
authors: I R
authors: IR
authors: Hambleton
authors: University of the West Indies, Cave Hill, Barbados.|MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
authors: N
authors: N
authors: Unwin
mesh_terms: D017691:Caribbean Region; D003906:Developing Countries; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy*; D006076:Government; D006291:Health Policy; D006801:Humans; D008954:Models, Biological; D010865:Pilot Projects; D011050:Policy Making; D015995:Prevalence; D012586:Science; D013597:Systems Analysis; D014481:United States
keywords: Developing countries; Diabetes; Health policy; Non-communicable disease; Policy simulation; System dynamics modelling