ARCHES Final Analysis

ARCHES Final (Rounds 1, 2, and 3)

0) Goals:

Quantify and characterize the effects, if any, that age, education, gender, and deprivation status (as group averages) have on the way that groups conceptualize the Dementia Risk system.

1) Demographics of groups

After completing three rounds with a total of 36 groups, there’s now a good range of variation among groups for the group characteristics.

Group	n_people	mean_age	mean_gender	mean_education	mean_ADI_S	mean_ADI_N	round	facilitator	model
1	8	58.38	1.75	16.57	4.29	56.00	1	JF	./Arches-CLD-JFT-MS-17-03-23-Final.mdl
2	11	59.64	1.91	15.70	5.10	59.00	1	JF	./Arches-GMB-Vensim-18-3-23-Final.mdl
3	6	68.50	1.83	15.40	8.20	84.80	1	MM	./Arches-CLD.3.19.2023_MM-AW-final.mdl
4	6	67.83	2.00	15.75	7.00	74.25	1	JF	./CLD-19-03-23-G2_JF_RAM_6_Final.mdl
5	8	66.38	1.88	15.20	7.00	76.00	1	JF	./ARCHES GMB Vensim Number 01 03.24.2023_Final.mdl
6	7	69.00	1.86	15.25	5.00	62.25	1	MS	./ARCHES GMB Vensim Number 02 03.24.2023_MS&AW-Final.mdl
7	7	68.57	1.86	16.00	9.00	89.67	1	AW	./ARCHES GMB Vensim Number 01-AW-WZ-03.25.2023_Final.mdl
8	6	60.17	2.00	14.25	7.00	74.50	1	JF	./ARCHES-GMB-JFT-NR-03-25-23-Final.mdl
9	5	62.40	1.60	13.20	6.75	77.00	2	JF	./Arches-GMB-Standardized-JFT-Ram-05-03-24-Final.mdl
10	7	69.71	2.00	14.71	4.86	62.71	2	AW	./ARCHES-GMB-AW-CC-05-03-24-Final.mdl
11	5	63.40	1.80	14.80	6.20	73.40	2	AW	./ARCHES-GMB-Standardised-AW-MM-05-0424-final.mdl
12	4	57.75	1.00	18.00	3.50	49.75	2	JF	./Standardized ARCHES-05-05-24-Meena,JF,Chen-final.mdl
13	6	64.00	2.00	15.50	6.83	73.33	2	AW	./ARCHES-GMB-5.5.24-AW-Ram-standardized-final.mdl
14	8	68.50	1.75	14.88	5.75	72.00	2	JF	./May 10 JF_chen.mdl
15	8	61.38	2.00	13.88	6.12	69.62	2	AW	./ARCHES051024.mdl
16	7	59.57	1.86	14.57	6.14	72.71	2	JF	./GMB_Vesim Diagram_05112024_Shuya (1).mdl
17	7	65.29	2.00	17.29	7.57	79.43	2	AW	./ARCHES_workshop_5.11.24_AWgroup.mdl
18	6	66.33	2.00	14.00	7.83	83.17	2	JF	./Arches-GMB-YZ-JF-5-16-24-Final.mdl
19	5	64.40	2.00	16.80	8.00	86.60	2	AW	./Arches-GMB-05-16-24-AW&YZ-Final.mdl
20	8	62.38	1.00	13.25	6.75	76.38	2	MM	./Arches-GMB-Standardized-MS-MM-05.16.24-final.mdl
21	5	60.00	2.00	14.20	6.20	74.00	2	JF	./Arches-GMB-5-17-24JF-Final.mdl
22	8	72.75	1.88	14.75	7.25	81.38	2	AW	./Arches-GMB-Standardized-AW-T-05-17-24-Final-v2.mdl
23	6	74.83	2.00	17.17	5.67	71.33	2	MM	./Arches-GMB-Mario-05-1724-Final.mdl
24	6	69.83	2.00	16.33	8.17	87.17	2	JF	./Arches-GMB-5-18-24-JFT-MS-Final.mdl
25	7	68.43	2.00	15.57	9.14	91.86	2	AW	./ARCHES_GMB-5.18.24-AW&TB-Final.mdl
26	6	67.33	2.00	15.83	7.33	80.83	2	MM	./Arches-GMB-05-18Mario-Yiou-Final.mdl
27	3	66.67	1.00	14.67	5.33	63.33	3	JF	./ARCHES CLD 10_19_24_JFT_Mia_Updated_Final_11.13.24.mdl
28	8	58.00	2.00	14.00	5.62	64.50	3	AW	./ARCHES CLD 10_19_24_AW_Chen_updated_V4_Final_11.14.24.mdl
29	4	56.50	1.00	12.50	8.50	88.75	3	MM	./ARCHE CLD 10_19_24_Mario_JW_updated_Final_11.14.24.mdl
30	6	62.83	2.00	14.67	5.67	69.50	3	JF	./ARCHES CLD 10_20_2024_JFT_Mia_Final_11.14.24.mdl
31	5	58.60	2.00	14.80	7.60	82.20	3	AW	./ARCHES CLD 10_20_2024_AW_Chen_updated_final_11.14.24.mdl
32	5	56.40	1.00	11.60	9.20	92.60	3	MM	./ARCHES CLD 10_20_24_MM_JW_V5_updated_Final_11.15..24.mdl
33	8	66.75	2.00	16.12	7.86	84.29	3	JF	./ARCHES CLD 10_25_2024_JFT_Mia_Updated_Final_11.15.2024.mdl
34	8	72.62	2.00	14.38	8.00	84.25	3	AW	./ARCHES CLD 10_25_24_Alexis_Vishnu_Updated_Final_11_15.24.mdl
35	8	71.50	1.62	14.62	7.38	75.62	3	MM	./ARCHE CLD 10_25_24_Mario_Inema-JFT_Updated_final_11.15.24.mdl
36	6	68.33	2.00	14.67	7.00	77.00	3	RS	./ARCHES CLD 10_25_24_RS_TB_Updated_Final_11.15.2024.mdl

2) Models

We now have 36 models from these 36 groups. Here’s a summary of each and interactive examples of three of them. As before, light blue indicates “increase” and light pink “decrease”. Darker colors are Action Ideas.

Group	number_edges	number_unique_nodes
1	73	45
2	116	81
3	94	73
4	108	67
5	122	65
6	116	68
7	98	56
8	137	74
9	118	66
10	67	41
11	68	43
12	115	57
13	141	51
14	108	63
15	100	46
16	72	46
17	98	32
18	106	61
19	91	52
20	101	50
21	126	76
22	125	59
23	59	45
24	145	76
25	197	60
26	72	35
27	69	44
28	148	57
29	96	56
30	141	74
31	138	47
32	107	42
33	148	62
34	169	53
35	101	39
36	136	63

3) Core model

As before, we built a model from the union set (i.e. including every edge from every group), and then focused it to a core model by A) considering only loops/cycles (so no ‘externals’ or ‘dead end’ nodes) and B) only considering those that have some connection to Dementia Risk. This gives us finally 89 nodes/vertices, connected by 417 edges/vectors.

Here’s an interactive version of this, with heavier line weight indicating connections reported by many models.

4) Indirect (i.e. intervening nodes)

When considering the similarity among the models different group propose (as in, e.g. calculating line width above), we have so far only considered as simlar groups that directly/explicitly named a certain connection between two nodes (a direct edge), e.g. (Group 1: “A increases B” = Group 2 “A increases B). However, thinking of each edge seperately does not fully characterize this connected system, which I would argue importantly includes the effects emergent from multiple connections. To approximate this, we may consider indirect edges from models that express the same causality, but with intervening nodes, e.g. (Group 1:”A increases B” = Group 2 “A increases C increases B”).

The table below shows the 89 edges (i.e. combination of “cause”, “increases / decreases” and “effect), total number of group models that that reported the edge, and which group models reported them as direct or indirect edges. You may have to scroll to the right to see all of the columns.

cause	polarity	effect	total models	models (direct)	models (indirect)
Health literacy	decreases	Dementia risk	30	20,26,28,32,35	1,2,3,4,5,6,8,9,10,11,12,13,15,17,18,19,21,22,24,25,29,30,33,34,36
Stress	increases	Dementia risk	27	4,6,13,14,15,22,33,34,36	3,5,7,8,9,12,16,17,19,20,21,24,25,26,28,30,32,35
Chronic disease	increases	Dementia risk	25	1,3,4,5,6,9,10,12,13,14,16,18,21,22,25,27,30,33,34,35	2,20,24,28,32
Healthy diet	decreases	Dementia risk	25	5,10,12,32,36	1,2,3,4,6,7,8,9,16,17,18,19,21,22,24,25,28,29,30,33
Social isolation	increases	Dementia risk	24	1,7,13,17,25,26,29,33,34	2,3,5,6,8,9,12,14,20,21,22,24,28,30,35
Access to quality healthcare	decreases	Dementia risk	24	3,4,14,20,23	1,6,8,9,12,13,16,17,19,21,22,24,27,29,30,32,33,35,36
Healthy diet	decreases	Chronic disease	23	1,4,6,7,8,9,10,18,21,22,25,28,30,31,33,36	3,5,12,16,24,32,35
Access to quality jobs	increases	Income	22	2,3,4,8,9,10,11,14,15,16,17,18,21,22,24,25,27,28,29,33,34,36
Stress	decreases	Mental health	22	3,4,5,6,7,8,12,16,17,20,25,26,29,30,32,35	9,19,21,24,34,36
Income	increases	Healthy diet	22	3,6,8,10,11,17,19,24,28,33,36	4,9,14,16,18,21,25,29,32,34,35
Dementia risk	increases	Stress	22	8,14,15,22,25,28,34,35	5,11,12,13,16,17,20,21,23,24,26,30,32,33
Exercise	decreases	Dementia risk	22	5,12,15,26,28,29,36	1,2,4,7,9,14,16,17,19,20,21,24,25,27,32
Income	increases	Access to quality healthcare	22	3,13,15,21,23,25,35	4,8,9,11,14,16,17,19,22,24,26,27,32,33,36
Income	decreases	Stress	22	11,17,19,28,29,34,36	6,8,9,13,14,15,16,21,23,24,25,26,32,33,35
Access to quality jobs	decreases	Stress	22	3,11,14,16,17,20	5,7,8,12,13,15,21,22,24,25,28,29,30,33,34,36
Health literacy	decreases	Stress	22	6,8,9,26	5,11,12,13,15,17,20,21,22,23,24,25,28,30,32,33,34,35
Access to quality jobs	increases	Access to quality healthcare	22	29,33,36	1,3,4,7,8,9,11,12,14,15,16,17,19,21,22,24,25,27,30
Quality health insurance	increases	Access to quality healthcare	21	1,3,7,8,9,13,14,15,16,17,19,21,22,24,26,27,29,33,36	25,30
Access to quality education	increases	Access to quality jobs	21	5,6,13,15,16,18,20,21,24,25,27,28,30,33,36	2,3,4,9,11,19
Dementia risk	increases	Social isolation	21	1,8,10,19,20,22,26,29,33	9,12,13,17,18,21,24,25,28,30,34,36
Substance use	increases	Dementia risk	21	5,15,17,28,32,36	2,3,6,8,9,12,13,14,18,20,21,22,24,25,34
Dementia risk	decreases	Healthy diet	21	10,11,34	1,4,8,9,12,14,16,17,18,21,24,25,28,30,32,33,35,36
Income	increases	Quality health insurance	20	3,6,13,14,15,16,17,18,19,23,24,25,26	8,9,10,22,27,33,36
Stress	increases	Substance use	20	5,7,8,12,13,14,20,21,25,28,30,32,34	3,9,15,17,22,26,29
Health literacy	increases	Healthy diet	20	1,4,5,10,11,18,29,30,32,33	8,9,12,17,21,24,25,28,34,36
Access to quality healthcare	increases	Health literacy	20	8,9,14,19,24,32,35	1,6,12,13,15,17,20,22,23,25,30,31,33
Access to quality healthcare	increases	Mental health	20	20,21,27,29	4,6,8,9,11,12,16,17,19,24,25,30,31,32,35,36
Access to quality jobs	increases	Quality health insurance	19	1,5,8,9,10,14,16,17,18,27,30,33,36	3,15,20,22,24,25
Mental health	decreases	Dementia risk	19	8,9,12,17,20,21,24,25,26,30,32,35,36	3,7,16,18,27,34
Health literacy	increases	Exercise	19	1,4,5,11,24,30	8,9,12,15,17,20,25,26,28,29,31,32,36
Access to quality healthcare	decreases	Stress	19	11,14,22,25	6,8,9,12,13,16,17,20,21,23,24,30,32,33,35
Dementia risk	increases	Chronic disease	19	10,12,25,35	1,4,5,8,9,13,14,18,21,22,28,32,33,34,36
Health literacy	increases	Access to quality healthcare	19	13,17,35,36	3,7,8,9,12,15,18,19,21,22,25,31,32,33,34
Food desert	decreases	Healthy diet	18	1,4,6,7,8,9,11,12,14,16,18,19,25,28,30,36	5,33
Stress	increases	Chronic disease	18	5,6,8,12,13,14,25,28,32,33	4,9,16,21,30,34,35,36
Dementia risk	decreases	Mental health	18	5,8,18,25,32,35,36	4,12,16,17,20,21,24,26,29,30,34
Exercise	increases	Mental health	18	7,9,19,20,25,27,32	4,5,12,16,17,21,24,26,29,31,36
Chronic disease	increases	Stress	18	6,7,12,30,33,34	5,13,14,16,20,21,22,24,25,28,32,35
Stress	increases	Social isolation	18	12,13,17,22	6,8,9,19,20,21,24,25,26,28,30,33,34,36
Dementia risk	decreases	Access to quality jobs	18	10,20,25	1,5,8,12,13,15,16,17,18,21,24,28,30,33,34
Social isolation	increases	Stress	18	8,25,34	6,9,12,13,14,17,20,21,22,24,26,28,30,33,35
Substance use	increases	Stress	18	22,25,34	5,6,8,9,12,13,14,15,17,20,21,24,28,32,36
Stress	decreases	Healthy diet	18	28,34	4,5,8,9,12,16,17,21,24,25,29,30,32,33,35,36
Crime	increases	Stress	17	6,7,10,13,21,24,25,30,34,35	5,8,9,11,14,15,22
Substance use	decreases	Mental health	17	3,5,6,20,25,31,36	8,9,12,17,18,21,24,29,32,34
Access to quality healthcare	decreases	Chronic disease	17	8,24	1,4,9,12,13,14,16,21,25,27,31,32,33,35,36
Access to quality jobs	decreases	Social isolation	17	17,34	8,10,12,13,18,19,20,21,22,25,28,29,30,33,36
Access to quality jobs	decreases	Substance use	17	22,25	3,7,8,12,13,14,17,18,20,21,28,29,30,34,36
Stress	decreases	Access to quality jobs	17	25,28	5,8,9,12,13,15,16,17,19,20,21,24,30,33,34
Mental health	decreases	Substance use	16	3,8,9,25,26,29,31	7,12,17,18,20,21,30,32,34
Social isolation	decreases	Mental health	16	5,17,20,25,30,34,35	3,6,8,9,12,21,24,26,29
Access to quality education	decreases	Crime	16	10,14,19,21,25,36	2,3,5,9,13,15,18,27,28,30
Exercise	decreases	Chronic disease	16	1,4,7,8,14,25	5,9,12,16,21,24,28,31,32,36
Stress	decreases	Sleep	16	4,9,15,17,30	3,8,14,21,22,24,25,28,32,34,35
Exercise	decreases	Stress	16	7,14,15,25	5,9,11,12,16,19,20,21,24,26,28,32
Healthy diet	increases	Mental health	16	7,24,30,31	4,5,6,8,12,16,18,21,25,29,32,36
Healthy diet	decreases	Stress	16	22,24,25,28	5,6,7,8,11,12,16,17,21,30,32,33
Crime	increases	Social isolation	16	7,18,24	6,8,9,10,13,19,21,22,25,28,30,34,36
Dementia risk	decreases	Income	16	22,34,35	2,8,10,15,16,17,18,21,24,25,28,32,33
Quality health insurance	decreases	Stress	16	17,20,22	5,6,8,9,13,14,16,21,24,25,26,30,33
Substance use	increases	Chronic disease	16	6,25,28	2,5,8,9,12,13,14,18,21,22,31,32,36
Community support	decreases	Dementia risk	16	26,32	2,3,6,9,12,13,14,16,19,20,21,24,28,30
Health literacy	increases	Sleep	16	4,30	3,8,9,10,15,17,21,22,24,25,28,32,34,35
Community support	increases	Health literacy	15	1,3,9,12,13,14,19,32	2,6,20,26,28,30,31
Mental health	decreases	Stress	15	7,20,21,24,25,26,34,35	8,9,12,16,17,30,32
Dementia risk	decreases	Exercise	15	17,20,29	5,8,14,15,16,24,25,26,28,30,32,36
Substance use	decreases	Access to quality jobs	15	17,28,36	5,8,9,12,13,15,18,20,21,24,25,34
Health literacy	increases	Brain activity	15	5,15	3,9,11,12,13,17,21,24,26,28,29,31,36
Substance use	increases	Social isolation	15	12,28	6,8,9,13,17,18,20,21,22,24,25,34,36
Dementia risk	decreases	Health literacy	14	20,23,26,35	13,14,15,17,22,25,28,30,32,33
Community support	increases	Mental health	14	4,16,21	3,6,9,12,19,20,24,26,30,31,32
Dementia risk	decreases	Sleep	14	10,28,35	8,14,15,17,21,22,24,25,30,32,34
Access to quality jobs	increases	Family quality relations	14	4,15	1,10,14,18,21,22,24,25,29,30,34,36
Exercise	increases	Physical health	13	2,3,7,11,15,19,20,30,36	1,9,14,31
Income	decreases	Crime	13	6,8,19,25,34,35,36	9,15,18,21,27,28
Community support	decreases	Social isolation	13	12,14,18,19,20,24	6,9,13,21,26,28,30
Sleep	decreases	Stress	13	14,15,22,25,28	7,8,9,17,24,32,34,35
Access to quality jobs	decreases	Poverty	13	9,12,30,33	2,4,11,14,15,18,21,24,27
Access to quality jobs	decreases	Crime	13	2,30,36	5,8,15,18,19,21,25,27,28,34
Family quality relations	decreases	Substance use	13	25,31,36	3,13,14,15,17,18,21,29,30,34
Access to quality education	increases	Health literacy	13	20,33	2,6,9,13,14,15,19,25,28,30,36
Community support	decreases	Stress	13	6,14	9,12,13,16,20,21,24,26,28,30,32
Stress	decreases	Brain activity	13	13,28	3,5,9,12,15,17,21,24,26,29,36
Health literacy	increases	Self advocacy for health services	12	3,6,12,17,22,30,32,34,35,36	21,31
Substance use	increases	Crime	12	5,8,9,15,18,24,25,31,34,36	21,28
Brain activity	decreases	Dementia risk	12	3,5,11,12,13,15,28,29	9,17,24,36
Family caregiving	decreases	Access to quality jobs	12	1,4,5,8,9,21,25,34	12,16,24,28
Family caregiving	increases	Stress	12	5,8,12,14,24,25,28,34	6,16,21,35
Collective trauma	increases	Substance use	12	2,12,22,31,32,36	3,7,8,9,14,29
Healthy diet	increases	Physical health	12	3,7,8,11,19,31	1,2,9,18,30,36
Depression	increases	Dementia risk	12	14,18,27,28,33	6,9,12,21,22,24,36
Family quality relations	decreases	Social isolation	12	10,18,24,29,34	1,13,17,21,25,30,36
Access to quality healthcare	increases	Physical health	12	11,13,20,31	3,8,9,14,15,19,30,36
Appropriate medication	decreases	Dementia risk	12	9,23,24,26	5,8,16,18,20,21,27,29
Depression	increases	Social isolation	12	6,10,19,22	9,12,18,21,24,28,33,36
Income	decreases	Homelessness	12	2,16,17,22	4,9,13,14,19,24,27,28
Dementia risk	decreases	Brain activity	12	23,26,36	5,12,13,15,17,21,24,28,29
Exercise	increases	Brain activity	12	17,31,36	5,9,12,15,21,24,26,28,29
Mental health	increases	Access to quality jobs	12	9,17,24	8,12,16,18,20,21,25,30,34
Mental health	increases	Exercise	12	31,32,36	8,9,16,17,20,24,25,26,30
Taxes	increases	Access to quality education	12	10,13,27	8,12,14,15,19,21,24,25,28
Income	increases	Access to quality education	12	15,21	8,9,11,16,19,24,25,27,28,33
Mental health	decreases	Chronic disease	12	31,32	8,9,12,16,18,21,25,34,35,36
Income	decreases	Poverty	11	4,9,11,14,15,18,21,24,27,33	2
Public transportation	increases	Access to quality jobs	11	8,13,17,19,20,25,34,36	10,15,30
Public transportation	increases	Access to quality healthcare	11	3,4,7,8,13,15,19	17,25,34,36
Self advocacy for health services	increases	Access to quality healthcare	11	3,22,31,33,34,35	12,16,17,21,32
Family quality relations	decreases	Stress	11	13,17,25,34,36	14,15,21,23,24,30
Quality health insurance	increases	Regular healthcare visits	11	2,20,22,25	9,10,14,15,16,24,30
Self advocacy for health services	increases	Health literacy	11	12,30,34,35	6,17,22,28,31,32,33
Collective trauma	increases	Dementia risk	11	22,32,36	2,3,7,8,9,12,14,19
Dementia risk	decreases	Family quality relations	11	10,21,29	4,14,15,18,24,25,30,34
Family quality relations	increases	Mental health	11	17,21,25	3,18,24,29,30,31,34,36
Mental health	increases	Sleep	11	3,30,35	8,9,17,21,24,25,32,34
Access to quality jobs	increases	Brain activity	11	17,24	3,5,12,13,15,21,28,29,36
Family quality relations	increases	Health literacy	11	1,34	3,13,14,15,17,25,30,31,36
Health literacy	increases	Community support	11	12,19	2,6,13,20,24,25,26,31,32
Income	decreases	Depression	11	6,24	9,10,14,18,21,22,27,28,33
Stress	increases	Depression	10	6,9,12,14,21,22,24,33	3,28
Dementia risk	increases	Family caregiving	10	2,8,12,21,24,25,34	1,5,16
Collective trauma	decreases	Mental health	10	8,9,29,31,32	3,7,12,19,36
Crime	increases	Food desert	10	4,5,8,9,18	6,14,25,28,36
Social isolation	increases	Depression	10	6,9,14,22,33	3,12,21,24,28
Chronic disease	decreases	Physical health	10	7,9,20,30	1,2,13,14,18,31
Dementia risk	decreases	Physical health	10	11,18,20,36	1,2,9,14,15,30
Mental health	decreases	Crime	10	8,34,35,36	9,18,21,25,30,31
Access to quality healthcare	increases	Regular healthcare visits	10	9,14,23	15,16,20,22,24,25,31
Community support	increases	Brain activity	10	23,24,26	3,9,12,13,21,28,31
Crime	decreases	Family quality relations	10	4,18,30	14,15,21,24,25,31,34
Depression	increases	Stress	10	9,21,24	6,12,14,22,28,33,36
Exercise	increases	Self care	10	19,21,26	2,9,12,15,17,25,28
Preventive health testing	decreases	Dementia risk	10	14,17,25	2,11,12,13,16,20,27
Stress	decreases	Physical health	10	7,11,30	8,9,14,15,19,20,36
Family caregiving	decreases	Income	10	2,4	8,9,16,21,24,25,28,34
Healthy diet	increases	Sleep	10	25,28	8,10,17,21,22,24,30,32
Quality health insurance	decreases	Depression	10	6,22	9,10,14,18,21,24,27,33
Substance use	increases	Depression	10	18,24	3,6,9,12,14,21,22,28
Substance use	decreases	Family quality relations	10	14,22	15,18,21,24,25,31,34,36
Substance use	decreases	Physical health	10	14,36	2,8,9,13,15,18,20,31
Crime	decreases	Safe neighborhood	9	6,8,11,12,15,22,31,34,36
Regular healthcare visits	decreases	Chronic disease	9	2,10,16,25,30	9,13,14,31
Exercise	increases	Sleep	9	15,17,25,32	9,14,21,24,28
Sleep	increases	Mental health	9	7,8,34,35	9,17,24,25,32
Self care	decreases	Stress	9	15,19,26	9,12,17,21,25,28
Side effects of medication	increases	Dementia risk	9	2,13,36	15,17,21,22,24,34
Stress	decreases	Self care	9	6,12,25	9,15,17,21,26,28
Substance use	increases	Homelessness	9	2,13,22	9,14,17,19,24,28
Substance use	decreases	Self care	9	2,12,25	6,9,15,17,21,28
Access to quality healthcare	decreases	Depression	9	24,27	6,9,12,14,21,22,33
Brain activity	decreases	Social isolation	9	17,18	9,12,13,24,28,29,36
Dementia risk	decreases	Community support	9	23,26	12,13,16,20,24,25,32
Dementia risk	increases	Depression	9	10,12	14,18,21,22,24,28,33
Health literacy	increases	Self care	9	9,17	6,12,15,21,25,26,28
Healthcare system trust	increases	Health literacy	9	12,20	3,6,25,30,31,32,33
Healthy diet	increases	Brain activity	9	28,29	5,12,17,21,24,31,36
Income	increases	Taxes	9	8,15	3,11,19,21,22,25,27
Poverty	decreases	Access to quality healthcare	9	4,21	1,9,12,13,15,27,33
Poverty	decreases	Healthy diet	9	12,18	1,4,9,21,24,30,33
Quality health insurance	increases	Appropriate medication	9	18,26	5,6,8,9,20,24,27
Social isolation	decreases	Brain activity	9	12,24	3,9,13,17,21,28,29
Social isolation	decreases	Self advocacy for health services	9	17,35	3,6,12,21,22,30,34
Crime	decreases	Black business	8	7,8,13,15,24,25,31	2
Access to quality healthcare	increases	Preventive health testing	8	12,13,15,16,27	14,17,25
Poverty	increases	Crime	8	9,13,15,24,30	18,21,27
Depression	increases	Substance use	8	18,21,28,36	9,12,14,22
Misdiagnosis	increases	Dementia risk	8	2,5,25,30	6,33,34,36
Self care	increases	Exercise	8	9,19,25,28	12,15,17,26
Social isolation	decreases	Community support	8	6,12,13,20	3,24,25,26
Appropriate medication	decreases	Substance use	8	8,21,30	9,18,20,26,29
Collective trauma	increases	Stress	8	14,22,32	7,8,9,12,36
Dementia risk	increases	Health literacy	8	1,2,21	8,9,12,24,34
Exercise	decreases	Depression	8	3,27,28	9,12,14,21,24
Health literacy	increases	Family caregiving	8	1,4,35	2,7,10,15,28
Health literacy	increases	Regular healthcare visits	8	10,23,24	9,20,22,25,31
Poverty	increases	Stress	8	12,13,21	9,15,24,30,33
Regular healthcare visits	increases	Physical health	8	19,20,31	2,9,13,14,30
Brain activity	increases	Mental health	8	24,36	5,9,12,17,29,31
Dementia risk	increases	Homelessness	8	14,17	2,13,16,22,24,28
Family caregiving	increases	Health literacy	8	1,8	2,12,15,21,24,34
Health literacy	decreases	Side effects of medication	8	13,17	15,21,24,31,34,36
Income	decreases	Food desert	8	8,36	4,6,9,18,25,28
Mental health	increases	Physical health	8	31,36	7,8,9,18,20,30
Preventive health testing	increases	Exercise	8	11,17	12,14,15,16,20,25
Preventive health testing	decreases	Stress	8	17,25	11,12,13,14,16,20
Self care	decreases	Social isolation	8	12,21	9,17,19,25,26,28
Appropriate medication	decreases	Chronic disease	7	5,8,9,16,18,27	21
Community clinics	increases	Access to quality healthcare	7	4,8,9,24,27,29	3
Education level	increases	Access to quality jobs	7	1,2,3,7,9,11	12
Income	increases	Private transportation	7	2,10,19,25,28,34	4
Black business	increases	Access to quality jobs	7	8,12,13,15,24	7,25
Depression	decreases	Mental health	7	6,9,12,18,24	21,36
Health research	increases	Health literacy	7	8,9,20,24,35	17,32
African American healthcare providers	increases	Healthcare system trust	7	3,5,25,36	2,6,12
Beneficial community resources	increases	Health literacy	7	28,30,34,35	13,15,22
Homelessness	increases	Stress	7	9,14,17,28	13,16,24
Income	increases	Quality neighborhood	7	11,15,23,25	18,28,36
Over medication	increases	Dementia risk	7	17,26,34,36	2,32,33
Physical health	decreases	Dementia risk	7	2,9,19,20	8,13,36
Preventive health testing	decreases	Chronic disease	7	2,16,25,27	12,13,14
Private transportation	increases	Access to quality healthcare	7	1,7,11,19	25,34,36
Self care	increases	Healthy diet	7	9,19,21,25	12,17,28
Chronic disease	increases	Mortality	7	27,31,33	18,24,28,30
Dementia risk	increases	Over medication	7	15,26,34	17,30,33,36
Over medication	increases	Substance use	7	2,17,30	15,26,32,34
Poverty	increases	Depression	7	18,24,33	9,12,21,27
Self care	increases	Mental health	7	17,19,25	9,12,21,26
Access to quality healthcare	increases	Healthcare system trust	7	11,32	6,12,22,25,30
Beneficial community resources	decreases	Crime	7	15,36	13,28,30,34,35
Beneficial community resources	decreases	Stress	7	28,34	13,15,22,30,35
Crime	decreases	Public transportation	7	30,34	8,13,15,18,19
Family caregiving	decreases	Sleep	7	8,25	14,21,24,34,35
Grief	increases	Social isolation	7	10,30	9,22,28,33,34
Homelessness	decreases	Healthy diet	7	14,17	4,9,16,24,28
Income	increases	Public transportation	7	15,17	8,18,19,28,34
Physical health	decreases	Social isolation	7	18,19	8,9,13,20,36
Social isolation	decreases	Family quality relations	7	30,34	14,21,24,25,29
Substance use	decreases	Regular healthcare visits	7	2,9	20,22,24,25,31
Family caregiving	decreases	Caregiver leisure time	6	1,5,7,8,25	6
Police substation	decreases	Crime	6	7,10,27,30,31	13
Taxes	increases	Public resources	6	3,14,22,24,28	21
Access to quality healthcare	increases	Appropriate medication	6	8,23,24,27	6,9
Dementia risk	increases	Regular healthcare visits	6	9,15,30,33	2,24
Knowledge of family health history	increases	Health literacy	6	11,17,31,34	9,15
Misdiagnosis	increases	Stress	6	6,25,33,34	5,30
Private transportation	increases	Access to quality jobs	6	19,25,28,36	10,34
Public resources	increases	Access to quality education	6	2,9,14,28	19,24
Taxes	increases	Public transportation	6	8,10,13,19	15,28
Crime	increases	Prison population	6	5,15,22	4,13,21
Dementia risk	increases	Out of pocket expenses	6	2,4,21	30,33,34
Physical health	decreases	Stress	6	7,11,13	8,15,20
Public transportation	increases	Access to quality education	6	13,19,25	8,15,20
Quality health insurance	decreases	Out of pocket expenses	6	6,19,30	2,21,33
Quality neighborhood	increases	Access to quality education	6	11,13,15	18,25,28
Self care	increases	Sleep	6	15,17,25	9,21,28
Sleep	decreases	Depression	6	3,24,28	9,14,22
Social isolation	decreases	Self esteem	6	21,22,34	9,25,33
Brain activity	increases	Health literacy	6	15,28	9,13,17,31
Brain activity	increases	Physical health	6	11,13	9,15,31,36
Crime	decreases	Public resources	6	7,18	9,21,22,28
Depression	decreases	Sleep	6	22,28	9,14,21,24
Fear of knowledge	increases	Social isolation	6	10,13	6,25,28,30
Fear of knowledge	increases	Stress	6	5,25	6,13,28,30
Grief	increases	Dementia risk	6	33,34	9,22,28,30
Health literacy	increases	Preventive health testing	6	11,25	12,13,15,17
Healthcare system trust	decreases	Misdiagnosis	6	6,36	3,5,25,33
Homelessness	decreases	Access to quality healthcare	6	17,22	4,9,13,14
Homelessness	decreases	Mental health	6	4,27	9,16,17,24
Mental health	decreases	Collective trauma	6	29,31	8,12,30,32
Neighborhood population size	increases	Public resources	6	2,22	9,14,18,24
Out of pocket expenses	increases	Poverty	6	2,4	9,21,30,33
Preventive health testing	increases	Healthy diet	6	11,17	12,14,16,25
Preventive health testing	increases	Physical health	6	13,15	2,11,14,20
Quality neighborhood	decreases	Crime	6	18,36	13,15,25,28
Side effects of medication	decreases	Mental health	6	21,24	17,31,34,36
Sleep	increases	Physical health	6	2,7	8,9,14,15
Stress	increases	Collective trauma	6	8,32	12,22,29,30
Substance use	increases	Domestic violence	6	2,34	21,28,31,36
Crime	decreases	Quality neighborhood	5	13,15,18,25,36
Access to quality healthcare	decreases	Misdiagnosis	5	6,30,33,36	25
Family quality relations	increases	Family caregiving	5	10,15,23,34	1
Healthcare system trust	increases	Regular healthcare visits	5	2,20,23,31	25
Healthy diet	decreases	Obesity	5	3,24,33,36	32
Neighborhood population size	increases	Public schools	5	14,18,24,25	22
Obesity	increases	Chronic disease	5	3,24,27,33	32
Over medication	increases	Side effects of medication	5	15,17,34,36	2
Family quality relations	increases	Knowledge of family health history	5	15,31,34	17,29
Health literacy	decreases	Mental health stigma	5	2,3,26	31,34
Healthcare professional miscommunication	decreases	Access to quality healthcare	5	7,32,36	22,25
Mortality	decreases	Family quality relations	5	24,31,34	15,30
Mortality	increases	Social isolation	5	30,33,34	24,28
Poverty	increases	Homelessness	5	9,24,27	2,13
Public transportation	increases	Regular healthcare visits	5	2,15,20	10,25
Safe neighborhood	decreases	Stress	5	11,15,34	3,6
Self esteem	decreases	Stress	5	21,23,34	9,25
Appropriate medication	increases	Access to quality healthcare	5	9,29	8,16,21
Caregiver stress	increases	Chronic disease	5	4,33	16,18,30
Chronic disease	increases	Side effects of medication	5	2,24	13,31,34
Collective trauma	decreases	Healthcare system trust	5	3,7	12,22,32
Dementia risk	increases	Appropriate medication	5	16,20	21,24,30
Dementia risk	increases	Caregiver stress	5	30,33	4,16,18
Depression	decreases	Self care	5	21,28	6,9,12
Domestic violence	decreases	Family quality relations	5	4,31	21,34,36
Family quality relations	decreases	Depression	5	18,24	3,14,21
Health literacy	decreases	Fear of knowledge	5	4,22	6,13,25
Homelessness	increases	Depression	5	24,28	9,14,27
Homelessness	decreases	Regular healthcare visits	5	2,22	9,14,24
Income	increases	Property value	5	9,16	8,21,25
Mental health	decreases	Homelessness	5	9,19	16,17,24
Mental health stigma	increases	Dementia risk	5	2,26	3,5,34
Out of pocket expenses	decreases	Income	5	21,34	2,9,33
Out of pocket expenses	increases	Stress	5	33,34	9,21,30
Preventive health testing	increases	Brain activity	5	11,17	12,13,15
Prison population	decreases	Access to quality jobs	5	1,22	5,15,33
Side effects of medication	decreases	Physical health	5	13,31	2,15,36
Sleep	increases	Brain activity	5	9,17	15,24,28
Substance use	increases	Mortality	5	15,31	18,24,28
Taxes	increases	Community clinics	5	24,27	3,8,10
Access to quality education	increases	Education level	4	2,3,9,11
Biased criminal justice system	increases	Prison population	4	4,15,21,33
Crime	increases	Black flight	4	18,24,28,36
Crime	increases	Gun violence	4	9,21,24,27
Dementia risk	increases	Formal caregiving	4	1,4,8,24
Domestic violence	increases	Collective trauma	4	2,30,31,36
Negative personal past experiences with health system	decreases	Healthcare system trust	4	2,3,22,32
Neighborhood population size	increases	Tax revenue	4	9,14,22,25
Neighborhood population size	increases	Taxes	4	10,13,22,24
Public schools	increases	Access to quality education	4	14,18,21,24
AI Awareness about lifestyle	increases	Healthy diet	4	7,8,12	5
Community clinics	increases	Regular healthcare visits	4	2,10,24	9
Doctor accountability	increases	Access to quality healthcare	4	3,12,21	17
Grief	increases	Depression	4	22,28,33	9
Income	increases	Formal caregiving	4	10,19,25	24
Misdiagnosis	increases	Mortality	4	25,33,34	30
Misdiagnosis	increases	Over medication	4	33,34,36	30
Physical health	increases	Mental health	4	8,20,36	7
Scholarships	increases	African American healthcare providers	4	2,6,8	5
AI Awareness about lifestyle	increases	Exercise	4	7,12	5,8
Chronic disease	increases	Over medication	4	24,34	30,33
Crime	increases	Collective trauma	4	22,30	8,31
Dementia risk	increases	Nursing home capacity and quality	4	24,30	12,33
Education level	decreases	Poverty	4	2,9	11,12
Healthcare professional miscommunication	decreases	Health literacy	4	22,25	7,32
Healthcare professional miscommunication	decreases	Healthcare system trust	4	7,25	22,32
Homelessness	decreases	Physical health	4	2,13	9,14
Income	increases	Nursing home capacity and quality	4	4,24	14,27
Income	decreases	Processed food	4	33,35	23,29
Neighborhood population size	increases	Black business	4	13,24	2,25
Nursing home capacity and quality	increases	Access to quality healthcare	4	7,24	12,16
Physical trauma	increases	Substance use	4	34,36	22,28
Property value	increases	Tax revenue	4	5,16	9,25
Quality neighborhood	increases	Access to quality healthcare	4	11,13	15,25
Quality neighborhood	decreases	Stress	4	13,25	11,15
Regular healthcare visits	increases	Preventive health testing	4	14,25	13,16
Safe neighborhood	increases	Exercise	4	4,8	15,36
Self advocacy for health services	decreases	Misdiagnosis	4	34,36	6,33
Sleep	decreases	Over medication	4	30,34	15,17
Social isolation	decreases	Family caregiving	4	5,35	28,34
Stress	increases	Domestic violence	4	21,34	4,28
Taxes	increases	Beneficial community resources	4	13,15	22,28
Access to quality education	increases	Level of education	3	4,5,8
Black business	increases	Tax revenue	3	7,15,25
Brain injury	increases	Dementia risk	3	7,21,27
Caregiver stress	increases	Stress	3	16,30,33
Health literacy	increases	AI Awareness about lifestyle	3	5,8,12
Quality neighborhood	increases	Taxes	3	11,15,25
Safety	decreases	Social isolation	3	10,13,24
Tax revenue	increases	Quality neighborhood	3	11,18,25
Anger	increases	Crime	3	30,35	31
Black flight	increases	Crime	3	24,36	18
Caregiver leisure time	decreases	Social isolation	3	1,8	25
Coping ability	decreases	Substance use	3	26,32	15
Crime	increases	Biased criminal justice system	3	4,21	15
Crime	decreases	Safety	3	10,13	24
Culturally aware healthcare professionals	increases	Access to quality healthcare	3	1,8	36
Dementia risk	decreases	Safety	3	23,24	13
Domestic violence	increases	Physical trauma	3	28,34	36
Family caregiving	increases	Safe neighborhood	3	15,34	8
Family caregiving	increases	Stress of caregiver	3	6,9	24
Financial resources	increases	Healthy diet	3	30,33	34
Financial resources	decreases	Stress	3	33,34	30
Formal caregiving	decreases	Income	3	8,24	25
Healthcare system trust	decreases	Healthcare professional miscommunication	3	25,36	32
Healthy diet	decreases	Processed food	3	23,35	33
Knowledge of family health history	increases	Preventive health testing	3	15,17	11
Mental health stigma	increases	Social isolation	3	5,34	26
Out of pocket expenses	decreases	Financial resources	3	30,33	34
Over medication	increases	Out of pocket expenses	3	33,34	2
Physical health	increases	Family caregiving	3	1,7	15
Private transportation	increases	Access to quality education	3	19,25	28
Quality neighborhood	increases	Tax revenue	3	11,15	25
Safe neighborhood	increases	Access to quality education	3	3,12	15
Safe neighborhood	decreases	Food desert	3	6,36	4
Self advocacy for health services	increases	Doctor accountability	3	12,21	17
Self care	increases	Self advocacy for health services	3	12,17	21
Self esteem	increases	Self care	3	9,25	21
Stress	decreases	Job productivity	3	8,16	30
Stress of caregiver	increases	Depression	3	6,24	9
Taxes	increases	Tax revenue	3	22,25	15
Access to quality insurance	increases	Access to quality healthcare	2	13,32
African American healthcare providers	increases	Culturally aware healthcare professionals	2	6,36
Black flight	decreases	Neighborhood population size	2	18,24
Caregiver leisure time	increases	Exercise	2	8,25
Coping ability	decreases	Stress	2	15,32
Crime	increases	Physical trauma	2	28,34
Crime	increases	Police substation	2	13,31
Culturally aware healthcare professionals	increases	Healthcare system trust	2	8,36
Dementia risk	increases	Health research	2	20,27
Dementia risk	increases	Stress of caregiver	2	9,24
Dementia treatment option	decreases	Dementia risk	2	24,27
Family caregiving	increases	Caregiver stress	2	4,16
Family structural breakdown	increases	Social isolation	2	2,35
Fear of knowledge	decreases	Regular healthcare visits	2	25,30
Gun violence	increases	Brain injury	2	21,27
Health literacy	decreases	Processed food	2	33,35
Health research	increases	Dementia treatment option	2	24,27
Healthcare professional miscommunication	increases	Misdiagnosis	2	25,36
Healthcare system trust	decreases	Poor medical treatment	2	5,33
Income	increases	Access to quality insurance	2	13,32
Income	increases	Black flight	2	18,24
Job productivity	increases	Access to quality jobs	2	16,30
Level of education	increases	Access to quality jobs	2	4,5
Level of education	increases	Scholarships	2	5,8
Mental health	decreases	Anger	2	31,35
Mental health	increases	Coping ability	2	26,32
Misdiagnosis	decreases	Appropriate medication	2	5,6
Mortality	decreases	Community support	2	24,31
Mortality	increases	Grief	2	28,34
Physical trauma	increases	Depression	2	22,28
Poor medical treatment	increases	Misdiagnosis	2	5,33
Poverty	increases	Public transportation	2	4,20
Prison population	decreases	Family quality relations	2	4,15
Processed food	decreases	Healthy diet	2	29,33
Processed food	increases	Obesity	2	27,33
Public resources	increases	Health research	2	9,24
Self advocacy for health services	decreases	Negative personal past experiences with health system	2	22,32
Social isolation	increases	Family structural breakdown	2	2,35
Taxes	increases	Police substation	2	10,13

5) Fitting characteristics of groups to similarity of the models they propose

Using this method (indirect & direct edges) of quantifying the similarity of one model to another, we may use methods borrowed from ecology to 1) construct a matrix of (dis-)similarity of each model to each other model, 2) use non-metric multidimensional scaling (NMMDS) to represent this multi-dimensional set of distances in a two-dimensional space, and 3) fit various characteristics of model-building groups the distances of models from one another in this NMMDS ordination space. (Note: the fit algorithm compares the fit of the observed characteristic to 999 permuted data sets, and so pvalues may vary slightly in each run)

Here are the fits for group means of age, gender (M=1, F=2), education, ADI State, ADI National, and in addition which round groups participated in, and who was their main facilitator.

We see that group means of ADI National and (to a slightly lesser degree) ADI State have significant (pval<0.05) and moderately strong (r-squared ~0.30) fit with where a group’s model falls in the ordination space. Group mean age has a borderline significant (p ~0.05) and less strong (r-squared ~0.15) fit, and other factors do not show a significant fit.

	p-value	r-squared
mean_age	0.061	0.156
mean_gender	0.355	0.061
mean_education	0.324	0.058
mean_ADI_S	0.005	0.283
mean_ADI_N	0.003	0.312
round	0.412	0.049
facilitator	0.820	0.061

If we break ADI National (a continuous variable) into quantile categories (lowest 20%, middle 40%, highest 20%), we can see there’s little overlap between the space of the low and high ADI groups, and they are bridged by the middle ADI groups.

Here, each point is one group’s model, and distances between each pair of points are defined by the dis-similiarity in the edges (indirect and direct) in those models. So, points that are relatively close together are groups that had similar models, points that are widely spaced apart had more dis-similar models. I’ve colored and drawn outlines around groups that fell into each of the three ADI categories.

We may also characterize which components are relatively more common in these ADI categories, (i.e. what the differences are that are driving the dissimilarity).

_____

Every edge that occurred in at least 75% of one ADI group

_____

Edges with the greatest difference

6) Importance of methodology

The analysis above were done using distances based on group models with similar edges (including direct and indirect edges); these are necessarily connected to the connected systems that participants were facilitated in proposing. In contrast, we could do a similar calculation using distances based simply on nodes (that is, what system components participants name during the process) or on direct edges only (that is, the system decomposed into simple linear A increases B connections between nodes).

Interestingly, each of these shows consistently significant fits only for facilitator (and borderline significance for round), suggesting that these more surface-level parts of the system are more affected by methodology.

______

By nodes

______

	p-value	r-squared
mean_age	0.862	0.009
mean_gender	0.255	0.082
mean_education	0.808	0.012
mean_ADI_S	0.116	0.121
mean_ADI_N	0.114	0.120
round	0.009	0.237
facilitator	0.002	0.311

_____

By direct edges

______

	p-value	r-squared
mean_age	0.803	0.012
mean_gender	0.869	0.008
mean_education	0.710	0.021
mean_ADI_S	0.156	0.103
mean_ADI_N	0.168	0.100
round	0.083	0.144
facilitator	0.001	0.319