Breadcrumb
- Essential Partners
- Our Stories
- Impact Stories
- Reflective Structured Dialogue Helps Address “Wicked” Public Health Challenges
Reflective Structured Dialogue Helps Address “Wicked” Public Health Challenges
In 2022, a group of researchers from Brigham Young University conducted a study to determine the power of Reflective Structured Dialogue to address “wicked public health problems,” which they describe as “complex social and political problems with dynamic root causes that are difficult to precisely delineate and that lack definitive and objective solutions, especially across different contexts.”
Examples of wicked problems in public health include obesity, HIV transmission, and vaccines. These problems are not merely technical—they are strongly related to a host of overlapping social factors, such as educational attainment, poverty, racial and ethnic identities, as well as political polarization.
“Political polarization and conflict over social issues are indelible features of American society,” the researchers wrote. “Since the beginning of the COVID-19 pandemic in 2020, critical public health-related problems have increasingly become the focus of many of the most heated debates in legislatures, communities, and schools across the country.”
“Polarization affects public health in at least two critical ways,” they write. “First, polarization has been found to directly affect stress and anxiety, which can lead to a variety of poor health outcomes. Second, and perhaps most crucially, polarization impedes collective problem-solving and increases social divisiveness—a factor that can be considered a determinant of health—which creates new and exacerbates existing health and social problems. Thus, in order to build a foundation of understanding upon which today’s wicked public health problems can be more effectively resolved, the public health community needs evidence-based approaches for promoting dialogue and reducing polarization around controversial issues.”
Developed by Essential Partners co-founders, Reflective Structured Dialogue (RSD) is a research-based, flexible, scalable framework that equips people to interrupt dysfunctional dynamics and build relationships across differences in order to address challenges where they live, work, worship, and learn. RSD and its adaptations are today used by many leading organizations in the fields of dialogue and deliberation, conflict resolution, and de-polarization.
Using RSD in partnership with longtime EP collaborators, Living Room Conversations, the researchers conducted a series of 27 Reflective Structured Dialogues on the Brigham Young University campus. Nearly 140 students participated in dialogues on three wicked public health problems: COVID-19, mental health, and racism.
“Structured dialogues, such as those used in this study, are more important now than ever as society becomes increasingly polarized along ideological, religious, racial, and other divides […] Reflective Structured Dialogue can serve as a useful tool in university settings and in the larger context of addressing wicked public health problems in communities.”
RSD Reduces Polarization, Improves Openness
Their findings were published in Frontiers in Public Health, a peer-reviewed research journal. “This study shows that [Reflective Structured Dialogue] is positively associated with improved polarization-related attitudes among university students,” the researchers wrote. “While not all changes were statistically significant, most survey questions showed positive changes between the pre- and post-surveys, with the biggest differences coming in questions related to outcomes of openness, tribal identity, and moral disdain. Nearly all students believed their experiences with RSD were positive, helped them understand the experiences of and feel more connected to others, and increased their empathy and compassion.
“[…] When asked to comment on their overall experiences, the open-ended responses from participants supported the quantitative findings. A representative comment from one student said, ‘I enjoyed being in a setting where people are encouraged to listen to others first without rebutting them. I usually do not talk about these kinds of topics due to being anxious about negative responses.’ Several students mentioned their desire to incorporate structured conversations into the university campus community in more permanent ways. For example, one participant wrote, ‘I believe this is important enough to be included in curriculum. I think that every BYU student should participate in such a discussion before they graduate.’
The researchers also identified the need for broader research among more diverse participants outside of a campus context, ideally with a less self-selecting group.
“Structured dialogues, such as those used in this study, are more important now than ever as society becomes increasingly polarized along ideological, religious, racial, and other divides. While this is a relatively small demonstration project in a somewhat unique context, the results are promising and lend strength to the argument that RSD can serve as a useful tool in university settings and in the larger context of addressing wicked public health problems in communities. Future projects should explore additional applications of RSD and use rigorous evaluation methods to better understand how to optimize outcomes.”
In the end, these researchers found the same consistent outcomes that Essential Partners has seen over four decades of real-world implementation, research, and field evaluations:
“Together, the quantitative data and participant comments suggest that, as in previous studies, Reflective Structured Dialogue helped participants create connections and understand different perspectives. This study also helps demonstrate how deliberative inquiry can contribute to student learning in higher education setting. These empirical findings are useful in supporting the theoretical justifications made about the value of RSD and other types of dialogue in building trust and understanding between diverse groups as a prerequisite to problem-solving. Successful consensual problem solving for wicked problems requires dialogue to create the conditions in which stakeholders with distinct interests can collaborate towards progress on solutions.”
Download the complete article from Frontiers in Public Health, a peer-reviewed research journal.