The Power of Positive Deviance

Positive deviance

Positive deviance is the observation that in most settings a few at risk individuals follow uncommon, beneficial practices and consequently experience better outcomes than their neighbours who share similar risks.14

 

Positive deviant behaviour is an uncommon practice that confers advantage to the people who practise it compared with the rest of the community. Such behaviours are likely to be affordable, acceptable, and sustainable because they are already practised by at risk people, they do not conflict with local culture, and they work.15 For example, in Egypt, contrary to custom, parents of poor but well nourished children were found to feed their children a diet that included eggs, beans, and green vegetables. Child nutrition programmes that provided opportunities to parents of malnourished children to follow this and other new behaviours, such as hand washing and hygienic food preparation, improved child growth.

Summary points

Even in the poorest communities, a few individuals or families achieve good health

Positive deviance is a quick, low cost method to identify the strategies used by these people and encourage the rest of the community to adopt them

The approach has been used successfully, mainly to improve child health

The potential for the approach to help communities to gain better health or other social benefits is vast and largely untapped

 

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7475.1177 (Published 11 November 2004) Cite this as: BMJ 2004;329:1177

Thought for Today 08.18.18

Life is about obstacles. Our lives are not determined by what happens to us, but how we react to what happens. Baseball is just a game. You should always play the game with passion, play the game with heart, and play the game you love, and possibly one day your dreams can come true just like mine did.

Wade Boggs – during his induction ceremony into the Baseball Hall of Fame

Thought for Today 02.28.18

In science, unlike politics, there is value in saying, “I don’t know,” or “We don’t really know, but it might be this,” or “Actually, what I believed last year is no longer likely correct.” Once you actually embrace this notion—that you can’t know everything, that facts have a half-life, and that humility is a blessing more than a curse when it comes to trying to understand the natural laws of our universe—you become obsessed with research.

Peter Attia MD

Myths debunked: Physicians’ incomes are too high and they are the cause of rising health costs

The deeply respected and revered Pulitzer Prize-winning columnist, Mike Royko, who wrote for the Chicago Sun-Times and the Chicago Tribune is remembered as a no-nonsense, tough but fair and probing reporter. Politicians cringed at the very mention of his name, especially if he was doing a story on them. When asked about a poll critical of physician earnings in April of 1993, he did not mince any words – in typical Royko style. In a column entitled, “Doctors’ Pay Poll Reflects a Whiny and Stupid Society,” he addressed those who felt that physicians were being paid too much. “Maybe the poll questions should have been phrased this way,” he began: “How much should a person earn if he or she must, (a) get excellent grades and a fine educational foundation in high school in order to, (b) be accepted by a good college and spend four years taking courses heavy in math, physics, chemistry and other lab work and maintain a 3.5 average or better, and, (c) spend four more years in grinding study in medical school, with the 3rd and 4th years in clinical training, working 80 to 100 hours a week and, (d) put in another three to ten years of post-graduate training, depending on your specialty and, (e) maybe wind up $ 100,000 in debt (editor’s note-more than $166,000 today) and, (f) then work an average of 60 hours a week, with many family doctors putting in 70 hours or more until they retire or fall over?”

He closed with one other pertinent comment: “Let us talk about medical care and one of the biggest problems we have. That problem is you, my fellow Americans. Yes, you, eating too much and eating the wrong foods; many of you guzzling too much hooch; still puffing away; getting your daily exercise by lumbering from the fridge to the microwave to the couch; doing dope; filling the big-city emergency rooms with gunshot victims; engaging in unsafe sex and catching a deadly disease while blaming the world for not finding a cure. You and your habits, not the doctors, are the single biggest health problem in the country. If anything, it is amazing that the docs keep you alive as long as they do.” Harsh words perhaps, but he uttered them 24 years ago, and there is still some truth in them.

Emphasis mine.  I try not to get into this debate with anyone.  But when I do, I don’t lose.

Source article here.

Thought for Today 09.09.17

MY LORD GOD, I have no idea where I am going. I do not see the road ahead of me. I cannot know for certain where it will end. Nor do I really know myself, and the fact that I think I am following your will does not mean that I am actually doing so. But I believe that the desire to please you does in fact please you. And I hope I have that desire in all that I am doing. I hope that I will never do anything apart from that desire. And I know that if I do this you will lead me by the right road, though I may know nothing about it. Therefore I will trust you always though I may seem to be lost and in the shadow of death. I will not fear, for you are ever with me, and you will never leave me to face my perils alone.

– Thomas Merton, “Thoughts in Solitude”

© Abbey of Gethsemani