Date of Award

Fall 2022

Degree Type

Restricted to Claremont Colleges Dissertation

Degree Name

Public Health, DPH


School of Community and Global Health

Advisor/Supervisor/Committee Chair

C. Anderson Johnson

Dissertation or Thesis Committee Member

Jay Orr

Dissertation or Thesis Committee Member

Wallace Chipidza

Terms of Use & License Information

Terms of Use for work posted in Scholarship@Claremont.

Rights Information

© 2022 Amanda Mitry

Subject Categories

Public Health


The complexity and limited reach of the U.S. healthcare delivery system necessitates better coordination across organizations and services beyond the scope of what has been thought of traditionally as the healthcare system to realize optimal population health outcomes. The COVID-19 pandemic made this abundantly clear and reminds us that the same limitations of the healthcare system pertain to control of chronic disease as well. How then to achieve better integration and effective coordination of critical non-health systems with the treatment sector to achieve those outcomes, especially those relevant to prevention of upstream causes as well as conditions necessary for effective disease management after and beyond the clinical encounter. This study addresses the problem of deep disconnects between “healthcare” and prevention, and between “healthcare” and disease management across the life space (Lewin, 1952). This study speaks to systems integration, the engineering of a virtual system to achieve integration of societal resources that stand to mitigate causes of disease and potentially mitigate post treatment lapses. The Stopping Diabetes in its Tracks (SDIT) collaboration is an integrated set of community, clinic, and hospital interventions to prevent and control type 2 diabetes in Pomona, CA that works to create a model that is effective, replicable, scalable, and sustainable. To manage the complexity and innovation of the SDIT project, SDIT adopted a systems-engineering (SE) approach which provides a framework for complete integration and performance of complex multidisciplinary systems. A defined understanding of the methods of communication and information in a public health organization is important for effective and efficient programming, illustrating the importance of a systems engineering. This study examines the communication patterns of individuals through use of a social network analysis (SNA) over three time points of SDIT including the original system (Se), implementation of systems engineering (SE), and SE post Covid-19 (SE Covid-19) lockdown. This study conducted a social network analysis which is a useful tool in providing insights into an organization’s process which can inform public health organizations and leaders with strategies to address any issues they may have and to help identify network strengths and weaknesses. The network analysis was used to study the implications of the implementation of the systems engineering approach at SDIT and recommend ways in which other transdisciplinary projects can utilize similar frameworks and analyses.