This qualitative research study aimed to examine the nature of systems change and to identify practices and strategies that states, specifically New Hampshire, use to promote community integration and deinstitutionalization of people with developmental disabilities. The study describes the New Hampshire system, including state practices, characteristics, issues and problems, and historical and thematic areas. Thematic areas include the role of the courts, the role of state institutions, structural factors in community services development, family support, and self advocacy and guardianship. Community integration service practices have focused on family support, supported employment, community living and home ownership, self advocacy, case management, guardianship, and aging and developmental disabilities. The study highlights comparative roles of groups in the change process, including families, external advocates, state and community administrators, media, litigators, and legislators and policymakers. A framework for thinking about systems change is presented, which views community integration as a slowly evolving process with key "events" occurring along the way which significantly altered or shaped others that followed. Selected research areas and hypotheses are outlined. (Contains 95 references.) (JDD)