Objectives Systems approaches are promising yet under-utilized methods for tackling complex public health problems. This paper explores how systems approaches are understood in the public health literature, how they have been applied in Canada, the insights, and implications for future practice. Methods A rapid review of the literature, including a content analysis and cross-case comparison, was conducted. It was used to distinguish concepts of systems approaches and identify case examples of the application of systems approaches in Canada. Seven cases with a population health perspective (non-health care related) were prioritized for analysis. Results Systems approaches are a variety of qualitative and quantitative methods that aim to understand a system of interest. Most case examples demonstrated systems thinking methods. Systems science methods were applied predominantly in health care. Only one case of systems science for the social determinants of health was found. Findings indicate that systems approaches were utilized because traditional methods were proving ineffective. These approaches can introduce new ways of thinking, enable collaboration across diverse stakeholders, identify where best to focus action and with what intensity, and provide more robust evidence for decision-making. Conclusion There is a need to build capacity among practitioners for more widespread adoption and use of systems approaches. Population health professionals need to move beyond reductionist approaches, generate more case examples, and use an iterative evaluation approach that prioritizes the application of processes. This will provide further insight into the usefulness of systems approaches as effective methods to address complex health problems.

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This study compares the use of evidence in two 18-month Canadian projects with a similar goal: improved prevention of type II diabetes in women from ethno-cultural communities with a gestational diabetes diagnosis. Evidence used for both projects included epidemiological data and research literature, needs assessments with the target population, and project evaluations. Contexts for the use of evidence differed between the two projects in terms of the innovation and its level of complexity; organizational context and system readiness for change; and partnership characteristics. This study showed that while evidence played some role in determining project success, it was but one factor in deciding how project activities were (or were not) sustained.