A scoping review of complex systems methods used in population physical activity research: do they align with attributes of a whole system approach?

Abstract

Background Complex systems approaches are increasingly used in health promotion and noncommunicable disease prevention research, policy and practice. Questions emerge as to the best ways to take a complex systems approach, specifically with respect to population physical activity (PA). Using an Attributes Model is one way to understand complex systems. We aimed to examine the types of complex systems methods used in current PA research and identify what methods align with a whole system approach as reflected by an Attributes Model. Methods A scoping review was conducted and two databases were searched. Twenty-five articles were selected and data analysis was based upon the following: the complex systems research methods used, research aims, if participatory methods were used and evidence of discussion regarding attributes of systems. Results There were three groups of methods used: system mapping, simulation modelling and network analysis. System mapping methods appeared to align best with a whole system approach to PA promotion because they largely aimed to understand complex systems, examined interactions and feedback among variables, and used participatory methods. Most of these articles focused on PA (as opposed to integrated studies). Simulation modelling methods were largely focused on examining complex problems and identifying interventions. These methods did not generally focus on PA or use participatory methods. While network analysis articles focused on examining complex systems and identifying interventions, they did not focus on PA nor use participatory methods. All attributes were discussed in some way in the articles. Attributes were explicitly reported on in terms of findings or were part of discussion and conclusion sections. System mapping methods appear to be well aligned with a whole system approach because these methods addressed all attributes in some way. We did not find this pattern with other methods. Conclusions Future research using complex systems methods may benefit from applying the Attributes Model in conjunction with system mapping methods. Simulation modelling and network analysis methods are seen as complementary and could be used when system mapping methods identify priorities for further investigation (e.g. what interventions to implement or how densely connected relationships are in systems).

Implementation processes of social network interventions for physical activity and sedentary behavior among children and adolescents: a scoping review

“…The findings of this scoping review contribute to the initiative of whole systems approaches for physical activity promotion [ 62 ] because tools such as social network analysis are used to understand systems as a central issue within implementation science [ 17 ]. Its application by public health and educational practitioners requires adopting a system approach [ 46 ], e.i., embracing the uncertainty and unpredictable nature of the relationship between actions and their consequences.…”

Follow the Arrows: Using a Co-Created Causal Loop Diagram to Explore Leverage Points to Strengthen Population Physical Activity Promotion in British Columbia, Canada

“…4 The inherent multisectoral nature (eg, sectors and settings) and the interdependence among factors that influence PPAP point to the use of complex systems methods to address the multisectoral coordination challenge. 5 Taking a whole-of-system approach is a growing trend in applying complex systems methods in health promotion and NCD prevention. 6 This approach in PPAP can be described as focusing on the "dynamic connections between the factors that collectively form the system, and considering the ways in which actors interact with them."…”

“…7 One way to study a whole-system for PPAP is to apply an Attributes Framework that was developed to delineate characteristics of effective systems for health promotion and NCD prevention. 5,8 The framework identifies 7 attributes (Leadership, a Health Equity Paradigm, Resources, Information, Collaborative Capacity, Implementation of Desired Actions, and a Complex System Thinking Paradigm) and associated dimensions that can be used to describe, assess, and strengthen systems for PPAP. For example, the Implementation of Desired Actions attribute relates to, in this project, actions targeting physical activity behavior and includes the following 3 dimensions: Coordinated (ie, integrated and intersectoral), Comprehensive (ie, multifaceted), Knowledge-based, and Multilevel (ie, local, regional, and provincial/subnational).…”

“…4 The Attributes Framework also provides a foundation for the study of relationships and feedback loops among attributes and dimensions. 5 Jackson 9 states that "according to the theory of system dynamics, the multitude of variables existing in complex systems become casually related in feedback loops" and the "systemic interrelationships between feedback loops constitute the structure of the system." There is a rich history of literature that claims this type of structure is a fundamental determinant of system behavior.…”

Editorial: A systems approach to personalized exercise and nutrition in health and disease

“…Nonlinearity is a key feature of complex systems, meaning that small changes in initial conditions can lead to large and unpredictable effects over time. As a result, the study of complex systems has important implications for a wide range of fields, including public health, physical activity promotion and noncommunicable disease (NCD) prevention research, policy, and practice ( 1 ).…”