A scoping review of systems approaches for increasing physical activity in populations

Abstract

Introduction The past decade has increasingly seen systems approaches as a featured theme in public health studies and policy documents. This trend is evident in the area of physical activity, which is a significant global health risk factor that is addressed in WHO’s Global Action Plan on Physical Activity. We undertook a comprehensive scoping review to characterize the application of systems approaches to physical activity, to develop a typology of the objectives, themes and methods of research papers that purported to apply systems thinking to this issue. Methods We searched electronic databases (PubMed, Web of Science, Scopus and PsycINFO) for studies published during the period 2010–2021 that explicitly applied systems approaches or methods to investigate and/or address population physical activity. A framework using systems-based methodological approaches was adapted to classify physical activity studies according to their predominant approach, covering basic descriptive, complex analytical and advanced forms of practice. We selected case studies from retained studies to depict the current “state of the art”. Results We included 155 articles in our narrative account. Literature reporting the application of systems approaches to physical activity is skewed towards basic methods and frameworks, with most attention devoted to conceptual framing and predictive modelling. There are few well-described examples of physical activity interventions which have been planned, implemented and evaluated using a systems perspective. There is some evidence of “retrofitted” complex system framing to describe programmes and interventions which were not designed as such. Discussion We propose a classification of systems-based approaches to physical activity promotion together with an explanation of the strategies encompassed. The classification is designed to stimulate debate amongst policy-makers, practitioners and researchers to inform the further implementation and evaluation of systems approaches to physical activity. Conclusion The use of systems approaches within the field of physical activity is at an early stage of development, with a preponderance of descriptive approaches and a dearth of more complex analyses. We need to see movement towards a more sophisticated research agenda spanning the development, implementation and evaluation of systems-level interventions.

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

“…Our aim was to examine the types of complex systems methods used in current PA research and explore alignment with a whole of systems approach as described by the Attributes Model [ 20 ]. A recently published literature review on systems approaches to PA promotion [ 21 ] complements and validates our aim, in that, there is a need to ‘address systems-level enablers that arguably include governance and leadership, legislation and regulation, multisectoral partnerships, workforce capabilities, advocacy, information systems, system surveillance and financing mechanisms’ (p. 12).…”

Child and family experiences of a whole-systems approach to physical activity in a multiethnic UK city: a citizen science evaluation protocol

“…36 However, the potential to understand whole-systems physical activity approaches using citizen science has not been realised. 22 A key principle of citizen science is that citizen scientists should benefit from participating. 37 Research indicates that positive experiences for young people can be achieved by considering power dynamics, relationships and personal growth within citizen science.…”

“… 36 However, the potential to understand whole-systems physical activity approaches using citizen science has not been realised. 22 …”

A critical analysis of walking policy in Ireland and its contribution to both national and international development goals

“…The introduction of systems thinking in public health practice and research has provided stakeholders embedded within public health systems new perspectives on the interconnections between their own work, and the work of organisations from other sectors and disciplines in the system (1,2). Many conceptual tools, such as applying a systems lens or "systems framing" have been adopted by researchers and practitioners to help stakeholders to develop a systems oriented view of the systems which they are embedded within (2,3). Oftentimes, this involves asking stakeholders to "take a step back" and can offer stakeholders insight into the wider goals and systems that they influence/are influenced by.…”