A Transdisciplinary Complex Adaptive Systems (T-CAS) Approach to Developing a National School-Based Culture of Prevention for Health Improvement: the School Health Research Network (SHRN) in Wales

Abstract

The paper reflects on a transdisciplinary complex adaptive systems (T-CAS) approach to the development of a school health research network (SHRN) in Wales for a national culture of prevention for health improvement in schools. A T-CAS approach focuses on key stages and activities within a continuous network cycle to facilitate systems level change. The theory highlights the importance of establishing transdisciplinary strategic partnerships to identify and develop opportunities for system reorientation. Investment in and the linking of resources develops the capacity for key social agents to take advantage of disruption points in the re-orientated system, and engagement activities develop the network to facilitate new social interactions and opportunities for transdisciplinary activities. A focus on transdisciplinary action research to co-produce interventions, generate research evidence and inform policy and practice is shown to play an important part in developing new normative processes that act to self-regulate the emerging system. Finally, the provision of reciprocal network benefits provides critical feedback loops that stabilise the emerging adaptive system and promote the network cycle. SHRN is shown to have embedded itself in the system by securing sustainability funding from health and education, a key role in national and regional planning and recruiting every eligible school to the network. It has begun to reorient the system to one of evidence generation (56 research studies co-produced) and opportunities for data-led practice at multiple levels. Further capacity development will be required to capitalise on these. The advantages of a complex systems approach to address barriers to change and the transferability of a T-CAS network approach across settings and cultures are highlighted.

From Complex Interventions to Complex Systems: Using Social Network Analysis to Understand School Engagement with Health and Wellbeing

“…The research network is a Welsh infrastructure for school-based health improvement research. It conducts biannual surveys with member secondary schools in Wales and provides bespoke pupil health and wellbeing reports to schools outlining statistics relating to their pupils’ levels of diet, physical activity, substance use, mental health and wellbeing, as well as a broad range of other school engagement action [15,31]. In 2014, there were 69 member schools [5].…”

“…CAS perspectives have gained much influence in school health research [14,15], and public health science more broadly in recent years [16,17]. Indeed, attempts have been made to operationalise the interaction between context and school-based interventions through conceptualising these as network systems comprised of human and non-human entities [18].…”

Testing the “Zero‐Sum Game” Hypothesis: An Examination of School Health Policies and Practices and Inequalities in Educational Outcomes

“…This study used school‐level data collected from secondary schools in Wales that are members of the Wales‐wide SHRN . The School Environment Questionnaire (SEQ), collected in 2016 was completed by school staff.…”

Commentary on the Culture of Prevention

“…However, creating a system or infrastructure to implement and sustain prevention interventions is complex and requires partnerships at all levels and resources (Bollmann et al 2020;Murphy et al 2018). The United Nations Office on Drugs andCrime (2013, 2018) in the publication, International Standards on Drug Use Prevention, presents a national comprehensive system to support evidence-based prevention that includes an array of services and resources.…”