Applying systems thinking to knowledge mobilisation in public health

Abstract

Context Knowledge mobilisation (KM) is a vital strategy in efforts to improve public health policy and practice. Linear models describing knowledge transfer and translation have moved towards multi-directional and complexity-attuned approaches where knowledge is produced and becomes meaningful through social processes. There are calls for systems approaches to KM but little guidance on how this can be operationalised. This paper describes the contribution that systems thinking can make to KM and provides guidance about how to put it into action. Methods We apply a model of systems thinking (which focuses on leveraging change in complex systems) to eight KM practices empirically identified by others. We describe how these models interact and draw out some key learnings for applying systems thinking practically to KM in public health policy and practice. Examples of empirical studies, tools and targeted strategies are provided. Findings Systems thinking can enhance and fundamentally transform KM. It upholds a pluralistic view of knowledge as informed by multiple parts of the system and reconstituted through use. Mobilisation is conceived as a situated, non-prescriptive and potentially destabilising practice, no longer conceptualised as a discrete piece of work within wider efforts to strengthen public health but as integral to and in continual dialogue with those efforts. A systems approach to KM relies on contextual understanding, collaborative practices, addressing power imbalances and adaptive learning that responds to changing interactions between mobilisation activities and context. Conclusion Systems thinking offers valuable perspectives, tools and strategies to better understand complex problems in their settings and for strengthening KM practice. We make four suggestions for further developing empirical evidence and debate about how systems thinking can enhance our capacity to mobilise knowledge for solving complex problems – (1) be specific about what is meant by ‘systems thinking’, (2) describe counterfactual KM scenarios so the added value of systems thinking is clearer, (3) widen conceptualisations of impact when evaluating KM, and (4) use methods that can track how and where knowledge is mobilised in complex systems.

From Understanding to Impactful Action: Systems Thinking for Systems Change in Chronic Disease Prevention Research

“…Initially, the ACF was used in its original form to evaluate the HE 2 Project, but it became apparent that many of the questions needed to be adapted to fit the prevention research context as opposed to the community psychology context.…”

“…We used the PSCF to both reflect on the research work that took place within the HE 2 Project, and to consider what will be necessary to create systems change through future work. The results are discussed under the four key components of the PSCF, with details of the specific reflections that informed the results narrative provided in Tables 4-6.…”

“…Population-level chronic disease prevention efforts are typically anchored in one or more of implementation science, knowledge mobilisation, or evidence-based practice [1][2][3][4]. More recently, chronic disease prevention research is applying systems thinking methods and tools to understand and address complexity [5,6].…”

“…The Prevention Centre is a national research-policy collaboration aimed at applying systems approaches to the study of chronic disease prevention; it was first funded in 2013-2018 and funded for a further 5 years in 2018 [47]. The HE 2 Project examined the drivers of inequities in healthy eating relevant to the Australian context, applied a systems lens and methodology, and took place in three stages (i.e., the HE 2 diagram, the HE 2 policy framework, and the HE 2 qualitative study) [10]. Soft systems conceptual modelling workshops were conducted using a participatory approach.…”

“…The HE 2 policy framework emerged from the diagramming work and extended previous conceptualisations of policy responses addressing nutrition-related inequities, by including the social determinants of healthy eating along with the seven sub-systems identified in the HE 2 System Diagram [18]. It presents a call to action to populate the framework with evidence-based actions that can be implemented to tackle inequities that constrain healthy eating.…”