Can We Build an Evidence Base on the Impact of Systems Thinking for Wicked Problems? Comment on "What Can Policy-Makers Get Out of Systems Thinking? Policy Partners’ Experiences of a Systems-Focused Research Collaboration in Preventive Health"

Finegood, Diane T.

doi:10.34172/ijhpm.2020.194

Cited by 11 publications

(15 citation statements)

References 12 publications

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“…At present, it appears that the evidence base (RCT or non-RCT) is largely wedded to the evaluation of downstream intervention. If we wish to see a change in how obesity is addressed in policy and practice, a paradigm shift in the design and evaluation of obesity prevention efforts is imperative [13,14].…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

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A secondary analysis of the childhood obesity prevention Cochrane Review through a wider determinants of health lens: implications for research funders, researchers, policymakers and practitioners

Nobles

Summerbell

Brown

et al. 2021

Int J Behav Nutr Phys Act

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Background Randomised controlled trials (RCTs) are often regarded as the gold standard of evidence, and subsequently go on to inform policymaking. Cochrane Reviews synthesise this type of evidence to create recommendations for practice, policy, and future research. Here, we critically appraise the RCTs included in the childhood obesity prevention Cochrane Review to understand the focus of these interventions when examined through a wider determinants of health (WDoH) lens. Methods We conducted a secondary analysis of the interventions included in the Cochrane Review on “Interventions for Preventing Obesity in Children”, published since 1993. All 153 RCTs were independently coded by two authors against the WDoH model using an adaptive framework synthesis approach. We used aspects of the Action Mapping Tool from Public Health England to facilitate our coding and to visualise our findings against the 226 perceived causes of obesity. Results The proportion of interventions which targeted downstream (e.g. individual and family behaviours) as opposed to upstream (e.g. infrastructure, environmental, policy) determinants has not changed over time (from 1993 to 2015), with most intervention efforts (57.9%) aiming to change individual lifestyle factors via education-based approaches. Almost half of the interventions (45%) targeted two or more levels of the WDoH. Where interventions targeted some of the wider determinants, this was often achieved via upskilling teachers to deliver educational content to children. No notable difference in design or implementation was observed between interventions targeting children of varying ages (0–5 years, 6–12 years, 13–18 years). Conclusions This study highlights that interventions, evaluated via RCTs, have persisted to focus on downstream, individualistic determinants of obesity over the last 25 years, despite the step change in our understanding of its complex aetiology. We hope that the findings from our analysis will challenge research funders, researchers, policymakers and practitioners to reflect upon, and critique, the evidence-based paradigm in which we operate, and call for a shift in focus of new evidence which better accounts for the complexity of obesity.

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Section: Comparison With Existing Literaturementioning

confidence: 99%

“…Randomised control trials are widely regarded as the highest quality source of evidence, and as such, are often used by policymakers and practitioners to shape their planning and decision making [13,14]. The Cochrane Collaboration builds upon this premise and seeks to synthesise the findings from high-quality RCTs.…”

Section: Introductionmentioning

confidence: 99%

A secondary analysis of the childhood obesity prevention Cochrane Review through a wider determinants of health lens: implications for research funders, researchers, policymakers and practitioners

Nobles

Summerbell

Brown

et al. 2021

Int J Behav Nutr Phys Act

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“…Additionally, systems thinking is "a set of synergistic analytic skills used to improve the capability of identifying and understanding systems, predicting their behaviors, and devising modifications to them in order to produce desired effects" [34]. From a systems thinking perspective, the individual parts of a system act differently when viewed in isolation from other component parts of a system [35]; thus, practitioners should explore the inter-relationships of a problem within the social, cultural, environmental, educational, political, and economic perspectives of a system [36] (Figure 1). Within the environmental system, AI is positioned to increase the sustainability of production agriculture [9].…”

Section: Systems Thinking Approachmentioning

confidence: 99%

Exploring Twitter Discourse around the Use of Artificial Intelligence to Advance Agricultural Sustainability

2021

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This paper presents an exploration of public discourse surrounding the use of artificial intelligence (AI) in agriculture, specifically related to precision agriculture techniques. (1) Advancements in the use of AI have increased its implementation in the agricultural sector, often framed as a sustainable solution for feeding a growing global population. However, lessons learned from previous agricultural innovations indicate that new technologies may face public scrutiny and suspicion, limiting the dissemination of the innovation. Using systems thinking approaches can help to improve the development and dissemination of agricultural innovations and limit the unintended consequences of innovations within society. (2) To analyze the current discourse surrounding AI in agriculture, a content analysis was conducted on Twitter using Meltwater to select tweets with specific reach and engagement. (3) Seven themes resulted from the analysis: precision agriculture and digital technology innovation; transformation and the future of agriculture; accelerate solutions, solve challenges; data management and accessibility; transforming crop management, prioritizing adoption; and AI and sustainability. (4) The discourse on AI in agriculture on Twitter was overwhelmingly positive, failing to account for the potential drawbacks or limits of the innovation. This paper examines the limits of the current communication and outreach across environmental, economic, social, cultural, political, and behavioral contexts.

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“…They are somewhat impossible for stakeholders to control, and instead, proponents are encouraged to be agile, working with the system and adapting their approach accordingly -what Donella Meadows refers to as "dancing with systems" (11). However, whilst the implementation of systems approaches has gained traction, the methods and mechanisms to study them are limited (4,5,7,(12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Ripple Effects Mapping: Capturing the Wider Impacts of Systems Change Efforts in Public Health

Nobles¹,

Wheeler²,

Dunleavy-Harris³

et al. 2021

Preprint

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Background: Systems approaches are currently being advocated and implemented to address complex challenges in Public Health. These approaches work by bringing multi-sectoral stakeholders together to develop a collective understanding of the system, and then to identify places where they can leverage change across the system. Systems approaches are unpredictable, where cause-and-effect cannot always be disentangled, and unintended consequences – positive and negative – frequently arise. Evaluating such approaches is difficult and new methods are warranted. Methods: Ripple Effects Mapping (REM) is a qualitative method which can capture the wider impacts, and adaptive nature, of a systems approach. Using a case study example from the evaluation of a physical activity systems approach in Gloucestershire, we: a) introduce the adapted REM method; b) describe how REM was applied in the example; c) explain how REM outputs were analysed; d) provide examples of how REM outputs were used; and e) describe the strengths, limitations, and future uses of REM based on our reflections. Results: Ripple Effects Mapping is a participatory method that requires the active input of programme stakeholders in data gathering workshops. It produces visual outputs (i.e., maps) of the programmes activities and impacts, which are mapped along a timeline to understand the temporal dimension of systems change efforts. The REM outputs from our example were created over several iterations, with data collected every 3-4 months, to build a picture of activities and impacts that have continued or ceased. Workshops took place both in person and online. An inductive content analysis was undertaken to describe and quantify the patterns within the REM outputs. Detailed guidance related to the preparation, delivery, and analysis of REM are included in this paper. Conclusion: REM may help to advance our understanding and evaluation of complex systems approaches, especially within the field of Public Health. We therefore invite other researchers, practitioners and policymakers to use REM and to continuously evolve the method to enhance its application and practical utility.

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Can We Build an Evidence Base on the Impact of Systems Thinking for Wicked Problems? Comment on "What Can Policy-Makers Get Out of Systems Thinking? Policy Partners’ Experiences of a Systems-Focused Research Collaboration in Preventive Health"

Cited by 11 publications

References 12 publications

A secondary analysis of the childhood obesity prevention Cochrane Review through a wider determinants of health lens: implications for research funders, researchers, policymakers and practitioners

A secondary analysis of the childhood obesity prevention Cochrane Review through a wider determinants of health lens: implications for research funders, researchers, policymakers and practitioners

Exploring Twitter Discourse around the Use of Artificial Intelligence to Advance Agricultural Sustainability

Ripple Effects Mapping: Capturing the Wider Impacts of Systems Change Efforts in Public Health

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