Integrating Complex Systems Methods to Advance Obesity Prevention Intervention Research

Abstract

Background. Whole-of-community interventions have been recommended and show promise for preventing obesity; however, research to understand the mechanisms underlying their success or failure is lacking. Complex systems approaches may be useful to address this gap. Purpose. To describe the evolution and utilization of qualitative and quantitative complex systems methods to understand and model whole-of-community obesity prevention interventions. Approach. We illustrate the retrospective qualitative development of a systems map representing community change dynamic within the Shape Up Somerville (SUS) intervention. We then describe how this systems map, and complementary work of other successful obesity prevention interventions (Romp & Chomp intervention), informed the COMPACT (childhood obesity modeling for prevention and community transformation) study. COMPACT’s design aligns complex systems science principles and community-engaged research to better understand stakeholders’ leadership roles in whole-of-community interventions. We provide an overview of the complex systems tools used in COMPACT: agent-based modeling, group model building, and social network analysis and describe how whole-of-community intervention stakeholders (“agents”) use their social networks to diffuse knowledge about and engagement with childhood obesity prevention efforts, laying the groundwork for community readiness for sustainable change. Conclusion. Complex systems approaches appear feasible and useful to study whole-of-community obesity prevention interventions and provide novel insights that expand on those gained from traditional approaches. Use of multiple methods, both qualitative and quantitative, from the complex systems toolkit working together can be important to success.

A System Dynamics and Participatory Action Research Approach to Promote Healthy Living and a Healthy Weight among 10–14-Year-Old Adolescents in Amsterdam: The LIKE Programme

“…To the best of our knowledge, there are only a few studies that aimed to evaluate how the system that shapes individual behaviours changes under influence of intervention programmes [61]. Recent work by Public Health England has shown how whole-of-systems approaches to obesity can be effective to help communities think in systems, but has not yet been able to examine how this way of working impacts on the local system of obesity causes [62].…”

“…Recent work by Public Health England has shown how whole-of-systems approaches to obesity can be effective to help communities think in systems, but has not yet been able to examine how this way of working impacts on the local system of obesity causes [62]. Hennessy et al developed retrospective systems maps representing community change dynamics within the Shape Up Somerville (SUS) intervention [61]. We propose to prospectively measure systems changes by conceptually linking the pre-existing systems maps with the developed actions and tracking changes over time in different levels of the system elements, system structures and/or the system as a whole, similar to that proposed by Egan et al [56].…”

An action‐oriented framework for systems‐based solutions aimed at childhood obesity prevention in US Latinx and Latin American populations

“…These diagrams are useful for eliciting and capturing mental models of individuals or teams and facilitating knowledge sharing 13 . For instance, the Shape‐Up Somerville project used causal loop diagrams to map the factors and feedback structures that could impact the success of its whole‐of‐community childhood obesity prevention intervention, identifying factors in eight subsystems or domains (individual, family, school, built environment, food environment, community, Shape Up Somerville Task Force, and media), illustrating the interplay with and between subsystems and how they come together as a whole system 9 …”

“…13 For instance, the Shape-Up Somerville project used causal loop diagrams to map the factors and feedback structures that could impact the success of its wholeof-community childhood obesity prevention intervention, identifying factors in eight subsystems or domains (individual, family, school, built environment, food environment, community, Shape Up Somerville Task Force, and media), illustrating the interplay with and between subsystems and how they come together as a whole system. 9 It is important to acknowledge that knowledge about the system's form and function and the potential drivers of the levels of childhood obesity is distributed among the actors contained in the system. This underscores the critical need to engage a broad range of stakeholders relevant to the problem and mobilize their viewpoints and knowledge to achieve a better understanding of the system as a whole.…”

Dietary Policies and Programs: Moving Beyond Efficacy and Into “Real-World” Settings

“…In the second example, the research team described Shape Up Under 5, a 2-year early childhood obesity prevention pilot study, 55,56 again borne out of a rich and longstanding partnership between stakeholders in the town of Somerville, MA, and academic researchers (Shape Up Somerville 2003-05). 57 The team developed the Stakeholder-driven Community Diffusion conceptual framework, which combined community-engaged research with concepts of systems science (i.e., agentbased modeling, group model building, and social networks analysis) woven throughout with a goal of identifying and implementing a community-driven approach toward reducing childhood obesity.…”