Developing a whole systems action plan promoting Dutch adolescents’ sleep health
Abstract Background Inadequate sleep health is a public health problem among Dutch adolescents with detrimental effects on their physical and mental well-being. System approaches are increasingly being used to understand and address public health problems. Therefore, a recent study created a compreh...
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| Format: | Article |
| Language: | English |
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BMC
2025-03-01
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| Series: | International Journal of Behavioral Nutrition and Physical Activity |
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| Online Access: | https://doi.org/10.1186/s12966-025-01711-0 |
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| author | Danique M. Heemskerk Maartje M. van Stralen Jessica T. Piotrowski Carry M. Renders Vincent Busch |
| author_facet | Danique M. Heemskerk Maartje M. van Stralen Jessica T. Piotrowski Carry M. Renders Vincent Busch |
| author_sort | Danique M. Heemskerk |
| collection | DOAJ |
| description | Abstract Background Inadequate sleep health is a public health problem among Dutch adolescents with detrimental effects on their physical and mental well-being. System approaches are increasingly being used to understand and address public health problems. Therefore, a recent study created a comprehensive Causal Loop Diagram (CLD) that integrated all relevant determinants of adolescent sleep health, underlying system dynamics and potential leverage points. Building on that, the current study aims to design a ‘whole systems action plan’ to promote sleep health of Dutch adolescents, combining systems science with a participatory approach. Methods Five (multi)stakeholder sessions with adolescents (N = 40, 12–15 years), parents (N = 14) and professionals (N = 13) were organized to co-create actions addressing preselected leverage points derived from the previously mapped CLD. Subsequently, three sessions with multidisciplinary representatives of regional and national oriented (health) organizations (N = 27) were held using the World Café Methodology to identify intervention actions as well as potential implementers. The Action Scales Model (ASM), a tool to understand and change the system at different levels (i.e., event, structure, goal, belief) of the system, was used to create a coherent whole systems action plan. Results The created whole systems action plan consisted of 66 (sets of) actions across different ASM levels (i.e., event, structure, goal, belief) targeting 42 leverage points across five subsystems: school environment N = 24; mental wellbeing N = 17; digital environment N = 9; family & home environment N = 9; personal system N = 7. Per action potential implementers were identified, which included amongst others schools and public health services. The previously mapped CLD visualizing system dynamics shaping adolescent sleep health were supplemented with how dynamics can be changed via the actions identified. Conclusions The resulting whole systems action plan provides a subsequent step in applying a whole systems approach to understand and promote adolescent sleep health. Combining a systems approach, using the ASM, and a co-creation approach was found to be mutually reinforcing and helpful in developing a comprehensive action plan. This action plan can guide strategic planning and implementation of actions that promote systemic change. With this, it is important to ensure coherence between actions being developed and implemented to increase the potential for lasting systems change. |
| format | Article |
| id | doaj-art-3f9a081ebc074da28d1b83b0b28b8d2e |
| institution | DOAJ |
| issn | 1479-5868 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Behavioral Nutrition and Physical Activity |
| spelling | doaj-art-3f9a081ebc074da28d1b83b0b28b8d2e2025-08-20T02:41:35ZengBMCInternational Journal of Behavioral Nutrition and Physical Activity1479-58682025-03-0122114510.1186/s12966-025-01711-0Developing a whole systems action plan promoting Dutch adolescents’ sleep healthDanique M. Heemskerk0Maartje M. van Stralen1Jessica T. Piotrowski2Carry M. Renders3Vincent Busch4Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit AmsterdamDepartment of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit AmsterdamAmsterdam School of Communication Research ASCoR, University of AmsterdamDepartment of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit AmsterdamDepartment of Healthy Living, Public Health Service (GGD), Sarphati AmsterdamAbstract Background Inadequate sleep health is a public health problem among Dutch adolescents with detrimental effects on their physical and mental well-being. System approaches are increasingly being used to understand and address public health problems. Therefore, a recent study created a comprehensive Causal Loop Diagram (CLD) that integrated all relevant determinants of adolescent sleep health, underlying system dynamics and potential leverage points. Building on that, the current study aims to design a ‘whole systems action plan’ to promote sleep health of Dutch adolescents, combining systems science with a participatory approach. Methods Five (multi)stakeholder sessions with adolescents (N = 40, 12–15 years), parents (N = 14) and professionals (N = 13) were organized to co-create actions addressing preselected leverage points derived from the previously mapped CLD. Subsequently, three sessions with multidisciplinary representatives of regional and national oriented (health) organizations (N = 27) were held using the World Café Methodology to identify intervention actions as well as potential implementers. The Action Scales Model (ASM), a tool to understand and change the system at different levels (i.e., event, structure, goal, belief) of the system, was used to create a coherent whole systems action plan. Results The created whole systems action plan consisted of 66 (sets of) actions across different ASM levels (i.e., event, structure, goal, belief) targeting 42 leverage points across five subsystems: school environment N = 24; mental wellbeing N = 17; digital environment N = 9; family & home environment N = 9; personal system N = 7. Per action potential implementers were identified, which included amongst others schools and public health services. The previously mapped CLD visualizing system dynamics shaping adolescent sleep health were supplemented with how dynamics can be changed via the actions identified. Conclusions The resulting whole systems action plan provides a subsequent step in applying a whole systems approach to understand and promote adolescent sleep health. Combining a systems approach, using the ASM, and a co-creation approach was found to be mutually reinforcing and helpful in developing a comprehensive action plan. This action plan can guide strategic planning and implementation of actions that promote systemic change. With this, it is important to ensure coherence between actions being developed and implemented to increase the potential for lasting systems change.https://doi.org/10.1186/s12966-025-01711-0AdolescentAction scales modelCausal loop diagramComplex systemsSleepSystem approach |
| spellingShingle | Danique M. Heemskerk Maartje M. van Stralen Jessica T. Piotrowski Carry M. Renders Vincent Busch Developing a whole systems action plan promoting Dutch adolescents’ sleep health International Journal of Behavioral Nutrition and Physical Activity Adolescent Action scales model Causal loop diagram Complex systems Sleep System approach |
| title | Developing a whole systems action plan promoting Dutch adolescents’ sleep health |
| title_full | Developing a whole systems action plan promoting Dutch adolescents’ sleep health |
| title_fullStr | Developing a whole systems action plan promoting Dutch adolescents’ sleep health |
| title_full_unstemmed | Developing a whole systems action plan promoting Dutch adolescents’ sleep health |
| title_short | Developing a whole systems action plan promoting Dutch adolescents’ sleep health |
| title_sort | developing a whole systems action plan promoting dutch adolescents sleep health |
| topic | Adolescent Action scales model Causal loop diagram Complex systems Sleep System approach |
| url | https://doi.org/10.1186/s12966-025-01711-0 |
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