Systems approaches in public health: beyond mapping the causes
Abstract Background Systems approaches are increasingly adopted in public health, commonly operationalised using system dynamics (SD). In public health, systems approaches have prioritised understanding the current system by describing the causes of a complex problem – e.g. obesity – as a system. It...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-06-01
|
| Series: | International Journal of Behavioral Nutrition and Physical Activity |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12966-025-01766-z |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850102242269462528 |
|---|---|
| author | Loes Crielaard Mary Nicolaou Andrew D. Brown S. Coosje Dijkstra Fleur ter Ellen Leonie K. Elsenburg Angie Luna Pinzon Wilma E. Waterlander Karien Stronks |
| author_facet | Loes Crielaard Mary Nicolaou Andrew D. Brown S. Coosje Dijkstra Fleur ter Ellen Leonie K. Elsenburg Angie Luna Pinzon Wilma E. Waterlander Karien Stronks |
| author_sort | Loes Crielaard |
| collection | DOAJ |
| description | Abstract Background Systems approaches are increasingly adopted in public health, commonly operationalised using system dynamics (SD). In public health, systems approaches have prioritised understanding the current system by describing the causes of a complex problem – e.g. obesity – as a system. It remains challenging to advance from understanding the current system producing undesired outcomes, towards responses to improve outcomes. Rather than creating models of the (entire) system, SD traditionally emphasises specific models to support policy development. While core concepts from SD have effectively been adopted in public health, there may be more to learn from SD when it comes to designing systems approaches that can fulfil the purpose of informing problem responses. Methods We reviewed seminal SD literature for clues on how to refine the focus of systems approaches, so that they lead to specific models supporting policy development. We conducted a narrative review, seeking a strategy that can be leveraged in systems approaches in public health. We concentrated on SD’s problem framing strategy, leading to two insights. Results Insight 1: Alongside the complex problem at stake (e.g. obesity), consider the intended result of the systems approach (coordination, learning, analysis or transformation). This helps recognise which system components are relevant to problem responses and make methodological decisions accordingly. Insight 2: If investigation of the current system reveals that only radical change can lead to improved outcomes, then proceed to envisioning how the system could be fundamentally transformed to support those desired outcomes. This next step helps to anticipate policy resistance, unintended consequences and counterintuitive behaviour by contemplating how the system would react due to proposed problem responses. Conclusions Applying a problem framing strategy, as is commonly done in SD, could make systems approaches in public health better positioned to inform problem responses. Problem framing stimulates the contribution of systems approaches to health policy, prioritising system components relevant to problem responses (Insight 1), which may not be part of the system (Insight 2). |
| format | Article |
| id | doaj-art-df1266e366864ab4a00e5dc47f37f475 |
| institution | DOAJ |
| issn | 1479-5868 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Behavioral Nutrition and Physical Activity |
| spelling | doaj-art-df1266e366864ab4a00e5dc47f37f4752025-08-20T02:39:48ZengBMCInternational Journal of Behavioral Nutrition and Physical Activity1479-58682025-06-0122111410.1186/s12966-025-01766-zSystems approaches in public health: beyond mapping the causesLoes Crielaard0Mary Nicolaou1Andrew D. Brown2S. Coosje Dijkstra3Fleur ter Ellen4Leonie K. Elsenburg5Angie Luna Pinzon6Wilma E. Waterlander7Karien Stronks8Amsterdam UMC, Department Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research InstituteAmsterdam UMC, Department Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research InstituteFaculty of Health, Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin UniversityAmsterdam UMC, Department Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research InstituteDepartment of Public Health, Erasmus MC, University Medical CenterAmsterdam UMC, Department Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research InstituteAmsterdam UMC, Department Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research InstituteAmsterdam UMC, Department Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research InstituteAmsterdam UMC, Department Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research InstituteAbstract Background Systems approaches are increasingly adopted in public health, commonly operationalised using system dynamics (SD). In public health, systems approaches have prioritised understanding the current system by describing the causes of a complex problem – e.g. obesity – as a system. It remains challenging to advance from understanding the current system producing undesired outcomes, towards responses to improve outcomes. Rather than creating models of the (entire) system, SD traditionally emphasises specific models to support policy development. While core concepts from SD have effectively been adopted in public health, there may be more to learn from SD when it comes to designing systems approaches that can fulfil the purpose of informing problem responses. Methods We reviewed seminal SD literature for clues on how to refine the focus of systems approaches, so that they lead to specific models supporting policy development. We conducted a narrative review, seeking a strategy that can be leveraged in systems approaches in public health. We concentrated on SD’s problem framing strategy, leading to two insights. Results Insight 1: Alongside the complex problem at stake (e.g. obesity), consider the intended result of the systems approach (coordination, learning, analysis or transformation). This helps recognise which system components are relevant to problem responses and make methodological decisions accordingly. Insight 2: If investigation of the current system reveals that only radical change can lead to improved outcomes, then proceed to envisioning how the system could be fundamentally transformed to support those desired outcomes. This next step helps to anticipate policy resistance, unintended consequences and counterintuitive behaviour by contemplating how the system would react due to proposed problem responses. Conclusions Applying a problem framing strategy, as is commonly done in SD, could make systems approaches in public health better positioned to inform problem responses. Problem framing stimulates the contribution of systems approaches to health policy, prioritising system components relevant to problem responses (Insight 1), which may not be part of the system (Insight 2).https://doi.org/10.1186/s12966-025-01766-zSystems scienceSystems thinkingSystem dynamicsCausal loop diagramsProblem framingResearch question |
| spellingShingle | Loes Crielaard Mary Nicolaou Andrew D. Brown S. Coosje Dijkstra Fleur ter Ellen Leonie K. Elsenburg Angie Luna Pinzon Wilma E. Waterlander Karien Stronks Systems approaches in public health: beyond mapping the causes International Journal of Behavioral Nutrition and Physical Activity Systems science Systems thinking System dynamics Causal loop diagrams Problem framing Research question |
| title | Systems approaches in public health: beyond mapping the causes |
| title_full | Systems approaches in public health: beyond mapping the causes |
| title_fullStr | Systems approaches in public health: beyond mapping the causes |
| title_full_unstemmed | Systems approaches in public health: beyond mapping the causes |
| title_short | Systems approaches in public health: beyond mapping the causes |
| title_sort | systems approaches in public health beyond mapping the causes |
| topic | Systems science Systems thinking System dynamics Causal loop diagrams Problem framing Research question |
| url | https://doi.org/10.1186/s12966-025-01766-z |
| work_keys_str_mv | AT loescrielaard systemsapproachesinpublichealthbeyondmappingthecauses AT marynicolaou systemsapproachesinpublichealthbeyondmappingthecauses AT andrewdbrown systemsapproachesinpublichealthbeyondmappingthecauses AT scoosjedijkstra systemsapproachesinpublichealthbeyondmappingthecauses AT fleurterellen systemsapproachesinpublichealthbeyondmappingthecauses AT leoniekelsenburg systemsapproachesinpublichealthbeyondmappingthecauses AT angielunapinzon systemsapproachesinpublichealthbeyondmappingthecauses AT wilmaewaterlander systemsapproachesinpublichealthbeyondmappingthecauses AT karienstronks systemsapproachesinpublichealthbeyondmappingthecauses |