Cockrell Skinner Asheley, Foster E Michael
Department of Pediatrics, The University of North Carolina at Chapel Hill, CB 7225, Chapel Hill, NC 27599, USA.
J Obes. 2013;2013:129193. doi: 10.1155/2013/129193. Epub 2013 Apr 23.
As a public health problem, childhood obesity operates at multiple levels, ranging from individual health behaviors to school and community characteristics to public policies. Examining obesity, particularly childhood obesity, from any single perspective is likely to fail, and systems science methods offer a possible solution. We systematically reviewed studies that examined the causes and/or consequences of obesity from a systems science perspective. The 21 included studies addressed four general areas of systems science in obesity: (1) translating interventions to a large scale, (2) the effect of obesity on other health or economic outcomes, (3) the effect of geography on obesity, and (4) the effect of social networks on obesity. In general, little research addresses obesity from a true, integrated systems science perspective, and the available research infrequently focuses on children. This shortcoming limits the ability of that research to inform public policy. However, we believe that the largely incremental approaches used in current systems science lay a foundation for future work and present a model demonstrating the system of childhood obesity. Systems science perspective and related methods are particularly promising in understanding the link between childhood obesity and adult outcomes. Systems models emphasize the evolution of agents and their interactions; such evolution is particularly salient in the context of a developing child.
作为一个公共卫生问题，儿童肥胖在多个层面上存在，从个人健康行为到学校和社区特征，再到公共政策。仅从任何单一角度审视肥胖，尤其是儿童肥胖，都可能会失败，而系统科学方法提供了一种可能的解决方案。我们系统地回顾了从系统科学角度研究肥胖成因和/或后果的研究。纳入的21项研究涉及肥胖领域系统科学的四个一般领域：（1）将干预措施大规模推广，（2）肥胖对其他健康或经济结果的影响，（3）地理因素对肥胖的影响，以及（4）社交网络对肥胖的影响。总体而言，很少有研究从真正的、综合的系统科学角度探讨肥胖问题，现有研究也很少关注儿童。这一缺陷限制了该研究为公共政策提供信息的能力。然而，我们认为当前系统科学中大量采用的渐进式方法为未来的工作奠定了基础，并展示了一个儿童肥胖系统模型。系统科学视角及相关方法在理解儿童肥胖与成人健康结果之间的联系方面尤其具有前景。系统模型强调主体及其相互作用的演变；这种演变在儿童成长的背景下尤为显著。
