Brennan Laura K, Sabounchi Nasim S, Kemner Allison L, Hovmand Peter
Transtria LLC, St Louis, Missouri (Dr Brennan and Ms Kemner); and Social Systems Design Lab, Brown School of Social Work and Public Health, Washington University in St Louis, St Louis, Missouri (Drs Sabounchi and Hovmand).
J Public Health Manag Pract. 2015 May-Jun;21 Suppl 3:S55-69. doi: 10.1097/PHH.0000000000000248.
Community partnerships to promote healthy eating and active living in order to prevent childhood obesity face a number of challenges. Systems science tools combined with group model-building techniques offer promising methods that use transdisciplinary team-based approaches to improve understanding of the complexity of the obesity epidemic. This article presents evaluation methods and findings from 49 Healthy Kids, Healthy Communities sites funded to implement policy, system, and environmental changes from 2008 to 2014.
Through half-day group model-building sessions conducted as part of evaluation site visits to each community between 2010 and 2013, a total of 50 causal loop diagrams were produced for 49 communities (1 community had 2 causal loop diagrams representing different geographic regions). The analysis focused on the following evaluation questions: (1) What were the most prominent variables in the causal loop diagrams across communities? (2) What were the major feedback structures across communities? (3) What implications from the synthesized causal loop diagram can be translated to policy makers, practitioners, evaluators, funders, and other community representatives?
A total of 590 individuals participated with an average of 12 participants per session. Participants' causal loop diagrams included a total of 227 unique variables in the following major subsystems: healthy eating policies and environments, active living policies and environments, health and health behaviors, partnership and community capacity, and social determinants. In a synthesized causal loop diagram representing variables identified by at least 20% of the communities, many feedback structures emerged and several themes are highlighted with respect to implications for policy and practice as well as assessment and evaluation.
The application of systems thinking tools combined with group model-building techniques creates opportunities to define and characterize complex systems in a manner that draws on the authentic voice of residents and community partners.
旨在促进健康饮食和积极生活方式以预防儿童肥胖的社区伙伴关系面临诸多挑战。系统科学工具与群体模型构建技术相结合，提供了有前景的方法，这些方法采用跨学科团队方法来增进对肥胖流行复杂性的理解。本文介绍了对2008年至2014年期间获得资助以实施政策、系统和环境变革的49个“健康儿童，健康社区”项目点的评估方法和结果。
在2010年至2013年期间对每个社区进行评估实地考察时，通过半天的群体模型构建会议，共为49个社区绘制了50个因果循环图（1个社区有2个因果循环图，分别代表不同地理区域）。分析聚焦于以下评估问题：（1）各社区因果循环图中最突出的变量是什么？（2）各社区的主要反馈结构是什么？（3）综合因果循环图能为政策制定者、从业者、评估者、资助者和其他社区代表带来哪些启示？
共有590人参与，平均每次会议有12名参与者。参与者的因果循环图在以下主要子系统中总共包含227个独特变量：健康饮食政策与环境、积极生活政策与环境、健康与健康行为、伙伴关系与社区能力以及社会决定因素。在一个综合因果循环图中，该图展示了至少20%的社区所确定的变量，出现了许多反馈结构，并突出了几个关于政策与实践以及评估与评价启示的主题。
系统思维工具与群体模型构建技术的应用创造了机会，以一种借鉴居民和社区伙伴真实声音的方式来定义和描述复杂系统。
