Savona Natalie, Macauley Talia, Aguiar Anaely, Banik Anna, Boberska Monika, Brock Jessica, Brown Andrew, Hayward Joshua, Holbæk Helene, Rito Ana Isabel, Mendes Sofia, Vaaheim Fredrik, van Houten Marloes, Veltkamp Gerlieke, Allender Steven, Rutter Harry, Knai Cecile
Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Department of Geography, System Dynamics Group, University of Bergen, Bergen, Norway.
Eur J Public Health. 2021 Apr 24;31(2):391-396. doi: 10.1093/eurpub/ckaa251.
To make effective progress towards a global reduction in obesity prevalence, there needs to be a focus on broader structural factors, beyond individual-level drivers of diet and physical activity. This article describes the use of a systems framework to develop obesity prevention policies with adolescents. The aim of this research was to use the group model building (GMB) method to identify young people's perceptions of the drivers of adolescent obesity in five European countries, as part of the EU-funded Co-Create project.
We used GMB with four groups of 16-18-year-olds in schools in each of the five European countries (The Netherlands, Norway, Poland, Portugal and the UK) to create causal loop diagrams (CLDs) representing their perceptions of the drivers of adolescent obesity. The maps were then merged into one, using a new protocol.
Two hundred and fifty-seven participants, aged 16-18 years, engaged in 20 separate system mapping groups, each of which generated 1 CLD. The findings were largely congruent between the countries. Three feedback loops in the merged diagram particularly stand out: commercial drivers of unhealthy diets; mental health and unhealthy diets; social media use, body image and motivation to exercise.
GMB provides a novel way of eliciting from young people the system-based drivers of obesity that are relevant to them. Mental health issues, social media use and commercial practices were considered by the young people to be key drivers of adolescent obesity, subjects that have thus far had little or no coverage in research and policy.
为在全球范围内有效降低肥胖率取得进展，需要关注更广泛的结构性因素，而非个人层面的饮食和身体活动驱动因素。本文描述了如何使用系统框架来制定针对青少年的肥胖预防政策。本研究的目的是作为欧盟资助的“共同创造”项目的一部分，使用群体模型构建（GMB）方法来确定五个欧洲国家年轻人对青少年肥胖驱动因素的看法。
我们在五个欧洲国家（荷兰、挪威、波兰、葡萄牙和英国）的学校中，对四组16 - 18岁的青少年使用GMB方法，以创建因果循环图（CLD）来表示他们对青少年肥胖驱动因素的看法。然后使用新协议将这些地图合并为一个。
257名年龄在16 - 18岁的参与者参与了20个独立的系统映射小组，每个小组生成1个CLD。各国的研究结果基本一致。合并图中的三个反馈回路尤为突出：不健康饮食的商业驱动因素；心理健康与不健康饮食；社交媒体使用、身体形象和锻炼动机。
GMB提供了一种从年轻人中引出与他们相关的基于系统的肥胖驱动因素的新颖方法。年轻人认为心理健康问题、社交媒体使用和商业行为是青少年肥胖的关键驱动因素，而这些主题在迄今为止的研究和政策中几乎没有涉及。
