Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081HV, Amsterdam, The Netherlands.
Int J Behav Nutr Phys Act. 2022 Mar 28;19(1):33. doi: 10.1186/s12966-022-01267-3.
Systems thinking embraces the complexity of public health problems, including childhood overweight and obesity. It aids in understanding how factors are interrelated, and it can be targeted to produce favourable changes in a system. There is a growing call for systems approaches in public health research, yet limited practical guidance is available on how to evaluate public health programmes within complex adaptive systems. The aim of this paper is to present an evaluation framework that supports researchers in designing systems evaluations in a comprehensive and practical way.
We searched the literature for existing public health systems evaluation studies. Key characteristics on how to conduct a systems evaluation were extracted and compared across studies. Next, we overlaid the identified characteristics to the context of the Lifestyle Innovations Based on Youth Knowledge and Experience (LIKE) programme evaluation and analyzed which characteristics were essential to carry out the LIKE evaluation. This resulted in the Evaluation of Programmes in Complex Adaptive Systems (ENCOMPASS) framework.
The ENCOMPASS framework includes five iterative stages: (1) adopting a system dynamics perspective on the overall evaluation design; (2) defining the system boundaries; (3) understanding the pre-existing system to inform system changes; (4) monitoring dynamic programme output at different system levels; and (5) measuring programme outcome and impact in terms of system changes.
The value of ENCOMPASS lies in the integration of key characteristics from existing systems evaluation studies, as well as in its practical, applied focus. It can be employed in evaluating public health programmes in complex adaptive systems. Furthermore, ENCOMPASS provides guidance for the entire evaluation process, all the way from understanding the system to developing actions to change it and to measuring system changes. By the nature of systems thinking, the ENCOMPASS framework will likely evolve further over time, as the field expands with more completed studies.
系统思维涵盖了公共卫生问题的复杂性，包括儿童超重和肥胖问题。它有助于理解因素是如何相互关联的，并且可以针对系统产生有利的变化。人们越来越呼吁在公共卫生研究中采用系统方法，但对于如何在复杂适应系统中评估公共卫生计划，可用的实践指导有限。本文旨在提出一个评估框架，以支持研究人员以全面和实用的方式设计系统评估。
我们在文献中搜索了现有的公共卫生系统评估研究。提取了关于如何进行系统评估的关键特征，并在研究之间进行了比较。接下来，我们将确定的特征与基于青年知识和经验的生活方式创新（LIKE）计划评估的背景进行叠加，并分析执行 LIKE 评估所需的特征。这导致了评估复杂适应系统中的计划（ENCOMPASS）框架。
ENCOMPASS 框架包括五个迭代阶段：（1）对整体评估设计采用系统动力学观点；（2）定义系统边界；（3）了解预先存在的系统以告知系统变化；（4）在不同系统级别监测动态计划输出；（5）根据系统变化衡量计划结果和影响。
ENCOMPASS 的价值在于整合现有系统评估研究的关键特征，以及其注重实际应用。它可用于评估复杂适应系统中的公共卫生计划。此外，ENCOMPASS 为整个评估过程提供了指导，从了解系统到制定改变系统的行动，再到衡量系统变化。由于系统思维的性质，随着该领域随着更多已完成研究的扩展，ENCOMPASS 框架可能会随着时间的推移进一步发展。
