University of Bristol, Bristol Medical School (Population Health Sciences), UK.
University of Bath, Institute for Policy Research, UK.
Health Place. 2023 May;81:103023. doi: 10.1016/j.healthplace.2023.103023. Epub 2023 Apr 18.
Tackling complex system challenges like creating healthy environments requires understanding priorities and structures affecting multiple actors. This qualitative study, involving 132 multi-sectoral stakeholders spanning the urban development decision-making system, explores how to influence healthier place-making. Using thematic analysis we develop themes around competing stakeholder priorities; structural 'rules' and influential relationships; and justifying a focus on health, requiring greater clarity and consensus around definitions of 'healthy' urban development. Building on the socio-ecological model we highlight how a multi-faceted approach is required for change at multiple levels in the complex system to target individual actor motivations, organisational priorities and structural 'rules'.
解决创建健康环境等复杂系统挑战需要了解影响多个行为者的优先事项和结构。这项涉及跨越城市发展决策系统的 132 个多部门利益相关者的定性研究探讨了如何影响更健康的场所营造。我们使用主题分析方法，围绕竞争的利益相关者优先事项、结构性“规则”和有影响力的关系以及为健康重点提供理由这三个主题展开，这需要在“健康”城市发展的定义方面有更大的清晰度和共识。我们借鉴社会生态模型，强调在复杂系统的多个层面上需要采取多方面的方法来针对个体行为者的动机、组织优先事项和结构性“规则”进行变革。
