Chair Group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University, Wageningen, 6706 KN, The Netherlands.
Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Health Res Policy Syst. 2024 Aug 12;22(1):101. doi: 10.1186/s12961-024-01199-3.
Current local food environments encourage poor diets, posing a significant threat to public and planetary health. Acknowledging and addressing its inherent complexity is vital to making meaningful improvements to the food environment. Using a participatory approach with local stakeholders, this study aims to gain insight into the factors and mechanisms underlying the local food environment and to identify leverage points and system-based actions to foster healthy and sustainable local food environments.
A systems-thinking approach was used in a Dutch municipality in 2022. Two group model building (GMB) workshops were held with community stakeholders (e.g. local policymakers, retailers and residents). During the first workshop (June 2022), factors and mechanisms influencing the local food environment were identified and visualized through a causal loop diagram (CLD). During the second workshop, leverage points and system-based actions to improve food environments were identified by the stakeholders. Four months after (October 2022), an action-implementation meeting was organized to stimulate the implementation of selected actions. Progress was monitored through brief telephone interviews 6 and 12 months after the second workshop.
The CLD visualises the factors and mechanisms influencing the local food environment from the point of view of the community stakeholders. The CLD consists of 46 factors shaping the local food environment, which were categorized into four identified subsystems: societal factors, individual, socio-economic factors, commercial factors and political factors. Eight leverage points were identified within the CLD, for example, 'lobby from food industry', 'governmental food policies' and 'e-commerce and platform economy'. Stakeholders formulated 20 actions targeting the identified leverage points. During the action-implementation meeting, long-term plans were created for five actions. After 1 year, only one participant (policy advisory role) remained actively engaged in three of these actions.
This study yields insight into the numerous factors and mechanisms underlying the local food environment and identified system-based actions as perceived by local stakeholders to improve this food environment locally. The CLD offers stakeholders valuable insights on employing a systems approach when enhancing food environments. More research is necessary, especially into the long-term processes and effects of implementing system-oriented actions to improve local food environments.
当前的本地食品环境鼓励不良饮食，对公众和地球健康构成重大威胁。承认并解决其内在复杂性对于改善食品环境至关重要。本研究采用与当地利益相关者合作的参与式方法，旨在深入了解本地食品环境背后的因素和机制，并确定促进健康和可持续本地食品环境的杠杆点和系统行动。
2022 年，在荷兰的一个市采用了系统思维方法。与社区利益相关者（如当地政策制定者、零售商和居民）举行了两次小组模型构建（GMB）研讨会。在第一次研讨会（2022 年 6 月）期间，通过因果循环图（CLD）确定并可视化了影响本地食品环境的因素和机制。在第二次研讨会期间，利益相关者确定了改善食品环境的杠杆点和系统行动。四个月后（2022 年 10 月），组织了一次行动实施会议，以促进选定行动的实施。通过第二次研讨会后 6 个月和 12 个月的简短电话访谈监测进展情况。
CLD 从社区利益相关者的角度可视化了影响本地食品环境的因素和机制。CLD 由 46 个影响本地食品环境的因素组成，这些因素分为四个已确定的子系统：社会因素、个人、社会经济因素、商业因素和政治因素。在 CLD 中确定了 8 个杠杆点，例如“游说食品行业”、“政府食品政策”和“电子商务和平台经济”。利益相关者针对确定的杠杆点制定了 20 项行动。在行动实施会议期间，为五项行动制定了长期计划。一年后，只有一名参与者（政策顾问角色）仍然积极参与其中三项行动。
本研究深入了解了本地食品环境背后的众多因素和机制，并确定了当地利益相关者认为可以改善该食品环境的系统行动。CLD 为利益相关者提供了在增强食品环境时采用系统方法的宝贵见解。需要进一步研究，特别是关于实施面向系统的行动以改善本地食品环境的长期过程和影响。
