Moore Travis R, Hennessy Erin, Chusan Yuilyn Chang, Ashcraft Laura Ellen, Economos Christina D
ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States.
ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States.
Ann Epidemiol. 2025 Jan;101:42-51. doi: 10.1016/j.annepidem.2024.12.002. Epub 2024 Dec 15.
Effective chronic disease prevention requires a systems approach to the design, implementation, and refinement of interventions that account for the complexity and interdependence of factors influencing health outcomes. This paper proposes the Participatory Implementation Systems Mapping (PISM) process, which combines participatory systems modeling with implementation strategy development to enhance intervention design and implementation planning. PISM leverages the collaborative efforts of researchers and community partners to analyze complex health systems, identify key determinants, and develop tailored interventions and strategies that are both adaptive and contextually relevant. The phases of the PISM process include strategize, innovate, operationalize, and assess. We describe and demonstrate how each phase contributes to the overall goal of effective and sustainable intervention implementation. We also address the challenges of data availability, model complexity, and resource constraints. We offer solutions such as innovative data collection methods and participatory model development to enhance the robustness and applicability of systems models. Through a case study on the development of a chronic disease prevention intervention, the paper illustrates the practical application of PISM and highlights its potential to guide epidemiologists and implementation scientists in developing interventions that are responsive to the complexities of real-world health systems. The conclusion calls for further research to refine participatory systems modeling techniques, overcome existing challenges in data availability, and expand the use of PISM in diverse public health contexts.
有效的慢性病预防需要一种系统方法来设计、实施和完善干预措施，这些干预措施要考虑到影响健康结果的因素的复杂性和相互依赖性。本文提出了参与式实施系统映射（PISM）过程，该过程将参与式系统建模与实施策略开发相结合，以加强干预措施设计和实施规划。PISM利用研究人员和社区伙伴的协作努力，分析复杂的卫生系统，确定关键决定因素，并制定既具有适应性又与具体情况相关的量身定制的干预措施和策略。PISM过程的阶段包括制定战略、创新、实施和评估。我们描述并展示了每个阶段如何有助于实现有效和可持续干预措施实施的总体目标。我们还讨论了数据可用性、模型复杂性和资源限制等挑战。我们提供了诸如创新数据收集方法和参与式模型开发等解决方案，以增强系统模型的稳健性和适用性。通过一项关于慢性病预防干预措施开发的案例研究，本文阐述了PISM的实际应用，并突出了其在指导流行病学家和实施科学家制定应对现实世界卫生系统复杂性的干预措施方面的潜力。结论呼吁进一步开展研究，以完善参与式系统建模技术，克服数据可用性方面的现有挑战，并扩大PISM在各种公共卫生背景下的应用。
