Geboers Lisanne, Dijkstra Coosje, Rongen Frédérique C, Djojosoeparto Sanne K, Poelman Maartje P
Chair Group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, 6706 KN, The Netherlands.
Public and Occupational Health, Amsterdam UMC, location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, Netherlands.
BMC Med. 2025 May 13;23(1):279. doi: 10.1186/s12916-025-04088-w.
Motorway food environments are dominated by roadside restaurants and petrol station stores offering predominantly unhealthy quick-service meals and foods for on-the-go consumption. Improving these environments to promote healthier diets is necessary, but how to achieve this is not fully understood. Therefore, this study aims to identify the complex underlying systems dynamics contributing to the continued predominance of the unhealthy motorway food environment as well as to identify potential leverage points and corresponding actions for change to improve the healthiness of the motorway food environment.
Two Group Model Building workshops were held in October 2023 with motorway food environment stakeholders (e.g. food providers, producers, national policymakers, truck drivers). In the first workshop, a Causal Loop Diagram (CLD) was created to identify the system that contributes to the continued predominance of the unhealthy motorway food environment. The research team then identified leverage points for change based on the CLD. During the second workshop, stakeholders formulated actions to improve the motorway food environment for each identified leverage point. Leverage points and actions were classified based on the Action Scales Model (ASM).
The resulting CLD comprised six interconnected subsystems (food providers, supply chain collaboration, government, social culture, road users, global trends) with six reinforcing feedback loops, underlying the continued predominance of the unhealthy motorway food environment. Additionally, 14 potential leverage points and 31 corresponding actions for change were identified at different levels of the system based on the ASM (i.e. events, structures, goals and beliefs).
The findings show many interrelated factors and mechanisms underlying the continued predominance of the unhealthy motorway food environment. Actions for change were proposed together with stakeholders aimed at leverage points at different system levels. The results show that the motorway food environment is shaped by broader societal goals and beliefs (e.g. the profitability of unhealthy products) and social-cultural beliefs particularly evident to the on-the-go setting, including the motorway food environment. Together they present the strongest potential for leveraging systems change. There is a need for a coherent multidimensional action plan targeting these leverage points, which is broadly supported by various stakeholders, to induce systemic change.
高速公路沿线的食品环境以路边餐馆和加油站商店为主，主要提供不健康的快餐和即食食品。改善这些环境以促进更健康的饮食是必要的，但如何实现这一目标尚未完全明确。因此，本研究旨在确定导致不健康的高速公路食品环境持续占主导地位的复杂潜在系统动态，同时确定潜在的杠杆点以及相应的变革行动，以改善高速公路食品环境的健康状况。
2023年10月，与高速公路食品环境利益相关者（如食品供应商、生产商、国家政策制定者、卡车司机）举办了两场小组模型构建研讨会。在第一场研讨会中，绘制了因果循环图（CLD），以确定导致不健康的高速公路食品环境持续占主导地位的系统。然后，研究团队根据因果循环图确定了变革的杠杆点。在第二场研讨会中，利益相关者针对每个确定的杠杆点制定了改善高速公路食品环境的行动。杠杆点和行动根据行动量表模型（ASM）进行分类。
最终的因果循环图由六个相互关联的子系统（食品供应商、供应链协作、政府、社会文化、道路使用者、全球趋势）组成，包含六个增强反馈回路，这些构成了不健康的高速公路食品环境持续占主导地位的基础。此外，根据行动量表模型（即事件、结构、目标和信念），在系统的不同层面确定了14个潜在杠杆点和31个相应的变革行动。
研究结果表明，不健康的高速公路食品环境持续占主导地位背后存在许多相互关联的因素和机制。与利益相关者共同提出了针对不同系统层面杠杆点的变革行动。结果表明，高速公路食品环境受到更广泛的社会目标和信念（如不健康产品的盈利能力）以及社会文化信念的影响，在包括高速公路食品环境在内的即食场景中尤为明显。它们共同展现了推动系统变革的最大潜力。需要制定一个针对这些杠杆点的连贯多维度行动计划，并得到各利益相关者的广泛支持，以引发系统性变革。
