Research question: What are the impacts of policies on environments and systems?
Research team: Steve Allender (Stream 3 Lead), Andrew Brown, Kristy Bolton, Nick Crooks, Penny Fraser, Josh Hayward, Penny Love, Jenny Marks, Jamie McGlashan, Lynne Millar, Melanie Nichols, Claudia Strugnell, Jill Whelan
Institutions: Deakin University
Outputs
- Systems thinking in Community Knowledge Exchange: This stream has pioneered research in systems tools to identify complex drivers of obesity (food environments, leadership engagement, policy settings) and track change in the systems (contexts) in which these drivers operate. Software –Systems Thinking in Community Knowledge Exchange (STICKE) – has been developed that allows community members to map complex drivers of childhood obesity, pinpoint intervention targets, use these in implementation, and track system change. This innovation has been recognised through awards and funding from VicHealth and is being used by WHO, the EU, Canada, the US, New Zealand, the UK and all Australian States and Territories.
- Interpersonal systems: To further understand the vital role that leaders such as health service CEOs and councillors and their networks have in driving the uptake of policy change and subsequent impact, Social Network Analysis (SNA) was applied to examine how relationships in social networks lead to change in systems, and to understand organisational and individual behaviours.
- HTV Childhood obesity monitoring system: To support evaluation, a Victorian-first opt-out monitoring system was created to gather anthropometric and behavioural data. The Victorian research achieved an 80% student participation rate across 33 of 79 Local Government Authorities.
Key findings
- Examination of prevention networks within 19 local government communities prior to a large-scale community-based obesity prevention intervention identified 996 professional network relationships within networks that were typically sparse, highly modular, and heterogeneous in size and relationship composition. Frequency of interaction, close and influential relationships were inversely associated with network density.
- Development of an opt-out monitoring system provided the means to track population trends in childhood obesity and identifying target areas for prevention. Differences were found between traditional opt-in and our new opt-out sample estimates for mean BMI-z, prevalence of overweight/obesity and obesity. Opt-in consent underestimated prevalence of childhood obesity.
- The STICKE technology was used to identify the causes and consequences of poor evidence use in food-related policymaking in selected government ministries in Fiji and to illicit strategies to strengthen the use of evidence in policymaking. Barriers to food-policy making were (1) consultation, (2) engagement with stakeholders, (3) access and use of evidence, and (4) delays in policy processes.
- Our trial of systems thinking in the school-based systems change for obesity prevention trial in adolescents conducted in partnership with the ACT reported significant reductions in both overweight and obesity prevalence and pre-clinical depression. The ACT Government has since translated our approach to a policy position for all ACT Schools.