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Group model building is a participatory workshop technique used in system dynamics for developing community consensus to address complex problems by consensus building on individual assumptions. This study examines changes in individual mental models of the complex problem of childhood obesity following participation in group model building (GMB), as part of a larger community-based system dynamics project. Data are drawn from GMB participants across six community sites in the Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHO STOPS) in rural and regional Victoria, Australia. Each community participated in two GMB sessions resulting in a causal loop diagram (CLD) of drivers of childhood obesity for each community. Presurvey and postsurvey captured participants' perspectives before and after (n = 25) participation in both GMB sessions and a blend of inductive and deductive qualitative content analysis was used to code individual responses. Three calculations were used to determine the number of responses, whether responses were a result of persuasion from others, and comparison of responses to those found in the CLD. Our study found participant mental models shifted during the course of the GMB sessions, with some responses persuaded by others and 75% of new insights identified in CLDs created by communities. The GMB process created a platform for participants to share ideas and learn from each other. In addition, participants listed new insights about childhood obesity in their community through developing CLDs.

Objective To identify and analyse ongoing nutrition-related surveillance programmes led and/or funded by national authorities in countries in South-East Asian and Western Pacific Regions. Methods We systematically searched for publications in PubMed(r) and Scopus, manually searched the grey literature and consulted with national health and nutrition officials, with no restrictions on publication type or language. We included low- and middle-income countries in the World Health Organization South-East Asia Region, and the Association of Southeast Asian Nations and China. We analysed the included programmes by adapting the United States Centers for Disease Control and Prevention's public health surveillance evaluation framework. Findings We identified 82 surveillance programmes in 18 countries that repeatedly collect, analyse and disseminate data on nutrition and/or related indicators. Seventeen countries implemented a national periodic survey that exclusively collects nutrition-outcome indicators, often alongside internationally linked survey programmes. Coverage of different subpopulations and monitoring frequency vary substantially across countries. We found limited integration of food environment and wider food system indicators in these programmes, and no programmes specifically monitor nutrition-sensitive data across the food system. There is also limited nutrition-related surveillance of people living in urban deprived areas. Most surveillance programmes are digitized, use measures to ensure high data quality and report evidence of flexibility; however, many are inconsistently implemented and rely on external agencies' financial support. Conclusion Efforts to improve the time efficiency, scope and stability of national nutrition surveillance, and integration with other sectoral data, should be encouraged and supported to allow systemic monitoring and evaluation of malnutrition interventions in these countries. Objectif Identifier et analyser les programmes de surveillance nutritionnelle en cours, menes et/ou finances par les autorites nationales de pays des regions de l'Asie du Sud-Est et du Pacifique occidental. Methodes Nous avons effectue une recherche systematique de publications sur PubMed(r) et Scopus, mene des recherches manuelles dans la litterature grise et consulte des responsables nationaux de la sante et de la nutrition, sans restriction quant au type de publication ou a la langue. Nous avons inclus les pays a revenu faible et intermediaire de la region de l'Organisation mondiale de la sante pour l'Asie du Sud-Est et de l'Association des nations de l'Asie du Sud-Est, ainsi que la Chine. Nous avons analyse les programmes inclus en adaptant le cadre d'evaluation de la surveillance de la sante publique des Centers for Disease Control and Prevention des Etats-Unis. Resultats Nous avons identifie 82 programmes de surveillance dans 18 pays qui collectent, analysent et diffusent regulierement des donnees sur la nutrition et/ou des indicateurs lies. Dix-sept pays ont mis en reuvre une enquete nationale periodique qui recueille exclusivement des indicateurs de resultats nutritionnels, souvent parallelement a des programmes d'enquete lies a l'echelle internationale. La couverture des differentes sous-populations et la frequence de surveillance varient considerablement d'un pays a l'autre. Nous avons constate dans ces programmes une integration limitee des indicateurs portant sur l'environnement alimentaire et le systeme alimentaire au sens large, et aucun programme ne surveille specifiquement les donnees prenant en compte la nutrition dans l'ensemble du systeme alimentaire. La surveillance nutritionnelle des personnes vivant dans des zones urbaines defavorisees est egalement limitee. La plupart des programmes de surveillance existent sous une forme numerisee, recourent a des mesures pour garantir la qualite des donnees et font preuve de flexibilite, mais beaucoup sont mis en reuvre de maniere incoherente et dependent du soutien financier d'agences exterieures. Conclusion Les efforts visant a ameliorer l'efficacite temporelle, la portee et la stabilite de la surveillance nutritionnelle a l'echelle nationale, ainsi que l'integration avec d'autres donnees sectorielles, devraient etre encourages et soutenus afin de permettre un suivi et une evaluation systemiques des interventions en matiere de malnutrition dans ces pays. Objetivo Identificar y analizar los programas de vigilancia en curso relacionados con la nutricion que dirigen o financian las autoridades nacionales de los paises de las regiones de Asia Sudoriental y el Pacifico Occidental. Metodos Se realizaron busquedas sistematicas de publicaciones en PubMed(r) y Scopus, busquedas manuales en la literatura gris y consultas con funcionarios nacionales de salud y nutricion, sin restricciones de tipo de publicacion ni de idioma. Se incluyeron paises de ingresos bajos y medios de la Region de Asia Sudoriental de la Organizacion Mundial de la Salud y de la Asociacion de Naciones de Asia Sudoriental y China. Para analizar los programas incluidos se adapto el marco de evaluacion de la vigilancia de la salud publica de los Centros para el Control y la Prevencion de Enfermedades de Estados Unidos. Resultados Se identificaron 82 programas de vigilancia en 18 paises que recopilan, analizan y difunden repetidamente datos sobre nutricion o indicadores relacionados. Diecisiete paises aplicaron una encuesta periodica nacional que recopila exclusivamente indicadores de resultados nutricionales, por lo general junto con programas de encuestas internacionales. La cobertura de las diferentes subpoblaciones y la frecuencia del seguimiento varian sustancialmente de un pais a otro. Se hallo una integracion limitada de los indicadores del entorno alimentario y del sistema alimentario en general en estos programas y ningun programa supervisa especificamente los datos que tienen en cuenta la nutricion en todo el sistema alimentario. Tambien es limitada la vigilancia relacionada con la nutricion de las personas que viven en areas urbanas desfavorecidas. La mayoria de los programas de vigilancia estan digitalizados, utilizan medidas para garantizar la alta calidad de los datos y presentan evidencias de flexibilidad; sin embargo, muchos se aplican de forma incoherente y dependen del apoyo financiero de organismos externos. Conclusion Se deben fomentar y apoyar los esfuerzos para mejorar la eficiencia temporal, el alcance y la estabilidad de la vigilancia nacional de la nutricion, asi como la integracion con otros datos sectoriales, para permitir un seguimiento y una evaluacion sistemicos de las intervenciones contra la malnutricion en estos paises. [phrase omitted], Introduction In south-east Asia, low- and middle-income countries have a high burden from all forms of malnutrition, such as underweight, wasting, stunting and micronutrient deficiencies, obesity and diet-related noncommunicable diseases. [...]

: Objective: To report the prevalence of healthy weight and related behaviours among Victorian Aboriginal and non‐Aboriginal children and explore associations between these factors and health‐related quality of life (HRQoL). Methods: Analysis of cross‐sectional data from two cluster randomised controlled trials using logistic and linear mixed models. The sample included Aboriginal (n=303) and non‐Aboriginal (n=3,026) children aged 8–13 years. Results: More than two‐thirds of Aboriginal children met guidelines for fruit (75.9%), sweetened drinks (66.7%), sleep (73.1%), screen time (67.7%) and objectively measured physical activity (83.6%); and 79.1% reported consuming take‐away foods less than once per week. Aboriginal children were more likely to meet vegetable consumption guidelines (OR=1.42, 95%CI: 1.05, 1.93), but less likely to have a healthy weight (OR=0.66, 95%CI: 0.52, 0.85) than non‐Aboriginal children. Mean HRQoL scores were significantly higher among non‐Aboriginal children and both Aboriginal and non‐Aboriginal children meeting health guidelines. Conclusions: Most Aboriginal children in this study met guidelines for fruit, physical activity, screen time and sleep, and those meeting these guidelines had significantly higher HRQoL. Implications for public health: Promoting nutrition, physical activity and sleep is likely to benefit all children. Aboriginal community‐controlled organisations can use these data to design culturally‐specific programs that may improve disparities in healthy weight and HRQoL., Aboriginal and Torres Strait Islander peoples have lived on the lands, now known as Australia, for over 65,000 years, and are one of the world's oldest continuous populations.[sup.1] Compared to [...]

Obesity prevention is an urgent public health priority that requires action at multiple levels. Collaboration between academics, policy and practice is necessary to ensure best-practice implementation. A national knowledge translation and exchange (KT) platform, the Collaboration of Community-based Obesity Prevention Sites (CO-OPS), was delivered and evaluated over three years (2013-15). A mixed-methods evaluation used communications and website data, knowledge-brokering data, event evaluations, interviews and tracer searches to assess process (reach, delivery, quality, cost, uptake) and impact (use of tools/resources, networking, improvements in practice). Results included: 1) average 27% yearly membership growth (330 new members per year) in response to KT activities including tailored communications, stakeholder engagement, knowledge brokering and networking opportunities; 2) sustained website use with approximately 1200 visits/month and 73% unique visitors; and high access to networking and professional development information (120 hits/month), and best practice guidelines (60 hits/month); 3) higher uptake of face-to-face interactive strategies (for example, workshops) than online interactive strategies (for example, knowledge broker service) and higher uptake of passive KT (for example, website resources) than interactive KT strategies (for example, workshops); 4) the KT function of CO-OPS was clearly valued, and appeared to address a gap in implementation. A central coordinating KT platform provided support for best practice and exchange opportunities to a broad network of practice, policy and academic professionals. Simple KT strategies such as tailored, targeted online resources were useful for practice, whilst more intensive KT strategies were important for network engagement. Findings are applicable to other information-sharing networks where professionals address complex public health problems.

Background: Over a quarter of children aged 2–17 years living in Australia are overweight or obese, with a higher prevalence reported in regional and remote communities. Systems thinking approaches that seek to support communities to generate and implement locally appropriate solutions targeting intertwined environmental, political, sociocultural, and individual determinants of obesity have the potential to ameliorate this. There have however been reported challenges with implementation of such initiatives, which may be strengthened by incorporating implementation science methods. Methods: This pilot randomised controlled trial protocol outlines the development and proposed evaluation of a multicomponent implementation strategy (Action-RESPOND). to increase the implementation of community-based systems thinking child obesity prevention initiatives The target of this intervention is ten rural and regional communities (or local government areas as the unit of allocation) within Northeast Victoria who were participants in a whole-of-systems intervention (RESPOND). Action-RESPOND builds on this intervention by assessing the impact of offering additional implementation strategies to five communities relative to usual care. The development of the multicomponent implementation strategy was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework and consists of seven implementation strategies primarily delivered via 'facilitation' methods. Implementation strategies aimed to ensure initiatives implemented are i) evidence-based, ii) address community's specific needs and iii) are suitable for local context. Strategies also aimed to increase the community's capacity to implement, through iv) improving the health promotion team's implementation knowledge and skills, fostering v) leadership, vi) physical resources and vii) community culture to drive implementation. The feasibility, acceptability, potential impact, and cost of the strategy will be assessed at baseline and follow up using surveys administered to key representatives within the community and internal records maintained by the research team. Discussion: By leveraging an existing community-based whole-of-systems intervention, Action-RESPOND offers a unique opportunity to collect pilot feasibility and early empirical data on how to apply implementation and systems science approaches to support obesity prevention in rural and regional communities in Victoria. [ABSTRACT FROM AUTHOR]

Background: System dynamics approaches, including group model building (GMB) and causal loop diagrams (CLDs), can be used to document complex public health problems from a community perspective. This paper aims to apply Social Network Analysis (SNA) methods to combine multiple CLDs created by local communities into a summary CLD, to identify common drivers of the health and wellbeing of children and young people. Methods: Thirteen community CLDs regarding children and young people health and wellbeing were merged into one diagram involving three steps: (1) combining variable names; (2) CLD merging, where multiple CLDs were combined into one CLD with a set of unique variables and connections; (3) paring, where the Decision-Making Trial and Evaluation Laboratory (DEMATEL) method was used to generate a cut-point to reduce the number of variables and connections and to rank the overall importance of each variable in the merged CLD. Results: Combining variable names resulted in 290 variables across the 13 CLDS. A total of 1,042 causal links were identified in the merged CLD. The DEMATEL analysis of the merged CLD identified 23 common variables with a net importance between 1.0 and 4.5 R + C values and 57 causal links. The variables with the highest net importance were 'mental health' and 'social connection & support' classified as high net receivers of influence within the system. Conclusions: Combining large CLDs into a simple diagram represents a generalisable model of the drivers of complex health problems. [ABSTRACT FROM AUTHOR]