Obesity is a major health priority globally because it is a determinant of Type 2 diabetes, coronary heart disease, and cancer. In Australia, obesity costs the health system more than $21 billion annually and recent estimates suggest more than one quarter (28%) of Australian children are overweight or obese.
The size and scope of the burden make the case for prevention compelling. Children are a critical focus for prevention because they are so susceptible to the environment and because treatment is so difficult. Childhood obesity has been recognized as a priority in the WHO’s Global 2013-2020 Action Plan for the Prevention and Control of Non Communicable Disease and recommendations have been provided to countries on ending childhood obesity.
Several attempts have been made or are underway to work at population scale to reduce and prevent childhood obesity in Australia, New Zealand and England. These population-level interventions begin by fostering a shared understanding of the systemic determinants of non-communicable disease and asking how existing systems can be strengthened or new systems created to better promote health and prevent disease.
One of the clear messages from previously successful trials is that building community capacity to apply systems thinking is critical. Systems thinking is characterized by attempts to identify the most important cause and effect relationships within a specific system boundary that create feedback and so amplify or stabilise change across a system. System dynamics, an approach to systems thinking, explicitly seeks to create informal maps and formal simulation models of this dynamic complexity. While many more traditional interventions have focused on linear cause-and-effect relationships, systems interventions focus on non-linear relationships (e.g., tipping points), feedback where a “causal” variable might in turn be impact by an “outcome variable”, and complexity in the multilevel factors involved, and multiplex relationships among these factors.
New methods are required that facilitate communities and researchers’ ability to measure the components and processes of relevant systems (i.e. systems that impact childhood obesity in their community), to map and understand these systems, and to use systems data and models in real time to implement change and make ongoing improvements to multiple levels of the system.
Our research program focuses on:
- Building the evidence on the effectiveness of systems approaches to community based obesity prevention
- Building the capacity of communities to use systems thinking in prevention to promote sustainability of change
- Creating new and innovative methods and tools for implementation and evaluation of systems approaches to community based interventions
- Developing reproducible processes that can be used at scale
- Using existing systems science methods (Agent Based modelling, Systems Dynamics, Social Network Analysis and Causal Loop Diagrams) in novel applications to public health prevention
A selection of our current projects include:
- Centre of Research Excellence (CRE) in Policy Research on Obesity and Food Systems (2012–2017): this NHMRC-funded project includes the economic evaluation of 40 obesity prevention interventions across a range of sectors including food, trade, physical activity and urban design
- WHO STOPS Childhood Obesity NHMRC Partnership Project (APP1114118; 2015-2020): Whole of Systems Trial of Prevention Strategies for childhood obesity in 11 communities the Great South Coast region of Victoria.
- Yarriambiack Creating Healthy Active Nourished Generations (YCHANGe) (2015-2017)
- Grampians PCP
- Prevention services in the PHN
- The Foresight Map project uses routinely collected data to quantify the variables in the Foresight Map of obesity determinants to test the explanatory power of this framework.
- COMPACT (Childhood Obesity Modelling for Prevention and Community Transformation): this project is funded by the NIH and involves collaborations across Deakin University, Harvard University, Tufts University, The University of Washington (St Louis), Brooking institute and the University of Auckland. COMPACT is investigating the diffusion of community based childhood obesity prevention interventions in Australia and the USA retrospectively and prospectively and explaining this process through Agent Based Modelling.