A Transdisciplinary Complex Adaptive Systems (T-CAS) Approach to Developing a National School-Based Culture of Prevention for Health Improvement: the School Health Research Network (SHRN) in Wales

Simon Murphy,Sarah Macdonald,Julie Bishop,Gillian Hewitt,Alexa Bishop,Joan Roberts,Richard Thurston,Graham Moore,Hannah Littlecott,Laurence Moore,Chris Roberts

doi:10.1007/s11121-018-0969-3

Abstract

The paper reflects on a transdisciplinary complex adaptive systems (T-CAS) approach to the development of a school health research network (SHRN) in Wales for a national culture of prevention for health improvement in schools. A T-CAS approach focuses on key stages and activities within a continuous network cycle to facilitate systems level change. The theory highlights the importance of establishing transdisciplinary strategic partnerships to identify and develop opportunities for system reorientation. Investment in and the linking of resources develops the capacity for key social agents to take advantage of disruption points in the re-orientated system, and engagement activities develop the network to facilitate new social interactions and opportunities for transdisciplinary activities. A focus on transdisciplinary action research to co-produce interventions, generate research evidence and inform policy and practice is shown to play an important part in developing new normative processes that act to self-regulate the emerging system. Finally, the provision of reciprocal network benefits provides critical feedback loops that stabilise the emerging adaptive system and promote the network cycle. SHRN is shown to have embedded itself in the system by securing sustainability funding from health and education, a key role in national and regional planning and recruiting every eligible school to the network. It has begun to reorient the system to one of evidence generation (56 research studies co-produced) and opportunities for data-led practice at multiple levels. Further capacity development will be required to capitalise on these. The advantages of a complex systems approach to address barriers to change and the transferability of a T-CAS network approach across settings and cultures are highlighted.

Highlights

Cardiff, UK 4 Cancer Research UK, Cardiff, UK 5 Medical Research Council (MRC)/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UKAdolescence is a period characterised by rapid biological maturation and significant behavioural and social change
This paper describes and reflects on the transdisciplinary complex adaptive systems (T-complex adaptive systems (CASs)) network cycle, which has initiated systems change towards a culture of prevention for health and wellbeing in the school system
Whilst acknowledging CAS change processes can apply across the cycle, this paper has theorised and evidenced a clear sequential approach to address dominant CAS mechanisms at each developmental cycle

Summary

Introduction

Adolescence is a period characterised by rapid biological maturation and significant behavioural and social change. There has been a failure to integrate academic, policy, practice and public communities to co-produce school health improvement research and build in processes to understand intervention congruence with existing systems and structures, and their sustainability. Responding to a similar situation in healthcare, UK Clinical Research Network initiatives have facilitated cultural change for evidence generation and practice These networks highlight the value of investing in infrastructures that support research capacity development and foster a culture of practitioner-led enquiry. They have adopted transdisciplinary approaches to integrate academic, policy-maker and practitioner communities to generate and translate policyand practice-relevant research for improved health outcomes. The transferability of a T-CAS network across national settings and cultures is considered

A T-CAS Network Cycle

Findings

Discussion