An Innovative Approach to Addressing Childhood Obesity: A Knowledge-Based Infrastructure for Supporting Multi-Stakeholder Partnership Decision-Making in Quebec, Canada

Nii Addy,Arash Shaban-Nejad,Laurette Dubé,David Buckeridge

doi:10.3390/ijerph120201314

Abstract

Multi-stakeholder partnerships (MSPs) have become a widespread means for deploying policies in a whole of society strategy to address the complex problem of childhood obesity. However, decision-making in MSPs is fraught with challenges, as decision-makers are faced with complexity, and have to reconcile disparate conceptualizations of knowledge across multiple sectors with diverse sets of indicators and data. These challenges can be addressed by supporting MSPs with innovative tools for obtaining, organizing and using data to inform decision-making. The purpose of this paper is to describe and analyze the development of a knowledge-based infrastructure to support MSP decision-making processes. The paper emerged from a study to define specifications for a knowledge-based infrastructure to provide decision support for community-level MSPs in the Canadian province of Quebec. As part of the study, a process assessment was conducted to understand the needs of communities as they collect, organize, and analyze data to make decisions about their priorities. The result of this process is a “portrait”, which is an epidemiological profile of health and nutrition in their community. Portraits inform strategic planning and development of interventions, and are used to assess the impact of interventions. Our key findings indicate ambiguities and disagreement among MSP decision-makers regarding causal relationships between actions and outcomes, and the relevant data needed for making decisions. MSP decision-makers expressed a desire for easy-to-use tools that facilitate the collection, organization, synthesis, and analysis of data, to enable decision-making in a timely manner. Findings inform conceptual modeling and ontological analysis to capture the domain knowledge and specify relationships between actions and outcomes. This modeling and analysis provide the foundation for an ontology, encoded using OWL 2 Web Ontology Language. The ontology is developed to provide semantic support for the MSP process, defining objectives, strategies, actions, indicators, and data sources. In the future, software interacting with the ontology can facilitate interactive browsing by decision-makers in the MSP in the form of concepts, instances, relationships, and axioms. Our ontology also facilitates the integration and interpretation of community data, and can help in managing semantic interoperability between different knowledge sources. Future work will focus on defining specifications for the development of a database of indicators and an information system to help decision-makers to view, analyze and organize indicators for their community. This work should improve MSP decision-making in the development of interventions to address childhood obesity.

Highlights

IntroductionAssuming an instrumental perspective of stakeholder theory in which stakeholders constitute organizational life [3,4,5], some multi-stakeholder partnerships (MSPs) proponents note that flexible governance structures and diverse expertise of multiple actors contribute to making such partnerships more effective in realizing desired policy outcomes, as compared with traditional single-actor structures [6]
In addressing the complex problem of childhood obesity, one widespread means for deploying policies in a whole-of-society strategy is through multi-stakeholder partnerships (MSPs) [1], defined here as “voluntary cooperative arrangements between actors from the public, business and civil society that display minimal degree of institutionalization, have common nonhierarchical decision-making structures and address public policy issues” [2]
We identified a sub-process of five steps over the course of MSP meetings that constitute the development of epidemiological profiles: (i) accessing and selecting data sources and information deemed by community networks and Québec en Forme (QEF) as pertinent to healthy eating and physical activity in the community; (ii) organizing the data and information; (iii) visualizing and analyzing the data and information; (iv) developing epidemiological profile documents; and (v) engaging stakeholders for validating epidemiological profile documents

Summary

Introduction

Assuming an instrumental perspective of stakeholder theory in which stakeholders constitute organizational life [3,4,5], some MSP proponents note that flexible governance structures and diverse expertise of multiple actors contribute to making such partnerships more effective in realizing desired policy outcomes, as compared with traditional single-actor structures [6]. According to such viewpoints, and of particular interest in this paper, the knowledge that diverse stakeholders bring to decision-making in MSPs is critical to their success in tackling childhood obesity. Changes in such behaviors, including physical activity and healthy nutrition, are necessary to slow the “obesity epidemic”, and could prevent up to 80% of heart disease, diabetes and respiratory diseases and 40% of cancers [9]

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