Abstract
Group model building (GMB) is a qualitative method aimed at engaging stakeholders to collectively consider the causes of complex problems. Tackling inequities in community nutrition is one such complex problem, as the causes are driven by a variety of interactions between individual factors, social structures, local environments and the global food system. This methods paper describes a GMB process that utilises three system mapping tools in a study with members of a multicultural, low-income community to explore declining fruit and vegetable intake in children. The tools were: (1) graphs over time, which captures the community’s understanding of an issue; (2) cognitive mapping, which enables participants to think systemically about the causes and consequences of the issue; (3) causal loop diagrams, which describe feedback loops that reinforce the issue and identify potential actions. Cognitive mapping, a tool not usually associated with GMB, was added to the research process to support the gradual development of participants’ thinking and develops the skills needed to tackle an issue from a systems perspective. We evaluate the benefits and impact of these three tools, particularly in engaging participants and increasing understanding of systems thinking in order to develop and mobilise action. The tools could be adapted for use in other community-based research projects. Key learnings were the value of genuine partnership with a local organisation for longevity of the project, recruitment of key decisionmakers from the community early in the process, and allowing time to create sustainable change.
Highlights
Tackling a complex public health issue such as poor nutrition is a challenging task
We evaluate the benefits and impact of the three tools used in the Group model building (GMB) process—graphs over time, cognitive mapping, and causal loop diagrams—in order to inform future researchers wishing to use this method
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Summary
Tackling a complex public health issue such as poor nutrition is a challenging task. The causes of poor nutrition are complex and multiple [1], with prevalence driven in part by the interaction between the global food system and local environments [2]. Poor nutrition is not just a health issue but is embedded in a social, political and cultural context; for example, in the way food is grown (i.e., agricultural subsidies), produced and marketed (e.g., influence of large multinational companies) and consumed (e.g., cultural traditions around food) [5] Public Health 2020, 17, 3457; doi:10.3390/ijerph17103457 www.mdpi.com/journal/ijerph
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