Systems approaches for chronic disease prevention: sound logic and empirical evidence, but is this view shared outside of academia?

Abstract

There is a need and desire to improve chronic disease prevention efforts across Australia. Increasingly, scientists are urging the use of systems thinking and its methods to significantly shift the way we think about, and intervene in, chronic diseases. This research aimed to examine the convergence between the systems science literature and the views of those working in and advocating for prevention, in relation to the value of systems thinking and its methods for the prevention of chronic diseases. Individual and small-group semistructured interviews were undertaken with 29 individuals across Australia. The interviewees reflected a diverse cross-section of senior public health managers and program implementation staff from state and territory health departments, and senior thought leaders and public health advocates. Interviews were audio recorded and coded into key themes. Feedback from informants illustrated that, among those working in and advocating for prevention, there is a mix of support for systems thinking for chronic disease prevention, and some healthy scepticism. The lack of consistent confluence between those promoting the value of systems science, and those responsible for working in and advocating for prevention indicates a level of confusion about language and definitions. It also reflects a desire for published evidence about systems methods that have proven effectiveness. Systems thinking and its methods have a promising and important role to play in creating a robust, effective and sustainable strategy for prevention of chronic diseases throughout Australia. However, the method requires further development and refinement, and promotion of case studies of effectiveness. We also need to heed lessons learnt overseas.