Using Systems
Applications to Inform
Obesity Solutions
PROCEEDINGS OF A WORKSHOP
Emily A. Callahan, Rapporteur
Roundtable on Obesity Solutions
Food and Nutrition Board
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported in part by the Academy of Nutrition and Dietetics; Alliance for a Healthier Generation; American Academy of Pediatrics; American College of Sports Medicine; American Council on Exercise; American Society for Nutrition; Banner Health; Bipartisan Policy Center; Blue Cross and Blue Shield of North Carolina Foundation; General Mills, Inc.; Intermountain Healthcare; The JPB Foundation; The Kresge Foundation; Mars, Inc., National Recreation and Park Association; Nemours; Novo Nordisk; Obesity Action Coalition; The Obesity Society; Partnership for a Healthier America; Reinvestment Fund; Robert Wood Johnson Foundation; SHAPE America; Society of Behavioral Medicine; Wake Forest Baptist Medical Center; Walmart; WW International; and YMCA. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-68172-8
International Standard Book Number-10: 0-309-68172-3
Digital Object Identifier: https://doi.org/10.17226/25900
Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2021 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2021. Using systems applications to inform obesity solutions: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/25900.
The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.
The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president.
The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.
The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.
Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.
Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.
Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.
For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.
PLANNING COMMITTEE ON USING SYSTEMS APPLICATIONS TO INFORM OBESITY SOLUTIONS1
CHRISTINA ECONOMOS (Co-Chair), Co-Founder and Director, ChildObesity180; Professor and New Balance Chair in Childhood Nutrition, Friedman School of Nutrition Science and Policy, Tufts University
NICOLAAS (NICO) PRONK (Co-Chair), President, HealthPartners Institute; Chief Science Officer, HealthPartners, Inc.; and Adjunct Professor, Harvard T.H. Chan School of Public Health
JAMY D. ARD, Professor, Department of Epidemiology and Prevention and Department of Medicine, Wake Forest University Baptist Medical Center
SARA CZAJA, Professor of Gerontology in Medicine, Weill Cornell Medicine
BRUCE Y. LEE, Professor, Health Policy and Management, City University of New York Graduate School of Public Health; Executive Director, Public Health Informatics, Computational, and Operations Research
DOUGLAS LUKE, Irving Louis Horowitz Professor in Social Policy and Director of the Center for Public Health Systems Science, Washington University in St. Louis
DAVID MENDEZ, Associate Professor, Department of Health Management and Policy, University of Michigan School of Public Health
DANIEL RIVERA, Professor of Chemical Engineering and Program Director of the Control Systems Engineering Laboratory, Arizona State University
STELLA YI, Assistant Professor, Department of Population Health, New York University Grossman School of Medicine
Health and Medicine Division Staff
LESLIE J. SIM, Roundtable Director (through December 2020)
HEATHER DEL VALLE COOK, Roundtable Director
AMANDA NGUYEN, Program Officer
CYPRESS LYNX, Research Associate
MEREDITH YOUNG, Research Associate
ZARIA FYFFE, Senior Program Assistant
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
This page intentionally left blank.
ROUNDTABLE ON OBESITY SOLUTIONS1
NICOLAAS (NICO) PRONK (Chair), HealthPartners Institute and HealthPartners, Inc., Bloomington, Minnesota
CHRISTINA ECONOMOS (Vice Chair), ChildObesity180 and Tufts University, Boston, Massachusetts
IHUOMA ENELI (Vice Chair), American Academy of Pediatrics, Columbus, Ohio
SHARON ADAMS-TAYLOR, The School Superintendents Association, Alexandria, Virginia
KATIE ADAMSON, YMCA of the USA, Washington, DC
JAMY D. ARD, Wake Forest University, Winston-Salem, North Carolina
ELLEN BECKJORD, UPMC Health Plan, Pittsburgh, Pennsylvania
ROBIN P. BLACKSTONE, University of Arizona, Phoenix
HEIDI MICHELS BLANCK, Centers for Disease Control and Prevention, Atlanta, Georgia
JEANNE BLANKENSHIP, Academy of Nutrition and Dietetics, Washington, DC
SARA N. BLEICH, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
DON W. BRADLEY, Duke University, Durham, North Carolina
HEIDI F. BURKE, Greater Rochester Health Foundation, Rochester, New York
JAMIE BUSSEL, Robert Wood Johnson Foundation, Princeton, New Jersey
DEBBIE I. CHANG, Blue Shield of California Foundation, San Francisco
MERRY DAVIS, Blue Cross and Blue Shield of North Carolina Foundation, Durham
JENNIFER FASSBENDER, Reinvestment Fund, Philadelphia, Pennsylvania
AMENDA FISHER, Walmart, Rogers, Arkansas
GARY D. FOSTER, WW International, New York, New York
DAVID FUKUZAWA, The Kresge Foundation, Troy, Michigan
TODD GALATI, American Council on Exercise, San Diego, California
ALLISON GERTEL-ROSENBERG, Nemours Children’s Health System, Washington, DC
MARJORIE A. INNOCENT, National Association for the Advancement of Colored People, Baltimore, Maryland
JOHN JAKICIC, University of Pittsburgh, Pennsylvania
ELIZABETH A. JOY, Intermountain Healthcare, Salt Lake City, Utah
SCOTT I. KAHAN, The George Washington University, Washington, DC
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
PETER T. KATZMARZYK, Pennington Biomedical Research Center, Baton Rouge, Louisiana
CATHERINE KWIK-URIBE, Mars, Inc., Germantown, Maryland
THEODORE KYLE, The Obesity Society, Pittsburgh, Pennsylvania
LISEL LOY, Bipartisan Policy Center, Washington, DC
MONICA VALDES LUPI, The Kresge Foundation, Troy, Michigan
KELLIE MAY, National Recreation and Park Association, Ashburn, Virginia
STACY MOLANDER, Partnership for a Healthier America, Washington, DC
MYETA M. MOON, United Way Worldwide, Alexandria, Virginia
STEPHANIE A. MORRIS, SHAPE America, Reston, Virginia
JOSEPH NADGLOWSKI, JR., Obesity Action Coalition, Tampa, Florida
MELISSA NAPOLITANO, The George Washington University, Washington, DC
PATRICIA NECE, Obesity Action Coalition, Alexandria, Virginia
MEGAN NECHANICKY, General Mills, Inc., Minneapolis, Minnesota
COURTNEY P. PAOLICELLI, Food and Nutrition Service, U.S. Department of Agriculture, Alexandria, Virginia
BARBARA PICOWER, The JPB Foundation, New York, New York
SUE P. POLIS, National League of Cities, Washington, DC
AMELIE G. RAMIREZ, Salud America!, San Antonio, Texas
TOM RICHARDS, American Council on Exercise, Arnold, Maryland
NANCY E. ROMAN, Partnership for a Healthier America, Washington, DC
SYLVIA ROWE, SR Strategy, LLC, Washington, DC
LAURIE STRADLEY, Alliance for a Healthier Generation, Asheville, North Carolina
SUSAN Z. YANOVSKI, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
LESLIE PLATT ZOLOV, Novo Nordisk, Plainsboro, New Jersey
Health and Medicine Division Staff
LESLIE J. SIM, Roundtable Director (through December 2020)
HEATHER DEL VALLE COOK, Roundtable Director
AMANDA NGUYEN, Program Officer
CYPRESS LYNX, Research Associate
MEREDITH YOUNG, Research Associate
ZARIA FYFFE, Senior Program Assistant
ANN L. YAKTINE, Director, Food and Nutrition Board
Consultant
WILLIAM (BILL) H. DIETZ, The George Washington University, Washington, DC
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
JENNIFER FASSBENDER, Reinvestment Fund
JILL REEDY, National Institutes of Health
BONNIE SPRING, Northwestern University Feinberg School of Medicine
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings, nor did they see the final draft before its release. The review of this proceedings was overseen by RUSSELL R. PATE, University of South Carolina. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.
This page intentionally left blank.
Contents
Organization of This Proceedings
2 THE PROMISES AND PITFALLS OF SYSTEMS SCIENCE APPROACHES: A PRACTITIONER’S PERSPECTIVE
3 EXPLORING THE USEFULNESS OF SYSTEMS SCIENCE APPROACHES FOR STAKEHOLDERS IN DIFFERENT SECTORS
The Business and Private Sector: Project Play
Communities: Baltimore, Maryland
4 REFLECTIONS ON USING SYSTEMS SCIENCE APPLICATIONS TO INFORM OBESITY SOLUTIONS
Boxes and Figures
BOXES
1-1 Workshop Statement of Task
2-1 Quotes About the Roles of Qualitative Maps and Group Models
4-1 Additional Systems Science Resources
4-2 Potential Future Directions for Systems Modeling Efforts
FIGURES
2-1 Comparison of characteristics of three simulations approaches to systems science modeling
2-2 The “possibility frontier” of reliable modeling
2-3 Work in progress for ReThink Health
3-1 Lifetime benefits of physical activity
3-2 Benefits to residents of active communities
3-4 Comparing the impact of key model variables on change in obesity prevalence in Baltimore City