Using Systems Applications to Inform Obesity Solutions Proceedings of a Workshop (2021) / Chapter Skim
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4 Reflections on Using Systems Science Applications to Inform Obesity Solutions
4 Reflections on Using Systems Science Applications to Inform Obesity Solutions
Pages 47-60
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From page 47... ...
(David Mendez) • Health care providers would benefit from training in systems science that helps shape their perspectives about the context in which their prescribed interventions occur, and also reinforces their opportunity to play an influencer role within systems, such as by helping to link patients to community supports and resources.
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From page 48... ...
• A technique for initiating community and stakeholder engage ment in a systems science modeling process is to invite them to draw path diagrams, an iterative process that ultimately results in the development of dynamic models that are useful for intervention and optimization. (Daniel Rivera)
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From page 49... ...
Sara Czaja, professor of gerontology in medicine at Weill Cornell Medicine, spoke about the importance of leveraging partnerships and multidisciplinary teams to address complex challenges. Given that systems science approaches involve the interaction of multisector stakeholders, she urged early planning for how the layers of participants will communicate effectively despite coming from different arenas.
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From page 50... ...
Jamy Ard, professor in the Department of Epidemiology and Prevention and the Department of Medicine at the Wake Forest University Baptist Medical Center and a member of the 2020–2025 Dietary Guidelines Advisory Committee, shared his perspective on the inclusion of systems thinking and modeling in the development of the Dietary Guidelines for Americans and on how using systems science approaches at the micro level affects his daily work as a clinician. Food, nutrition, and the consequences of dietary intake for health are interrelated, Ard remarked, and manipulating one variable leads to a s eries of consequences that affect nutritional status and health trajectory in the context of disparities in obesity and other chronic diseases.
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From page 51... ...
Nonetheless, he appealed for helping providers understand how even at the individual level they can play an influencer role within systems, such as by helping to link patients to community supports. Stella Yi discussed the formative work involved in engaging stakeholders and community members in participatory group model building.
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From page 52... ...
Daniel Rivera, professor of chemical engineering and program director of the Control Systems Engineering Laboratory at Arizona State University, offered suggestions for initiating community and stakeholder engagement in the systems science modeling process. These suggestions, he noted, were based on his viewpoint as a chemical engineer who works as a modeler in partnership with intervention and behavioral scientists to deliver optimized, personalized interventions related to behavioral medicine.
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From page 53... ...
Lee concluded his remarks by proposing a change in the paradigm of how systems science modeling is used, asserting that most stakeholders harness only a small percentage of modeling capabilities. PANEL AND AUDIENCE DISCUSSION Following the reflections summarized above, the workshop organizers discussed early-life opportunities for introducing systems thinking, systems science models of the effects of taxing sugar-sweetened beverages, strategies for enabling novices to get started with modeling, and potential unintended consequences of defining obesity in systems science models.
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From page 54... ...
Systems Science Models of Taxing Sugar-Sweetened Beverages Lee responded to a participant's question about the existence of systems science models examining the effect of taxing sugar-sweetened beverages on their consumption and ultimately on the incidence of obesity. He confirmed that such models exist, noting that the Global Obesity Prevention Center funded a pilot project at the University of California, Berkeley, to collect data on these taxes in various Bay Area municipalities.
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Potential Unintended Consequences of Defining Obesity in Systems Science Models A participant commented that some stakeholders have suggested that the use of weight status to assess health results in stigma and disordered eating, and asked whether assigning definitions for obesity in systems science models could have such unintended consequences. Lee replied that systems science models incorporate a host of factors and processes that affect the outcomes of interest, so there is rarely one factor, such as weight, that drives everything.
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From page 56... ...
; and All of Us Research Hub, a new NIH research program that is collecting longitudinal data from participants of all backgrounds to support efforts to reduce health disparities and improve health equity, among other purposes. Mabry touched on sources for data on social determinants of health, highlighting the NIH PhenX Toolkit and a number of additional sources on the Centers for Disease Control and Prevention's website (RTI International, 2020a,b)
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From page 57... ...
Next, Mabry enumerated challenges in systems modeling that make it a difficult endeavor: finding appropriate sources of data, particularly longitudinal data; maintaining stakeholder engagement (i.e., with policy makers, health care systems, or businesses) ; dealing with impatience to produce actionable results, particularly for policy makers who have limited time in office; building interdisciplinary teams and communicating across disciplinary boundaries; doing what one knows instead of learning what one should do (i.e., lack of self-efficacy)
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From page 58... ...
It is difficult to convince people to take action based on these modeling results because they did not feel the pain of paying those billions of dollars, she explained, and they will not receive billions of dollars back in cash or some other tangible form by taking such action. Mabry moved on to the topic of recruiting systems modeling teams, detailing various types of stakeholders and experts to consider including, such as health geographers or other experts who know how to integrate spatial information into models, modelers themselves, community members, and policy makers.
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From page 59... ...
• National Collaborative on Childhood Obesity Research Envision (https:// www.nccor.org/envision, accessed December 3, 2020) • Society for Prevention Research 2007 Symposia Series on Systems Science and Health (https://www.preventionresearch.org/conferences/ training/2007-symposia-series-on-systems-science-and-health, accessed December 3, 2020)
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From page 60... ...
60 USING SYSTEMS APPLICATIONS TO INFORM OBESITY SOLUTIONS BOX 4-2 Potential Future Directions for Systems Modeling Efforts • Addressing the root causes of inequalities in the distribution of obesity • Fostering cross-sector stakeholder engagement • Developing geographically explicit models and involving health geographers to explore disparities • Procuring funding to form community-based research relationships • Pressuring funders to support education for practitioners in the use of systems science to inform research priorities • Undertaking more comparative modeling efforts • Leveraging artificial intelligence and data science in modeling • Using the resources available to keep learning • Pursuing interdisciplinary collaborations • Building a community of systems scientists and better coordinating and r eusing research assets • Realigning the incentives in the research system SOURCE: Presented by Patty Mabry, September 16, 2020.
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