ArticleBMJ open2022
Navigating the river(s) of systems change: a multi-methods, qualitative evaluation exploring the implementation of a systems approach to physical activity in Gloucestershire, England.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- What makes community-based, multilevel physical activity promotion last? A systematic review with narrative synthesis on factors for sustainable implementation.Perspectives in public health · 2025Pooled it
- Developing and implementing whole systems approaches to reduce inequalities in childhood obesity: A mixed methods study in Dundee, Scotland.Public health in practice (Oxford, England) · 2025Article
- Applying a participatory system dynamics approach to childhood overweight and obesity in the local context: reflections from the LIKE project.Health research policy and systems · 2025Article
- Stakeholders' perceptions on the role of professional sports clubs in local community health promotion.Health promotion international · 2025Article
- Monitoring and adaptation of a system dynamics approach to prevent childhood overweight and obesity: findings from the LIKE programme.Health research policy and systems · 2025Article
- Where Do Professional Sports Clubs and Organisations Sit Within a Local Health Promotion System? A Social Network Analysis Study.International journal of environmental research and public health · 2025Article
- Physical activity-the past, present and potential future: a state-of-the-art review.Health promotion international · 2025Review
- 'It's about collaboration': a whole-systems approach to understanding and promoting movement in Suffolk.The international journal of behavioral nutrition and physical activity · 2025Article
- Taking a partnership approach to embed physical activity in local policy and practice: a Bradford District case study.The international journal of behavioral nutrition and physical activity · 2025Article
- Towards realist-informed ripple effects mapping (RREM): positioning the approach.BMC medical research methodology · 2024Article
- Systems thinking for local food environments: a participatory approach identifying leverage points and actions for healthy and sustainable transformations.Health research policy and systems · 2024Article
- Young people's experiences of physical activity insecurity: a qualitative study highlighting intersectional disadvantage in the UK.BMC public health · 2024Article
- Tackling physical inactivity and inequalities: implementing a whole systems approach to transform community provision for disabled people and people with long-term health conditions.BMC public health · 2024Article
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Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectivesSystems approaches aim to change the environments in which people live, through cross-sectoral working, by harnessing the complexity of the problem. This paper sought to identify: (1) the strategies which support the implementation of We Can Move (WCM), (2) the barriers to implementation, (3) key contextual factors that influence implementation and (4) impacts associated with WCM.
designA multi-methods evaluation of WCM was completed between April 2019 and April 2021. Ripple Effects Mapping (REM) and semi-structured interviewers were used. Framework and content analysis were systematically applied to the dataset.
settingWCM-a physical activity orientated systems approach being implemented in Gloucestershire, England.
participants31 stakeholder interviews and 25 stakeholders involved in 15 REM workshops.
resultsA white-water rafting analogy was developed to present the main findings. The successful implementation of WCM required a facilitative, well-connected and knowledgeable guide (ie, the lead organisation), a crew (ie, wider stakeholders) who's vision and agenda aligned with WCM's purpose, and a flexible delivery approach that could respond to ever-changing nature of the river (ie, local and national circumstances). The context surrounding WCM further strengthened and hampered its implementation. Barriers included evaluative difficulties, a difference in stakeholder and organisational perspectives, misaligned expectations and understandings of WCM, and COVID-19 implications (COVID-19 also presented as a facilitative factor). WCM was said to strengthen cohesion and collaboration between partners, benefit other agendas and policies (eg, mental health, town planning, inequality), and improve physical activity opportunities and environments.
conclusionsThis paper is one of the first to evaluate a systems approach to increasing physical activity. We highlight key strategies and contextual factors that influenced the implementation of WCM and demonstrate some of the wider benefits from such approaches. Further research and methodologies are required to build the evidence base surrounding systems approaches in Public Health.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.