ArticlePloS one2023
Leverage point themes within Dutch municipalities' healthy weight approaches: A qualitative study from a systems perspective.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Mapping Longitudinal Dynamics of Learning Communities Dealing With Dutch Healthy Weight Approaches: An Updated Causal Loop Diagram.Evaluation & the health professions · 2026Article
- 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
- Exploring learning communities' actions and perceived impact on healthy weight approaches across Dutch municipalities.BMC public health · 2025Article
- The multidisciplinary and participatory process to develop the Rubric for Learning Communities about Health Approaches.Frontiers in public health · 2025Article
- Mapping the dynamics of learning communities about Dutch healthy weight approaches: a causal loop diagram.Archives of public health = Archives belges de sante publique · 2024Article
- Citizens' perspectives on healthy weight approaches in low SEP neighborhoods: a qualitative study from a systems perspective.BMC public health · 2024Article
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Authors and funding
6 authors.
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Abstract
introductionDespite all efforts of national and local approaches, obesity rates continue to rise worldwide. It is increasingly recognized that the complexity of obesity should be further addressed by incorporating a systems perspective when implementing approaches. Such an approach has four interconnected system levels: events, structures, goals, and beliefs, in which small changes ('leverage points') can lead to substantial changes in the functioning of the entire system. The current research examined the functioning of five Dutch municipalities' healthy weight approaches (HWAs) and the leverage point themes that can be identified in their system.
methodsThirty-four semi-structured interviews were conducted with various stakeholders about the HWA, including policy advisors, care professionals, practice professionals, and citizens. An inductive thematic analysis was performed.
resultsThree main themes were identified: 1) HWA organization structure, 2) collaboration between professionals, and 3) citizen participation. Across all system levels, we identified leverage point themes. The upper-levels events and structures occurred the most and were explained by underlying goals and beliefs. Leverage point themes regarding "HWA organization structure" were municipal processes, such as perceived impact; diversity of themes, activities, and tasks; network; and communication strategies, such as messages about the HWA. Leverage point themes regarding "collaboration between professionals" were linking pins, indicating central players within the network; motivation and commitment including support base; and stimulating one another to work on the HWA by spurring other professionals into action. Lastly, leverage point themes under "citizen participation" included reaching the target group, e.g., look for entry points; and citizens' motivation, including customization. DISCUSSION: This paper provides unique insights into HWAs' leverage point themes that can lead to substantial changes in how the entire system functions and makes suggestions about underlying leverage points to help stakeholders improve their HWA. Future research could focus on studying leverage points within leverage point themes.
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