ArticleBMC public health2025
A participatory needs assessment to map the system dynamics of overweight related behaviours of 10-14-year-old adolescents living in an underserved neighbourhood in Amsterdam, the Netherlands.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Using systems archetypes to understand system behaviour and identify leverage points for change in local obesity prevention in The Netherlands.Health promotion international · 2026Article
- Article
- Applying system dynamics methods for local obesity prevention: results from a group model building study in Amsterdam, the Netherlands.Health research policy and systems · 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
- Applying systems thinking in youth-centred participatory action research for health promotion in an underserved neighbourhood.Frontiers in public health · 2024Article
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Authors and funding
8 authors.
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Abstract
backgroundDeveloping interventions along with the population of interest using systems thinking is a promising method to address the underlying system dynamics of overweight. The purpose of this study is twofold: to gain insight into the perspectives of adolescents regarding: (1) the system dynamics of energy balance-related behaviours (EBRBs) (physical activity, screen use, sleep behaviour and dietary behaviour); and (2) underlying mechanisms and overarching drivers of unhealthy EBRBs.
methodsWe conducted Participatory Action Research (PAR) to map the system dynamics of EBRBs together with adolescents aged 10-14 years old living in a lower socioeconomic, ethnically diverse neighbourhood in Amsterdam East, the Netherlands. For just over two years, we conducted weekly PAR sessions (45-120 min) with four dynamic groups - two in primary schools and two in secondary schools - each school year (n = 4-8 adolescents in each group (0-100% girls); n = 40-54 sessions in total per group). These adolescents acted as co-researchers and created Causal Loop Diagrams (CLDs) for each EBRB and explored important underlying mechanisms for unhealthy EBRBs. Based on the underlying mechanisms, three overarching drivers for unhealthy EBRBs were distinguished.
resultsThe three overarching drivers for unhealthy EBRBs are: (1) the physical environment, (2) social norms, and (3) unhealthy behaviours reinforcing each other. The adolescents explained that their physical environment fosters unhealthy behaviour by providing easy access to unhealthy food products while restricting physical activity. They explained the importance of social norms around EBRBs that are formed by their peers, friends, and family. The influence of their peers often led to unhealthier EBRBs, especially after the transition to secondary school. The adolescents explained that unhealthy behaviours reinforced each other, while healthy behaviour led to more healthy behaviour.
conclusionsOur novel approach combining PAR with systems thinking gained valuable insights into the system dynamics of EBRBs from the adolescent perspective. These insights can inform future interventions targeting systems change regarding EBRBs.
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