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      Systems science and systems thinking for public health: a systematic review of the field

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          Abstract

          Objectives

          This paper reports on findings from a systematic review designed to investigate the state of systems science research in public health. The objectives were to: (1) explore how systems methodologies are being applied within public health and (2) identify fruitful areas of activity.

          Design

          A systematic review was conducted from existing literature that draws on or uses systems science (in its various forms) and relates to key public health areas of action and concern, including tobacco, alcohol, obesity and the social determinants of health.

          Data analysis

          117 articles were included in the review. An inductive qualitative content analysis was used for data extraction. The following were systematically extracted from the articles: approach, methodology, transparency, strengths and weaknesses. These were then organised according to theme (ie, commonalities between studies within each category), in order to provide an overview of the state of the field as a whole. The assessment of data quality was intrinsic to the goals of the review itself, and therefore, was carried out as part of the analysis.

          Results

          4 categories of research were identified from the review, ranging from editorial and commentary pieces to complex system dynamic modelling. Our analysis of each of these categories of research highlighted areas of potential for systems science to strengthen public health efforts, while also revealing a number of limitations in the dynamic systems modelling being carried out in public health.

          Conclusions

          There is a great deal of interest in how the application of systems concepts and approach might aid public health. Our analysis suggests that soft systems modelling techniques are likely to be the most useful addition to public health, and align well with current debate around knowledge transfer and policy. However, the full range of systems methodologies is yet to be engaged with by public health researchers.

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          Most cited references81

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          Synthesising qualitative and quantitative evidence: a review of possible methods.

          The limitations of traditional forms of systematic review in making optimal use of all forms of evidence are increasingly evident, especially for policy-makers and practitioners. There is an urgent need for robust ways of incorporating qualitative evidence into systematic reviews. In this paper we provide a brief overview and critique of a selection of strategies for synthesising qualitative and quantitative evidence, ranging from techniques that are largely qualitative and interpretive through to techniques that are largely quantitative and integrative. A range of methods is available for synthesising diverse forms of evidence. These include narrative summary, thematic analysis, grounded theory, meta-ethnography, meta-study, realist synthesis, Miles and Huberman's data analysis techniques, content analysis, case survey, qualitative comparative analysis and Bayesian meta-analysis. Methods vary in their strengths and weaknesses, ability to deal with qualitative and quantitative forms of evidence, and type of question for which they are most suitable. We identify a number of procedural, conceptual and theoretical issues that need to be addressed in moving forward with this area, and emphasise the need for existing techniques to be evaluated and modified, rather than inventing new approaches.
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            Systems thinking for strengthening health systems in LMICs: need for a paradigm shift.

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              • Article: not found

              Advancing the science of community-level interventions.

              Community interventions are complex social processes that need to move beyond single interventions and outcomes at individual levels of short-term change. A scientific paradigm is emerging that supports collaborative, multilevel, culturally situated community interventions aimed at creating sustainable community-level impact. This paradigm is rooted in a deep history of ecological and collaborative thinking across public health, psychology, anthropology, and other fields of social science. The new paradigm makes a number of primary assertions that affect conceptualization of health issues, intervention design, and intervention evaluation. To elaborate the paradigm and advance the science of community intervention, we offer suggestions for promoting a scientific agenda, developing collaborations among professionals and communities, and examining the culture of science.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2015
                30 December 2015
                : 5
                : 12
                : e009002
                Affiliations
                [1 ]Regulatory Institutions Network Australian National University , Canberra, Australia
                [2 ]The Australian Prevention Partnership Centre, Sax Institute , Sydney, Australia
                [3 ]Self-organizing Systems Research Group School of engineering and applied sciences Harvard University
                [4 ]Centre for Social Impact, Swinburne University , Melbourne, Victoria, Australia
                [5 ]Centre for Epidemiology and Preventive Health. Monash University , Melbourne, Australia
                [6 ]Maths Science Institute Australian National University
                Author notes
                [Correspondence to ] Dr Gemma Carey; Gemma.carey@ 123456anu.edu.au
                Article
                bmjopen-2015-009002
                10.1136/bmjopen-2015-009002
                4710830
                26719314
                d630a68f-848a-4926-b84d-5be3c01f95da
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 6 June 2015
                : 23 October 2015
                : 11 November 2015
                Categories
                Public Health
                Research
                1506
                1724
                1724
                1703

                Medicine
                systems thinking,complexity,systems science
                Medicine
                systems thinking, complexity, systems science

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