As explained above, the LIKE logic model provides an overview of LIKE as a whole. We have developed materials and tools for each of the 7 steps; building in part on other (international) research. The various steps and associated tools can be used separately, however, the underlying idea of LIKE is to use the model as a whole. For more information on this approach, see this scientific publication(System dynamics and PAR approach – Waterlander et al., 2020)

Important here is to get an idea of what we mean by systems thinking. For this, we created an animation:

And what exactly is Participatory Action Research? Read more about this via the fact sheet below [link volgt].

We will explain each step in the following tabs and refer to related tools and articles.

The first step in our participatory systems approach was to map the system (Needs Assessment) from different perspectives. In the LIKE study, we did this with the young people themselves, as well as other key stakeholders in Amsterdam East and the researchers in the consortium.

Needs assessment – perspectives of stakeholders & youth:

• Group Model Building is a participatory, qualitative method for identifying perspectives of different stakeholders around a given complex problem. For more information, read the Group Model Building Manual. (In Dutch only)
• Co-creation is a form of collaboration that leads to a final product where all stakeholders have an influence on the process and outcome. For more information, read the co-creation inspiration guide.
• Photovoice is a participatory action research method in which participants work as photographers themselves based on an assignment. For more information, read the [link volgt].

Needs assessment – researchers’ perspectives:

• In the LIKE study, we also used scientific information to map the “outside” perspective. For more on this, read the article[Understanding obesity-related behaviors in youth from a systems dynamics perspective: The use of causal loop diagrams – Waterlander et al., 2021]
• Social network analysis is a method for understanding key actors in relation to a particular issue. For more information, see “Resource F” here.
• Action mapping – action mapping can help map existing actions (and new actions). For more information, see step 4 in the ENCOMPASS framework via the [ENCOMPASS tool] and the scientific article[The ENCOMPASS Framework: A Practical Guide for the Evaluation of Public Health Programs in Complex Adaptive Systems – Luna Pinzon et al., 2022].
• Interviews with healthcare professionals – for more information see the scientific article[Perspectives of healthcare professionals on facilitators, barriers and needs in children with obesity and their parents in achieving a healthier lifestyle – de Pooter et al., 2022].

At this step, it is important to map the system in the form of a causal loop diagram (CLD). The tools from steps 1 & 2 help to create the CLD and this can vary (e.g., through literature, Group Model Building, interviews, etc.). In LIKE, we combined the information from the methods named in steps 1 & 2 into an overarching system map or visualization of the system. For more information, read the scientific article[Understanding the system dynamics of obesity-related behaviors in 10- to 14-year-old adolescents in Amsterdam from a multi-actor perspective – Luna Pinzon et al., 2023].

There are tools to draw the map itself. In LIKE, we used the following tools to draw the system maps, such as STICK-E or KUMU.

Once the system is mapped, “leverage points” or points of leverage can be identified to change the system (for more on this, see step 3 of the ENCOMPASS framework). An important insight here is to look for opportunities in different levels of the system namely:

• system elements (the individual puzzle pieces in the system, for example, a healthy school cafeteria)
• system structure (e.g. networks in the system, such as network between school, parents and supermarket)
• system goals (e.g., including health in governmental policies)
• paradigm (e.g., that the system is committed to health promotion over economic growth)

In LIKE, we used two methods to identify points of leverage: (1) the youth themselves (in PAR groups) (2) through groups with researchers, policy staff and professionals.

We are currently working on a scientific publication on this (link to follow).

Multiple models are available to identify leverage points:

• Intervention Level Framework
• Action Scales Model
• Iceburg Model
• The Public Health 12

Based on the identified leverage points, we developed actions that could change the system. It is also possible to modify existing interventions to better address the identified leverage points.

We are currently working on a scientific publication about this (link to follow).

A program in a complex adaptive system also requires a different method of evaluation, which should take complexity into account. The ENCOMPASS evaluation framework was specifically developed for this purpose. The framework consists of five phases.

1. Adopt a system-dynamic perspective in overall evaluation design
2. Define the system boundaries
3. Develop an understanding of the existing system to inform system change
4. Monitor dynamic program output at different system levels
5. Measure program outcomes and impact in terms of systemic change

For more information, read the scientific article[The ENCOMPASS framework: a practical guide for the evaluation of public health programs in complex adaptive systems – Luna Pinzon et al., 2022].
To better understand the steps, we also developed a tool[ENCOMPASS tool].