Poster Presentation ANZOS Annual Scientific Meeting 2021

The PH12 framework: translating the Meadows 12 leverage points for use in obesity prevention (#243)

Jillian Whelan 1 , Penny Fraser 2 , Andrew Brown 2 , Colin Bell 1 , Steve Allender 2 , Kristy Bolton 3
  1. School of Medicine and Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
  2. Global Obesity Centre, Deakin University, Geelong, VIC, Australia
  3. Institute of Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia

Background: System science has a prominent place in understanding and designing potential solutions to address complex public health challenges. Systems approaches strengthen multi-level, multi-component initiatives by acknowledging the interaction between variables impacting the issue, feedback loops and consequences from initiative activity. Several system approaches empower communities to understand and act within their local system.  For researchers and practitioners, it can be challenging to identify ‘where’ and ‘how’ to intervene in a system. The pioneering work of Donella Meadows, based in conservation and economic development, identified 12 places to intervene in a system for maximum impact (Meadows 12). We set out to translate Meadows 12 for the field of obesity prevention and present here the Public Health 12 Framework (PH12).

Methods: Definitions from Meadows 12 were translated into public health, user friendly language by a team of six researchers (practitioners, implementation scientists, systems specialists). We allocated actions from three existing complex large-scale community-based systems thinking obesity prevention interventions conducted in Victoria, Australia between 2016-2020 to determine where most intervention activity occurred.

Results: PH12 was created, and actions were mapped to illustrate the translated definitions. This mapping of actions revealed most actions targeted levels of the systems that potentially have less impact, thereby identifying opportunities to build, develop, or advocate for actions with potentially greater impact.

Conclusions: The PH12 is a public health translation of Meadows 12. PH12 has the potential to support practitioners, researchers, and policy makers to analyse actions and identify where more targeted work may enhance implementation and outcomes in system approaches to obesity prevention. The next step is to test the validity and acceptability of PH12 in both practice and academic environments.