Abstract：
Interventions are needed to prevent and mitigate unhealthy commodity industry (UCI) influence on public health policy. Whilst literature on interventions is emerging, current conceptualisations remain incomplete as they lack considerations of the wider systemic complexities surrounding UCI influence, which may limit intervention effectiveness. This study applies systems thinking as a theoretical lens to help identify and explore how possible interventions relate to one another in the systems in which they are embedded. Related challenges to addressing UCI influence on policy, and actions to support interventions, were also explored.
Online participatory workshops were conducted with stakeholders with expertise in UCIs. A systems map, depicting five pathways to UCI influence, and the Action Scales Model were used to help participants identify interventions and guide discussions. Codebook thematic analysis was used to analyse the data.
Fifty-two stakeholders participated in 23 workshops. Participants identified 27 diverse, interconnected and interdependent interventions corresponding to the systems map\'s pathways that reduce the ability of UCIs to influence policy. These include, for example, reform policy financing; regulate public-private partnerships (PPPs); reform science governance and funding; frame and reframe the narrative, challenge neoliberalism and gross domestic product (GDP) growth; leverage human rights; change practices on multistakeholder governance; and reform policy consultation and deliberation processes. Participants also identified four potential key challenges to interventions (ie, difficult to implement or achieve; partially formulated; exploited or misused; requires tailoring for context), and four key actions to help support intervention delivery (ie, coordinate and cooperate with stakeholders; invest in civil society; create a social movement; nurture leadership).
A systems thinking lens revealed the theoretical interdependence between disparate and heterogenous interventions. This suggests that to be effective, interventions need to align, work collectively, and be applied synchronously to different parts of the system, including multiple levels of governance. Importantly, these interventions need to be supported by intermediary actions to be achieved. Urgent action is now required to strengthen healthy alliances and implement interventions.
Online participatory workshops were conducted with stakeholders with expertise in UCIs. A systems map, depicting five pathways to UCI influence, and the Action Scales Model were used to help participants identify interventions and guide discussions. Codebook thematic analysis was used to analyse the data.
Fifty-two stakeholders participated in 23 workshops. Participants identified 27 diverse, interconnected and interdependent interventions corresponding to the systems map\'s pathways that reduce the ability of UCIs to influence policy. These include, for example, reform policy financing; regulate public-private partnerships (PPPs); reform science governance and funding; frame and reframe the narrative, challenge neoliberalism and gross domestic product (GDP) growth; leverage human rights; change practices on multistakeholder governance; and reform policy consultation and deliberation processes. Participants also identified four potential key challenges to interventions (ie, difficult to implement or achieve; partially formulated; exploited or misused; requires tailoring for context), and four key actions to help support intervention delivery (ie, coordinate and cooperate with stakeholders; invest in civil society; create a social movement; nurture leadership).
A systems thinking lens revealed the theoretical interdependence between disparate and heterogenous interventions. This suggests that to be effective, interventions need to align, work collectively, and be applied synchronously to different parts of the system, including multiple levels of governance. Importantly, these interventions need to be supported by intermediary actions to be achieved. Urgent action is now required to strengthen healthy alliances and implement interventions.
摘要：
背景：需要采取干预措施来预防和减轻不健康的商品行业（UCI）对公共卫生政策的影响。虽然有关干预措施的文献正在兴起，当前的概念化仍然不完整，因为它们缺乏对围绕UCI影响的更广泛的系统复杂性的考虑，这可能会限制干预效果。本研究将系统思维作为理论透镜，以帮助识别和探索可能的干预措施在嵌入其中的系统中如何相互关联。解决UCI对政策影响的相关挑战，以及支持干预措施的行动，也被探索过。
方法：在线参与式研讨会与具有UCI专业知识的利益相关者一起进行。系统地图，描绘了UCI影响的五种途径，和行动量表模型用于帮助参与者识别干预措施并指导讨论。使用码本主题分析来分析数据。
结果：52个利益攸关方参加了23个研讨会。参与者确定了27个不同的，与系统相对应的相互关联和相互依赖的干预映射了降低UCI影响政策能力的途径。这些包括,例如,改革政策融资；规范公私伙伴关系(PPP)；改革科学治理和资金；框架和重新框架叙述，挑战新自由主义和国内生产总值（GDP）增长；利用人权；改变多利益攸关方治理的做法；改革政策咨询和审议过程。与会者还确定了干预措施的四个潜在关键挑战(即，难以实施或实现；部分制定；被利用或滥用；需要根据上下文进行调整)，以及帮助支持干预交付的四个关键行动(即，与利益相关者协调和合作；投资于民间社会；创建社会运动；培养领导力）。
结论：系统思维透镜揭示了不同干预和异质干预之间的理论相互依存关系。这表明要有效，干预措施需要保持一致，集体工作,并同步应用于系统的不同部分，包括多层次的治理。重要的是,这些干预措施需要得到中介行动的支持。现在需要采取紧急行动，以加强健康的联盟并实施干预措施。
方法：在线参与式研讨会与具有UCI专业知识的利益相关者一起进行。系统地图，描绘了UCI影响的五种途径，和行动量表模型用于帮助参与者识别干预措施并指导讨论。使用码本主题分析来分析数据。
结果：52个利益攸关方参加了23个研讨会。参与者确定了27个不同的，与系统相对应的相互关联和相互依赖的干预映射了降低UCI影响政策能力的途径。这些包括,例如,改革政策融资；规范公私伙伴关系(PPP)；改革科学治理和资金；框架和重新框架叙述，挑战新自由主义和国内生产总值（GDP）增长；利用人权；改变多利益攸关方治理的做法；改革政策咨询和审议过程。与会者还确定了干预措施的四个潜在关键挑战(即，难以实施或实现；部分制定；被利用或滥用；需要根据上下文进行调整)，以及帮助支持干预交付的四个关键行动(即，与利益相关者协调和合作；投资于民间社会；创建社会运动；培养领导力）。
结论：系统思维透镜揭示了不同干预和异质干预之间的理论相互依存关系。这表明要有效，干预措施需要保持一致，集体工作,并同步应用于系统的不同部分，包括多层次的治理。重要的是,这些干预措施需要得到中介行动的支持。现在需要采取紧急行动，以加强健康的联盟并实施干预措施。
