Abstract：
BACKGROUND: Unhealthy commodity industries (UCIs) engage in political practices to influence public health policy, which poses barriers to protecting and promoting public health. Such influence exhibits characteristics of a complex system. Systems thinking would therefore appear to be a useful lens through which to study this phenomenon, potentially deepening our understanding of how UCI influence are interconnected with one another through their underlying political, economic and social structures. As such this study developed a qualitative systems map to depict the complex pathways through which UCIs influence public health policy and how they are interconnected with underlying structures.
METHODS: Online participatory systems mapping workshops were conducted between November 2021 and February 2022. As a starting point for the workshops, a preliminary systems map was developed based on recent research. Twenty-three online workshops were conducted with 52 geographically diverse stakeholders representing academia, civil society (CS), public office, and global governance organisations (CGO). Analysis of workshop data in NVivo and feedback from participants resulted in a final systems map.
RESULTS: The preliminary systems map consisted of 40 elements across six interdependent themes. The final systems map consisted of 64 elements across five interdependent themes, representing key pathways through which UCIs impact health policy-making: (1) direct access to public sector decision-makers; (2) creation of confusion and doubt about policy decisions; (3) corporate prioritisation of commercial profits and growth; (4) industry leveraging the legal and dispute settlement processes; and (5) industry leveraging policy-making, norms, rules, and processes.
CONCLUSIONS: UCI influence on public health policy is highly complex, involves interlinked practices, and is not reducible to a single point within the system. Instead, pathways to UCI influence emerge from the complex interactions between disparate national and global political, economic and social structures. These pathways provide numerous avenues for UCIs to influence public health policy, which poses challenges to formulating a singular intervention or limited set of interventions capable of effectively countering such influence. Using participatory methods, we made transparent the interconnections that could help identify interventions in future work.
METHODS: Online participatory systems mapping workshops were conducted between November 2021 and February 2022. As a starting point for the workshops, a preliminary systems map was developed based on recent research. Twenty-three online workshops were conducted with 52 geographically diverse stakeholders representing academia, civil society (CS), public office, and global governance organisations (CGO). Analysis of workshop data in NVivo and feedback from participants resulted in a final systems map.
RESULTS: The preliminary systems map consisted of 40 elements across six interdependent themes. The final systems map consisted of 64 elements across five interdependent themes, representing key pathways through which UCIs impact health policy-making: (1) direct access to public sector decision-makers; (2) creation of confusion and doubt about policy decisions; (3) corporate prioritisation of commercial profits and growth; (4) industry leveraging the legal and dispute settlement processes; and (5) industry leveraging policy-making, norms, rules, and processes.
CONCLUSIONS: UCI influence on public health policy is highly complex, involves interlinked practices, and is not reducible to a single point within the system. Instead, pathways to UCI influence emerge from the complex interactions between disparate national and global political, economic and social structures. These pathways provide numerous avenues for UCIs to influence public health policy, which poses challenges to formulating a singular intervention or limited set of interventions capable of effectively countering such influence. Using participatory methods, we made transparent the interconnections that could help identify interventions in future work.
摘要：
背景：不健康的商品行业（UCI）从事政治实践以影响公共卫生政策，这对保护和促进公众健康构成了障碍。这种影响表现出复杂系统的特征。因此，系统思考似乎是研究这种现象的有用镜头，潜在加深我们对UCI影响力如何通过其潜在的政治相互联系的理解，经济和社会结构。因此，这项研究开发了一个定性系统图，以描绘UCI影响公共卫生政策的复杂途径以及它们如何与基础结构相互联系。
方法：在线参与式系统制图研讨会于2021年11月至2022年2月期间举办。作为研讨会的起点，根据最近的研究开发了初步的系统图。与代表学术界的52个地理上不同的利益攸关方举行了23次在线讲习班，公民社会（CS），公职,全球治理组织（CGO）。对NVivo中的研讨会数据和参与者的反馈的分析得出了最终的系统图。
结果：初步系统图包括六个相互依存主题的40个元素。最终的系统地图由五个相互依存的主题的64个元素组成，代表UCI影响卫生政策制定的关键途径：（1）直接接触公共部门决策者；（2）对政策决定造成混乱和怀疑；（3）公司对商业利润和增长的优先考虑；（4）行业利用法律和争端解决程序；（5）行业利用政策制定，规范,规则,和过程。
结论：UCI对公共卫生政策的影响非常复杂，涉及相互关联的实践，并且不能简化到系统内的单个点。相反，UCI影响的途径来自不同的国家和全球政治之间的复杂互动，经济和社会结构。这些途径为UCI影响公共卫生政策提供了许多途径，这对制定能够有效应对这种影响的单一干预措施或有限的干预措施提出了挑战。使用参与式方法，我们使相互联系变得透明，这有助于确定未来工作中的干预措施。
方法：在线参与式系统制图研讨会于2021年11月至2022年2月期间举办。作为研讨会的起点，根据最近的研究开发了初步的系统图。与代表学术界的52个地理上不同的利益攸关方举行了23次在线讲习班，公民社会（CS），公职,全球治理组织（CGO）。对NVivo中的研讨会数据和参与者的反馈的分析得出了最终的系统图。
结果：初步系统图包括六个相互依存主题的40个元素。最终的系统地图由五个相互依存的主题的64个元素组成，代表UCI影响卫生政策制定的关键途径：（1）直接接触公共部门决策者；（2）对政策决定造成混乱和怀疑；（3）公司对商业利润和增长的优先考虑；（4）行业利用法律和争端解决程序；（5）行业利用政策制定，规范,规则,和过程。
结论：UCI对公共卫生政策的影响非常复杂，涉及相互关联的实践，并且不能简化到系统内的单个点。相反，UCI影响的途径来自不同的国家和全球政治之间的复杂互动，经济和社会结构。这些途径为UCI影响公共卫生政策提供了许多途径，这对制定能够有效应对这种影响的单一干预措施或有限的干预措施提出了挑战。使用参与式方法，我们使相互联系变得透明，这有助于确定未来工作中的干预措施。
