背景:考虑到非传染性疾病(NCDs)的复杂决定因素,以及动态的政策格局,研究人员和政策制定者正在探索使用系统思维和复杂性科学(STCS)在制定有效的政策。本次审查的目的是系统地确定和分析STCS知情方法在非传染性疾病预防政策中的现有应用。
方法:系统范围审查:我们搜索了学术数据库(Medline,Scopus,WebofScience,EMBASE)适用于2020年10月13日之前索引的所有出版物,筛选标题,摘要和全文,并根据已发布的指南提取数据。我们总结了每项研究的关键数据,将STCS通知的方法的应用程序映射到策略进程域。我们进行了专题分析,以确定优势,局限性,使用STCS的障碍和促进者。
结果:共筛选了4681篇论文,纳入了112篇论文。最常见的政策领域是烟草控制,预防肥胖和促进体力活动。应用的方法包括系统动力学建模,基于代理的建模和概念图。优势包括支持循证决策;对复杂系统进行建模并解决多部门问题。限制包括STCS方法对现实的抽象,尽管目标是包含更大的复杂性。挑战包括资源密集型;利益攸关方对模型缺乏信任;结果过于复杂,利益攸关方无法理解。确保利益相关者的所有权并以用户友好的方式提供调查结果,从而促进了STCS的使用。
结论:本文概述了STCS方法在非传染性疾病预防政策中的应用。STCS方法有可能产生量身定制的动态证据,为循证决策增加了稳健性,但必须是政策利益相关者可以接触到的,并拥有强大的利益相关者所有权,以建立共识并改变利益相关者的观点。评估是否,在什么情况下,与传统方法相比,STCS方法导致更有效的策略缺乏,并将能够更有针对性和建设性地使用这些方法。
Given the complex determinants of non-communicable diseases (NCDs), and the dynamic policy landscape, researchers and policymakers are exploring the use of systems thinking and complexity science (STCS) in developing effective policies. The aim of this
review is to systematically identify and analyse existing applications of STCS-informed methods in NCD prevention policy.
Systematic scoping
review: We searched academic databases (Medline, Scopus, Web of Science, EMBASE) for all publications indexed by 13 October 2020, screening titles, abstracts and full texts and extracting data according to published guidelines. We summarised key data from each study, mapping applications of methods informed by STCS to policy process domains. We conducted a thematic analysis to identify advantages, limitations, barriers and facilitators to using STCS.
4681 papers were screened and 112 papers were included in this
review. The most common policy areas were tobacco control, obesity prevention and physical activity promotion. Methods applied included system dynamics modelling, agent-based modelling and concept mapping. Advantages included supporting evidence-informed decision-making; modelling complex systems and addressing multi-sectoral problems. Limitations included the abstraction of reality by STCS methods, despite aims of encompassing greater complexity. Challenges included resource-intensiveness; lack of stakeholder trust in models; and results that were too complex to be comprehensible to stakeholders. Ensuring stakeholder ownership and presenting findings in a user-friendly way facilitated STCS use.
This
review maps the proliferating applications of STCS methods in NCD prevention policy. STCS methods have the potential to generate tailored and dynamic evidence, adding robustness to evidence-informed policymaking, but must be accessible to policy stakeholders and have strong stakeholder ownership to build consensus and change stakeholder perspectives. Evaluations of whether, and under what circumstances, STCS methods lead to more effective policies compared to conventional methods are lacking, and would enable more targeted and constructive use of these methods.