Causal Loop diagrams

BACKGROUND: Improving the adoption and implementation of policies to curb non-communicable diseases (NCDs) is a major challenge for better global health. The adoption and implementation of such policies remain deficient in various contexts, with limited insights into the facilitating and inhibiting factors. These policies have traditionally been treated as technical solutions, neglecting the critical influence of political economy dynamics. Moreover, the complex nature of these interventions is often not adequately incorporated into evidence for policy-makers...

Urban densification is a key strategy to accommodate rapid urban population growth, but emerging evidence suggests serious risks of urban densification for individuals' mental health. To better understand the complex pathways from urban densification to mental health, we integrated interdisciplinary expert knowledge in a causal loop diagram via group model building techniques. Six subsystems were identified: five subsystems describing mechanisms on how changes in the urban system caused by urban densification may impact mental health, and one showing how changes in mental health may alter urban densification...

BACKGROUND: Healthy sleep is crucial for the physical and mental wellbeing of adolescents. However, many adolescents suffer from poor sleep health. Little is known about how to effectively improve adolescent sleep health as it is shaped by a complex adaptive system of many interacting factors. This study aims to provide insights into the system dynamics underlying adolescent sleep health and to identify impactful leverage points for sleep health promotion interventions. METHODS: Three rounds of single-actor workshops, applying Group Model Building techniques, were held with adolescents (n = 23, 12-15 years), parents (n = 14) and relevant professionals (n = 26)...

OBJECTIVES: Despite Canada's universal health system, sex workers across the country face an alarmingly high number of barriers when they seek to healthcare services. This has resulted in unmet healthcare needs and substantially poorer health outcomes than the general Canadian population. The objective of this study was to use a systems thinking approach to gain an in-depth understanding of the barriers sex workers face and how access could be improved. METHODS: The analysis was conducted using a systems thinking methodology, which incorporates systems tools and inquiry processes...

BACKGROUND: System dynamics approaches, including group model building (GMB) and causal loop diagrams (CLDs), can be used to document complex public health problems from a community perspective. This paper aims to apply Social Network Analysis (SNA) methods to combine multiple CLDs created by local communities into a summary CLD, to identify common drivers of the health and wellbeing of children and young people. METHODS: Thirteen community CLDs regarding children and young people health and wellbeing were merged into one diagram involving three steps: (1) combining variable names; (2) CLD merging, where multiple CLDs were combined into one CLD with a set of unique variables and connections; (3) paring, where the Decision-Making Trial and Evaluation Laboratory (DEMATEL) method was used to generate a cut-point to reduce the number of variables and connections and to rank the overall importance of each variable in the merged CLD...

Causal-loop diagramming, a method from system dynamics, is increasingly used in evaluation to describe individuals' understanding of how policies or programs do or could work ("mental models"). The use of qualitative interviews to inform model development is common, but guidance for how to design and conduct these interviews to elicit causal information in participant mental models is scant. A key strength of semi-structured qualitative interviews is that they let participants speak freely; they are not, however, designed to elicit causal information...

Several modeling tools commonly used for supporting flood risk assessment and management are highly effective in representing physical phenomena, but provide a rather limited understanding of the multiple implications that flood risk and flood risk reduction measures have on highly complex systems such as urban areas. In fact, most of the available modeling tools do not fully account for this complexity-and related uncertainty-which heavily affects the interconnections between urban systems evolution and flood risk, ultimately resulting in an ineffective flood risk management...

As coal mines shift from shallow to deeper excavation, the number of mines facing the risk of rock burst disasters is gradually increasing. Rockburst, with their characteristics of vibration, suddenness, complexity, and unpredictability, make it increasingly difficult to prevent and control these disasters. Therefore, the challenges of preventing and controlling rock burst disasters are becoming more and more severe. This paper, based on the system-theoretic accident model and processes (STAMP) theory, extracts the causal factors affecting coal mine rock burst accidents...

The increased movement of humans throughout the world allowed the transportation of several species, such as Moringa oleifera Lam. (moringa), into biomes far away from their native habitation. Native to India, moringa is a versatile, drought-tolerant, and fast-growing tree that is easily adaptable to wide-ranging tropical and sub-tropical conditions around the world. It is used in cosmetics, as food and medicine for humans, livestock feed, crop biostimulant, and green manure. Even though moringa is an alien species to South Africa, its production is increasing, and its numerous uses are recognised by communities...

The purpose of this report is to provide a perspective on the use of qualitative systems mapping, provide examples of physical activity (PA) systems maps, discuss the role of PA systems mapping in the context of iterative learning to derive breakthrough interventions, and provide actionable recommendations for future work. Systems mapping methods and applications for PA are emerging in the scientific literature in the study of complex health issues and can be used as a prelude to mathematical/computational modeling where important factors and relationships can be elucidated, data needs can be prioritized and guided, interventions can be tested and (co)designed, and metrics and evaluations can be developed...

System dynamics approaches are increasingly addressing the complexity of public health problems such as childhood overweight and obesity. These approaches often use system mapping methods, such as the construction of causal loop diagrams, to gain an understanding of the system of interest. However, there is limited practical guidance on how such a system understanding can inform the development of an action programme that can facilitate systems changes. The Lifestyle Innovations Based on Youth Knowledge and Experience (LIKE) programme combines system dynamics and participatory action research to improve obesity-related behaviours, including diet, physical activity, sleep and sedentary behaviour, in 10-14-year-old adolescents in Amsterdam, the Netherlands...

INTRODUCTION: Climate change is a global phenomenon with far-reaching consequences, and its impact on human health is a growing concern. The intricate interplay of various factors makes it challenging to accurately predict and understand the implications of climate change on human well-being. Conventional methodologies have limitations in comprehensively addressing the complexity and nonlinearity inherent in the relationships between climate change and health outcomes. OBJECTIVES: The primary objective of this paper is to develop a robust theoretical framework that can effectively analyze and interpret the intricate web of variables influencing the human health impacts of climate change...

As one of the most rapidly developing cities in China, Shenzhen grapples with an increasing challenge in managing water resources due to escalating conflicts with its soaring water demand. This study established a system dynamics (SD) model based on a causal loop diagram to explore the intricate interconnections within the urban water resources system. Through simulating water supply and demand in Shenzhen from 2021 to 2035, the model identified key sensitive factors and examined various utilization scenarios for multiple water resources...

In 2019, national immunization programs in Ghana, Kenya, and Malawi commenced the implementation of RTS,S/AS01 vaccination in large-scale pilot schemes. Understanding the implementation context of this malaria vaccination in the pilot countries can provide useful insights for enhancing implementation outcomes in new countries. There has not yet been a proper synthesis of the implementation determinants of malaria vaccination programs. A rapid review was conducted to identify the implementation determinants of the pilot malaria vaccination programs in Ghana, Kenya, and Malawi, and describe the mechanism by which these determinants interact with each other...

Sexual and gender minority (SGM) populations experience extensive health disparities compared to their straight and cisgender counterparts. The importance of addressing these disparities is paramount, as SGM groups often encounter significant barriers to accessing comprehensive healthcare, including societal stigma, provider bias, and financial constraints. This study utilizes a community-based system dynamics approach to understand and visualize the barriers to and facilitators of healthcare engagement for SGM groups across their life course...

Actual cost fluctuations in construction projects are common in the construction industry, including the Kingdom of Saudi Arabia (KSA). This study's objective is to establish a simulation forecasting model for Saudi projects' cost changes that will be used to anticipate the actual cost spent at the project's end. It also indicates if there are cost overruns or savings by considering ten identified cost-risk impact factors. The study involves a systematic, integrated approach to developing system dynamics (SD) to reflect the ten cost overrun impact factors (COICs) in the KSA construction industry...

BACKGROUND: An important consequence of climate change for urban health is heat-related mortality. Vulnerable groups, especially elderly, will be the most affected. A solution put forward in many reports and policy documents is the introduction or expansion of urban green spaces. While they have a proven effect in decreasing the ambient temperature and reducing heat related mortality, the causal pathways are far from clear. Moreover, results vary for different contexts, population types and characteristics of green spaces as they are 'complex systems thrusted into complex systems'...

BACKGROUND: Vocational school students exhibit significant risk behaviors in terms of poor diet, frequent use of nicotine products, inadequate fruit and vegetable intake, low levels of physical activity, and poor mental health. This makes vocational students vulnerable to the development of noncommunicable diseases. Therefore, effective health promotion programs targeting vocational students are required. OBJECTIVE: The Danish study "Data-driven and Systems Approach to Health Promotion Among Vocational Students" (Data Health) aims to develop, implement, and evaluate a systems approach to support vocational schools, municipalities, and local communities in implementing locally relevant health promotion actions among and for vocational students...

BACKGROUND: Interest in applying a complex systems approach to understanding socioeconomic inequalities in health is growing, but an overview of existing research on this topic is lacking. In this systematic scoping review, we summarize the current state of the literature, identify shared drivers of multiple health and health behavior outcomes, and highlight areas ripe for future research. METHODS: SCOPUS, Web of Science, and PubMed databases were searched in April 2023 for peer-reviewed, English-language studies in high-income OECD countries containing a conceptual systems model or simulation model of socioeconomic inequalities in health or health behavior in the adult general population...

The cost of physical inactivity is alarming, and calls for whole-of-system approaches to population physical activity promotion (PPAP) are increasing. One innovative approach to PPAP is to use a framework of interdependent attributes and associated dimensions of effective systems for chronic disease prevention. Describing system boundaries can be an elusive task, and this article reports on using an attribute framework as a first step in describing and then assessing and strengthening a provincial system for PPAP in British Columbia, Canada...