Systems approaches in prevention research: Striking a balance between systemic and systematic

The language of complex systems is almost becoming mainstream and there is growing agreement in the public health literature on the importance of systems thinking in prevention research.  Yet what does that really look like? How are systems approaches operationalised by research groups when studying chronic disease prevention? And how are these different to more traditional systematic ways of working in public health research?

In writing about the hidden power of systems thinking Ison and Straw* proposed that to address complexity, the right balance must be struck between ‘systemic’ and ‘systematic’ paradigms. A team of investigators including Prevention Centre Co-Director Professor Lucie Rychetnik applied these ideas to examine six case studies and explore how the systemic and systematic paradigms appear across different types of prevention research.  

We found the ways of working varied significantly for each case. For example, an obesity modelling project and a community-based childhood obesity program could be described as highly systemic due to their explicit uses of systems science theory and methods. However, both also demonstrated highly systematic, process-driven, and detail-focused public health research methodologies.   

Professor Lucie Rychetnik

Conversely, the team found a food policy project and health service prevention program that could be described as systematic due to their underpinning theories, research designs, and data collection methods. Yet several other dimensions of those cases were also clearly systemic, including the focus on systems change, bringing together multiple perspectives, building system leadership, and their systemic approaches to capacity building.  

There is inherent value in being more explicitly conscious and bilingual in both systemic and systematic paradigms so that their respective value and strengths can address complexity in prevention research.

Dr Melanie Pescud

Findings from this research have been published in a Systems paper ‘Addressing complexity in chronic disease prevention‘ and included in a video presentation.

The systemic and systematic paradigms used by the team were defined as:

Systemic 

• Exploring the bigger picture 
• Focus on whole systems composed of interconnected parts 
• Natural experiments 
• A non-linear focus 
• Supporting change and change-agents in leveraging systems 
• Non-dualistic thinking (embracing the continuum) 
• “What works for what systems in what contexts?” 
• A focus on strengthening existing systems 

Systematic 

• A focus on details
• Methodical
• Examining the parts within a system
• A more linear focus
• Duality (black and white, night and day, inhale and exhale, yin and yang, etc.)
• Randomised controlled trials and cluster randomised controlled trials
• “What intervention works?”;
• A focus on fidelity in program delivery 

*Ison, R.; Straw, E. The Hidden Power of Systems Thinking: Governance in a Climate Emergency; Routledge: Oxfordshire, UK, 2020.