Building a systems map of the influences on physical activity

Slide 1:

Welcome to building a systems map of the influences on physical activity.  This short video comes to you from ASAPa – the Australian Systems Approaches to Physical Activity project team. This particular piece of work has been led by my colleague Prof Bill Bellew. Other members of the team are Professor Ben Smith, myself Tracy Nau, and Project Director Professor Adrian Bauman.

Slide 2:

This is an overview of what we will be covering. We’ll firstly start with an introduction into the purpose and boundaries of the map; we’ll unpack the different layers of the map; show you some of the potential connections between the various components; and finally offer some guidance on how to use the systems map whilst avoiding potential pitfalls.

Slide 3:

Let’s start with the introduction, purpose and boundaries of the systems map that we’ll show you in this video.

Slide 4:

The purposes of this video are threefold:

1. Firstly, to provide the latest update to the physical activity systems map that we’ve developed with the National Physical Activity Network for Australia. The boundary that we’ve got here is at the national level and it covers all the states and territories of Australia;
2. Secondly, to suggest that this Australian systems map could serve as a template that might help other jurisdictions – whether they be countries, regions, cities, or towns – to consider how to go about building their own systems map;
3. Finally, we identify some of the opportunities for practical use as well as potential pitfalls to avoid in using systems approaches for your own specific physical activity context.

Slide 5:

Let’s look at how we build the levels of the systems map, remembering that the boundary of this particular mapping is at a national level for all Australian States and Territories.

Slide 6:

Let’s begin with level 1, the centre of the map.

Slide 7:

At the centre is human movement otherwise known as physical activity. By this we mean all forms of physical activity including active transport, sport and recreation, incidental lifestyle activities, structured activity, and movement for people of all abilities and ages.

Slide 8:

Here, we’ve added our first layer to the map. We have four core broad domains of influences on physical activity: they are psychological, physiological, demographic (e.g. gender and socioeconomic status), and taking account of how people interact with their social environment and norms.

Slide 9:

Let’s move on to the next layer of the map, interventions by strategy and setting.

Slide 10:

Here we’ve made eight additions to the map – they show intervention points in the system through strategies (e.g. Mass communication) and settings (e.g. Schools, Workplaces, and Healthcare).

Slide 11:

These intervention points are also known as the ‘8 investments that work for physical activity’ as recognised by the International Society for PA and Health (ISPAH). There is expert consensus as well as the accumulation of compelling evidence that these are the best investment areas to create more active populations.

Slide 12:

The 8 intervention points/best investments are also fully consistent with the framework for action set out by the World Health Organization in the 2018 Global Action Plan on Physical Activity (GAPPA) – More Active People for a Healthier World.

Slide 13:

So what we’ve got so far, is an inner layer of core influences, and an outer layer of intervention points by strategy and setting.

Slide 14:

We’re now going to add another layer to show system-level enablers and leverage points.

Slide 15:

Here we see the addition of 10 elements (in dark green), which are the system-level enablers and leverage points. As the name suggests, these enablers and leverage points can operate across the system rather than in a single setting or through one specific strategy. They include Legislation and regulation, Workforce establishment and capability, Whole of system surveillance, as well as Leadership, Governance and Multisectoral partnerships.  These leverage points are also connected to each other as you will see later.

Slide 16:

In this section we will look at the connection for each of the eight interventions by strategy and setting.

Slide 17:

In each of the following slides, we highlight the expected connections from the intervention node (identified using a dotted circle as you see here with ‘Transport and Human Movement’) to any other part of the systems map. Links to Whole of system surveillance are shown with a blue dotted line. Many links are in one direction only, while in some cases the influences are two-way or bi-directional in nature.

Slide 18:

Here we see the hypothetical linkages for interventions through the Workplace setting. Note there are linkages to the core influences of activity (in light blue), as well as to systems-level enablers (in outer dark green).

Slide 19:

Here we see linkages for interventions through Community-wide programs.

Slide 20:

And on this slide, through the Education setting. Note that the different investments/settings connect to different parts of the system; there is some overlap, but also some unique patterns.

Slide 21:

Here we see the linkages for interventions through the Sport and recreation setting.

Slide 22:

And here for Primary and secondary healthcare settings.

Slide 23:

And over here for linkages for interventions through Mass communication, public education and information systems.

Slide 24:

Over here we see the linkages for interventions through Planning, the physical environment, urban design and strategies for liveability and walkability.

Slide 25:

Now in this section we’ll look at the connections from the 10 ‘system-level enablers and leverage points’.

Slide 26:

Just to remind you, the systems-level enablers and leverage points are the ones in the outer-most layer in dark green.

Slide 27:

Here we see the system linkages for financing mechanisms.

Slide 28:

Over here the system linkages for workforce establishment and capability.

Slide 29:

Here we’ve got it for knowledge development and mobilization.

Slide 30:

And over here, the linkages for whole-of-system surveillance.

Slide 31:

We also see linkages here for Leadership, Governance, Transparency and Accountability.

Slide 32:

As well as here, for Multisectoral strategic partnerships.

Slide 33:

Here we look at the system linkages for Advocacy and Social movements.

Slide 34:

And over here for the Political environment.

Slide 35:

Here we see the linkages for the Commercial environment.

Slide 36:

And over here for Legislation, Regulation and Public policy.

Slide 37:

Finally, let’s map the connections systems-wide.

Slide 38:

So here we have the whole of systems map for PA in Australia, which brings together core influences, strategic/settings interventions and enablers/leverage points.

Slide 39:

In this section, we’ll consider how this tool can be used by taking a look at its strengths as well as some potential pitfalls to avoid.

Slide 40:

The strengths and practical uses of this systems map include Understanding, Planning (e.g. identifying assets/needs and priorities for action), Action (identifying starting points for intervention and potential partners or allies) and Evaluation (e.g. in terms of identifying what areas will be the focus).

Slide 41:

It’s important to remember the following so as to avoid potential pitfalls.

First of all “The map is not the end point”. The purpose is to find pathways to get people moving – and that goes for you too – so maintain a bias for action.

Secondly “Map building is a team sport”. It involves inputs from different partners, local knowledge which will help us build a ‘better’ map’ and through co-production and as we learn more, the map may evolve over time.

Thirdly “Maps may be adapted as well as adopted”. The systems map for physical activity in Australia may be transferable to other countries, regions, areas – but you will most likely need to adapt it – so choose the boundaries that are appropriate for your map, discard the elements that are NOT helpful, and include new elements that ARE helpful.

Finally, “Maps can be adapted in many ways”: you may adapt the boundary and scale (whether that be local, regional or state), the focus (will you look at all systems and settings or a particular sub-setting), feasibility (so take a reality check), social justice (whether you’ll look at it through a gender or equity lens), or whether you will tailor it for a particular subpopulation (for example, children, teens, adults, or will you take a whole-of-lifecourse approach).

Slide 42:

We hope this has been helpful for you. For more information and resources, please feel free to visit our project webpage on the Prevention Centre website.

Slide 43:

Finally, we’d like to acknowledge our funders and the funding partners for the Australian Prevention Partnership Centre.

Slide 44:

Please consider subscribing to the Prevention Centre newsletter if you’d like to stay connected with prevention research in Australia.

Slide 45:

Thank you for listening.