Addressing Complexity in Chronic Disease Prevention Research
Melanie Pescud,
Lucie Rychetnik,
Sharon Friel,
Michelle J. Irving,
Therese Riley,
Diane T. Finegood,
Harry Rutter,
Ray Ison,
Steven Allender
Affiliations
Melanie Pescud
Menzies Centre for Health Governance, School of Regulation and Global Governance (RegNet), Australian National University, Canberra, ACT 0200, Australia
Lucie Rychetnik
The Australian Prevention Partnership Centre, The Sax Institute, Glebe, NSW 2037, Australia
Sharon Friel
Menzies Centre for Health Governance, School of Regulation and Global Governance (RegNet), Australian National University, Canberra, ACT 0200, Australia
Michelle J. Irving
The Australian Prevention Partnership Centre, The Sax Institute, Glebe, NSW 2037, Australia
Therese Riley
Therese Riley Consulting, Melbourne, VIC 3191, Australia
Diane T. Finegood
Morris J. Wosk Centre for Dialogue, Simon Fraser University, Vancouver, BC V6B 5K3, Canada
Harry Rutter
Department of Social & Policy Sciences, University of Bath, Bath BA2 7AY, UK
Ray Ison
Faculty of Science, Technology, Engineering and Mathematics, School of Engineering and Innovation, Open University, Milton Keynes MK7 6AA, UK
Steven Allender
Faculty of Health, School of Health and Social Development, Deakin University, Geelong, VIC 3125, Australia
There is wide agreement on the need for systems thinking to address complexity in chronic disease prevention but there is insufficient understanding of how such approaches are operationalised in prevention research. Ison and Straw propose that to address complexity, the right balance must be struck between ‘systemic’ and ‘systematic’ paradigms. We examined the nature and characteristics of this relationship in a series of six qualitative case studies of prevention research. Data comprised 29 semi-structured interviews with 16 participants, and online documents. The analysis combined inductive methods from grounded theory with a theoretically informed framework analysis. Systemic and systematic ways of working varied across each case as a whole, and within the dimensions of each case. Further, the interplay of systemic and systematic approaches was described along a dynamic continuum of variable proportions, with greater emphasis on systemic aspects balanced by less focus on the systematic, and vice versa. By expanding the boundaries for exploring prevention research, we gained empirical understanding of the potential and scope of systemic and systematic paradigms for addressing complexity in prevention research. There is inherent value in being more explicitly conscious and bilingual in both systemic and systematic paradigms so that their respective value and strengths may be utilised. Our findings propose a coherent theoretical frame to better understand existing approaches for addressing complexity in prevention research.
