A rapid synthesis of evidence on whole systems approaches to obesity prevention to inform policy

BACKGROUND: The Department of Health in Northern Ireland is developing a new obesity prevention strategy. To support policy development, the Institute of Public Health commissioned a rapid synthesis of evidence on whole systems approaches to obesity prevention. Objectives were to present evidence from existing reviews on whole systems approach effectiveness, describe case studies where a whole systems approach has been applied and propose key policy considerations. METHODS: A rapid synthesis of evidence on whole systems approaches, rather than a full systematic evidence review, was conducted to meet policy development timelines. Review articles were included, as were national and international case studies that described whole systems approach implementation and/or evaluation. The Methodological Index for Non-Randomised Studies Framework was used to assess the methodological quality of the case studies. RESULTS: Five review articles and five case studies (majority moderate-borderline strong quality) were included. Results showed whole systems approaches can be associated with improvements in Body Mass Index, physical activity environment and improved community wellbeing, with a school component being particularly effective. Facilitators to implementation included leadership, community involvement, consistent language, adequate resources and evaluation/systems science knowledge. CONCLUSIONS: Whole systems approaches can be effective in enhancing the capacity of communities to create healthier environments and deliver measurable reductions in Body Mass Index. KEY MESSAGES: • Whole systems approaches to obesity prevention can be effective in creating healthier environments. • Findings from this research could support any future pilot of this approach in Northern Ireland.