Two examples include: the current climate change crisis where system methodologies are used to identify mitigation opportunities 20 another example is the focus on creating support for children’s mental health. Systems science methodologies are utilised to address a multitude of complex problems. 16 Proposed reasons for this include insufficient training of staff in systems methods, 17 18 or actions arising from the systems workshops have not aligned well with the barriers and enablers previously identified by participants. To date, larger scale, multicommunity interventions have produced mixed results. While the success of trials in community interventions is promising, a sustained population impact requires the translation and scaling up of successful initiatives to achieve a broader reach across multiple levels of practice including regions, states, and countries. 14 Encouragingly, studies have shown that community interventions can prevent overweight and obesity in a cost-effective manner. Some have identified diffusion into adjacent communities 12 and related populations, 13 although few studies have shown evidence of long-term impact. These studies identified the importance of capacity building with communities and of the role of leadership. Published evaluations of community-based interventions, such as Romp and Chomp, 8 Be Active, Eat Well, 9 It’s Your Move 10 and Shape Up Somerville, 11 have demonstrated reductions in body mass index z-score (BMI-z) and/or health behaviours within 3 years of intervention in individual communities. 6 This target was not met and no country has reversed the epidemic and existing systemic and institutional drivers remain largely unchanged. 4 5 The WHO’s Commission for Ending Childhood Obesity set a target to halt the rise in diabetes and obesity by 2020. 2 In Australia, approximately 63% of adults and 28% of children have overweight or obesity, 3 which is estimated to cost the economy as much as $21bn annually in direct and indirect healthcare costs. Addressing overweight and obesity is a priority due to the high global prevalence, with 1.97 billion adults and 337 million children affected, 1 and due to the increased risk of various chronic diseases including type 2 diabetes, ischaemic heart disease and multiple cancers.
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