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A system dynamics approach to understand Dutch adolescents' sleep health using a causal loop diagram

INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY 2024年第1期21卷 1页

作者： Heemskerk, Danique M. Busch, Vincent Piotrowski, Jessica T. Waterlander, Wilma E. Renders, Carry M. van Stralen, Maartje M. Vrije Univ Amsterdam Fac Sci Dept Hlth Sci Amsterdam Netherlands Vrije Univ Amsterdam Amsterdam Publ Hlth Res Inst Amsterdam Netherlands Sarphati Amsterdam Dept Hlth Living Publ Hlth Serv GGD City Of Amsterdam Netherlands Univ Amsterdam Amsterdam Sch Commun Res ASCoR Amsterdam Netherlands Amsterdam UMC Locat Univ Amsterdam Amsterdam Publ Hlth Res Inst Dept Publ & Occupat Hlth Amsterdam Netherlands

BackgroundHealthy sleep is crucial for the physical and mental wellbeing of adolescents. However, many adolescents suffer from poor sleep health. Little is known about how to effectively improve adolescent sleep health as it is shaped by a complex adaptive system of many interacting factors. This study aims to provide insights into the system dynamics underlying adolescent sleep health and to identify impactful leverage points for sleep health promotion *** rounds of single-actor workshops, applying Group Model Building techniques, were held with adolescents (n = 23, 12-15 years), parents (n = 14) and relevant professionals (n = 26). The workshops resulted in a multi-actor causal loop diagram (CLD) visualizing the system dynamics underlying adolescent sleep health. This CLD was supplemented with evidence from the literature. Subsystems, feedback loops and underlying causal mechanisms were identified to understand overarching system dynamics. Potential leverage points for action were identified applying the Action Scales Model (ASM).ResultsThe resulting CLD comprised six subsystems around the following themes: (1) School environment;(2) Mental wellbeing;(3) Digital environment;(4) Family & Home environment;(5) Health behaviors & Leisure activities;(6) Personal system. Within and between these subsystems, 16 reinforcing and 7 balancing feedback loops were identified. Approximately 60 potential leverage points on different levels of the system were identified as *** multi-actor CLD and identified system dynamics illustrate the complexity of adolescent sleep health and supports the need for developing a coherent package of activities targeting different leverage points at all system levels to induce system change.

关键词： Adolescent Action scales model causal loop diagram Complex systems Sleep System dynamics System mapping Teens Youth

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Mapping the dynamics of learning communities about Dutch healthy weight approaches: a causal loop diagram

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ARCHIVES OF PUBLIC HEALTH 2024年第1期82卷 1-12页

作者： ter Bogt, Maud J. J. Bevelander, Kirsten E. Kramer, Esther A. H. van der Wal, Merel M. Molleman, Gerard R. M. van den Muijsenbergh, Maria Fransen, Gerdine A. J. Radboud Univ Nijmegen Med Ctr Primary & Community Care Nijmegen Netherlands AMPHI Acad Collaborat Ctr Nijmegen Netherlands Radboud Univ Nijmegen Inst Management Res Nijmegen Netherlands Dutch Ctr Expertise Hlth Dispar Pharos Utrecht Netherlands

BackgroundLearning communities (LCs) are increasingly used among multidisciplinary public health challenges, such as local healthy weight approaches. LCs aim to stimulate learning, collaboration and actions. Previous research has provided insights into the underlying elements of multidisciplinary LCs, but little is known about the perceived causalities of these elements. Therefore, limited is known about what can be done to leverage LCs. This study aims to gain insights into the perceived dynamics of multidisciplinary LCs during the starting phase, including variables, and interconnectedness between *** elucidate LC dynamics, all members of two separate LCs participated in a qualitative interview about experiences, perceived learning, and actions during the first six months. Interviews were analyzed thematically. Subsequently, a qualitative causal loop diagram was *** qualitative causal loop diagram showed three intertwined themes. The first theme explains why group dynamics are essential, and how jointly arranging the LC may optimize group dynamics. The second theme explains how insights are obtained through multidisciplinary knowledge exchange. The third theme explains how actions are executed when conditions are met. These LC group dynamics, learning and action influenced one *** optimize LCs, it is highly recommended that stakeholders arrange them jointly, involve the appropriate partners, match with LC members' needs, and motivate members to execute action. LC facilitators are recommended to use the causal loop diagram to identify their bottlenecks and how to intervene in those to optimize the LC.

关键词： Learning community Community of practice Healthy weight Community approach causal loop diagram Collaboration

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A causal loop diagram of older persons' emergency department visits and interactions of its contributing factors: a group model building approach

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EUROPEAN GERIATRIC MEDICINE 2023年第4期14卷 837-849页

作者： Smeekes, Oscar S. Willems, Hanna C. Blomberg, Ilse Buurman, Bianca M. Univ Amsterdam Sect Geriatr Med Internal Med Amsterdam UMC Meibergdreef 9 NL-1105 AZ Amsterdam Netherlands Vrije Univ Amsterdam Amsterdam Publ Hlth Res Inst Med Older People Amsterdam UMC Boelelaan 117 Amsterdam Netherlands

PurposeUnderstanding the etiology of older persons' emergency department (ED) visits is highly needed. Many contributing factors have been identified, however, the role their interactions play remains unclear. causal loop diagrams (CLDs), as conceptual models, can visualize these interactions and therefore may elucidate their role. This study aimed to better understand why people older than 65 years of age visit the ED in Amsterdam by capturing the interactions of contributing factors as perceived by an expert group in a CLD through group model building (GMB).MethodsSix qualitative online focus group like sessions, known as GMB, were conducted with a purposefully recruited interdisciplinary expert group of nine that resulted in a CLD that depicted their shared *** CLD included four direct contributing factors, 29 underlying factors, 66 relations between factors and 18 feedback loops. The direct factors included, 'acute event', 'frailty', 'functioning of the healthcare professional' and 'availability of alternatives for the ED'. All direct factors showed direct as well as indirect contribution to older persons' ED visits in the CLD through *** of the healthcare professional and availability of alternatives for the ED were considered pivotal factors, together with frailty and acute event. These factors, as well as many underlying factors, showed extensive interaction in the CLD, thereby contributing directly and indirectly to older persons' ED visits. This study helps to better understand the etiology of older persons' ED visits and in specific the way contributing factors interact. Furthermore, its CLD can help to find solutions for the increasing numbers of older adults in the ED. Key summary pointsAimThis study aimed to better understand why people older than 65 years of age visit the ED in Amsterdam and capture the interactions of contributing factors in a causal loop diagram (CLD) through group model building (GMB).Findin

关键词： causal loop diagram Emergency department visits Older persons Acute care demand Contributing factors System dynamics

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Quantifying reciprocal relationships between poverty and health: combining a causal loop diagram with longitudinal structural equation modelling

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INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH 2024年第1期23卷 1页

作者： Reumers, Laurens Hameleers, Niels Hilderink, Henk Bekker, Marleen Jansen, Maria Ruwaard, Dirk Maastricht Univ Care & Publ Hlth Res Inst CAPHRI Dept Hlth Serv Res Maastricht Netherlands Natl Inst Publ Hlth & Environm Bilthoven Netherlands Wageningen Univ & Res Chair Grp Hlth & Society Ctr Space Pl & Soc Wageningen Netherlands Acad Collaborat Ctr Publ Hlth Publ Hlth Serv South Limburg Heerlen Netherlands

Background This study takes on the challenge of quantifying a complex causal loop diagram describing how poverty and health affect each other, and does so using longitudinal data from The Netherlands. Furthermore, this paper elaborates on its methodological approach in order to facilitate replication and methodological *** After adapting a causal loop diagram that was built by stakeholders, a longitudinal structural equation modelling approach was used. A cross-lagged panel model with nine endogenous variables, of which two latent variables, and three time-invariant exogenous variables was constructed. With this model, directional effects are estimated in a Granger-causal manner, using data from 2015 to 2019. Both the direct effects (with a one-year lag) and total effects over multiple (up to eight) years were calculated. Five sensitivity analyses were conducted. Two of these focus on lower-income and lower-wealth individuals. The other three each added one exogenous variable: work status, level of education, and home *** The effects of income and financial wealth on health are present, but are relatively weak for the overall population. Sensitivity analyses show that these effects are stronger for those with lower incomes or wealth. Physical capability does seem to have strong positive effects on both income and financial wealth. There are a number of other results as well, as the estimated models are extensive. Many of the estimated effects only become substantial after several *** Income and financial wealth appear to have limited effects on the health of the overall population of The Netherlands. However, there are indications that these effects may be stronger for individuals who are closer to the poverty threshold. Since the estimated effects of physical capability on income and financial wealth are more substantial, a broad recommendation would be that including physical capability in efforts that are aimed at impro

关键词： Poverty Income Financial wealth Social determinants of health Quantification Longitudinal Structural equation modelling Latent variables Indirect effects causal loop diagram

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Development of a causal loop diagram to Understand the Complexity of a Food Bank's Supply Chain Processes 30th

Development of a Causal Loop Diagram to Understand the Compl...

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30th International Joint Conference on Industrial Engineering and Operations Management-IJCIEOM

作者： de Assumpcao, Nathalia Holanda Alcantara, Beatryz de Almeida de Souza Lima, Isabela Antunes Altimari Samed, Marcia Marcondes Univ Estadual Maringa Maringa Parana Brazil

ISBN: (纸本)9783031807879;9783031807855;9783031807848

Food insecurity is defined as the inability of people in socially vulnerable situations to obtain food in sufficient quantity and quality to meet their needs for a healthy life. On the other hand, food banks are institutions that can help alleviate, in the short term, the symptoms of food insecurity, which can be considered a long-term crisis. The supply chain of a food bank is established in a complex environment, involving a rapidly growing demand (increased poverty and food insecurity, especially in developing countries), a low adherence of food donors, associated with several factors limiting factors such as physical resources, human resources, infrastructure, among others. This article aims to identify the processes that form the humanitarian assistance chain of a food bank and the connection between them. To this end, this article demonstrates the step-by-step process for constructing a causal loop diagram that represents these processes and the associated complexities. The results provide an understanding of the variables, their relationships and complexities in the search for an increase in the number of beneficiaries served by the food bank.

关键词： causal loop diagram Food bank Supply chain Sustainable development goals SDG 2 Food security

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Examining the Feedback Effects of Support System Facilities on Tourism Industry Performance: A causal loop diagram Modeling Approach

Examining the Feedback Effects of Support System Facilities ...

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2023 IEEE International Conference on Industrial Engineering and Engineering Management, IEEM 2023

作者： Achmad, Fandi Prambudia, Yudha Rumanti, Augustina Asih Telkom University Department of Industrial Engineering West Java Bandung40257 Indonesia

ISBN: (纸本)9798350323153

Achieving optimal tourism industry performance requires strong support from support system facilities. Through increasing optimal performance, the tourism industry can grow sustain ably. Therefore, this study aims to develop a causal loop diagram (CLD) model to analyze the relationship between support system facilities variables in improving the tourism industry's performance. The indicators of support system facilities used are telecommunication, waste management, clean water sources, and spatial. The development of the CLD model was carried out in two stages. Firstly, identify the relevant variables. Secondly, establish a logical relationship between variables based on interviews and literature review. The research result is a CLD conceptual model that stakeholders can use in formulating strategies and policies. This model is intended to be the basis for further development into a simulation model, so research and empirical validation are needed. © 2023 IEEE.

关键词： causal loop diagram Support System Facilities Tourism Industry Performance

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Implementation of Clinical Services for Adults with Obesity in Different Health Systems: A Scoping Review and causal loop diagram

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DIABETES METABOLIC SYNDROME AND OBESITY 2025年 18卷 1695-1709页

作者： Xue, Yan Song, Menghuan Yu, Honho Chen, Xianwen Ung, Carolina Oi Lam Hu, Hao Univ Macau Inst Chinese Med Sci State Key Lab Qual Res Chinese Med Macau Peoples R China Univ Macau Ctr Pharmaceut Regulatory Sci Macau Peoples R China Kiang Wu Hosp Dept Gastroenterol & Hepatol Macau Peoples R China Univ Macau Fac Hlth Sci Dept Publ Hlth & Med Adm Macau Peoples R China

The medical needs of obesity have been underrecognized, though it has posed long-term and enormous challenges to global health. Correspondingly, clinical services for obesity are still uncommon and in their infancy across health systems. It is meaningful to sort out the implementation of such clinical services involving a multiplicity of factors to identify measures for service development, scaling-up and optimization. This study aims to generate a comprehensive understanding of key variables and factors in the utilization and delivery of clinical services for adult patients with obesity and their dynamic patterns and to explore viable options for improved implementation of such services in health systems. We conducted a scoping review of published articles in the database from the lens of system dynamics through causal loop diagramming. Based on the data obtained from the review, we employed the causal loop diagramming as a tool to capture the variables in the implementation of clinical obesity services and their causal relationships. Twentyone studies were finally included in the review. Based on the evidence consolidated through the review, we developed a causal loop diagram containing 19 causal variables and 38 causal arrows in single directions centered around the service utilization and delivery in the clinical obesity service. The feedback loops revealed potential activation points to intervene to facilitate the service implementation, such as, promotion of obesity as a disease with medical needs and available clinical services, provision of obesity-specific medical education and training opportunities, and prioritization of obesity-specific procedures in clinical protocols. The possible intervention points identified through the causal loop analysis can facilitate the development, implementation, and optimization of clinical obesity services in health systems.

关键词： clinical service service implementation adult obesity causal loop diagram health systems

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Investigating the pathways from preconception care to preventing maternal, perinatal and child mortality: A scoping review and causal loop diagram

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PREVENTIVE MEDICINE REPORTS 2023年 34卷 102274-102274页

作者： Poix, Sebastien Elmusharaf, Khalifa Univ Limerick Sch Med Limerick Ireland Univ Birmingham Dubai Appl Hlth Res Dubai U Arab Emirates

In recent years, there has been a growing recognition that developing preconception care provides an opportunity to significantly reduce maternal and child mortality and morbidity. This involves targeting multiple risk factors through a large array of medical, behavioural and social interventions. In this study, we created a causal loop diagram (CLD) to describe several pathways by which a set of preconception interventions may lead to women's improved health and better pregnancy outcomes. The CLD was informed by a scoping review of metaanalyses. It summarises evidence on the outcomes and interventions related to eight preconception risk factors. The authors reviewed literature from two databases (PubMed and Embase) and used the framework developed by Arksey and O'Malley. The CLD includes 29 constructs categorised into five different levels (mortality, causes of death, preconception risk factors, intermediate factors, interventions or policies). The model indicates interconnections between five sub-systems and highlights the role of preventing early and rapidly repeated pregnancies, as well as optimising women's nutritional status in the preconception period. It also shows the prevention of preterm birth as a privileged route for lowering child mortality and morbidity. The CLD demonstrates the potential benefits of strategies that address multiple preconception risk factors simultaneously and can be used as a tool to promote the integration of preconception care into efforts to prevent maternal and child mortality. With further improvements, this model could serve as a basis for future research on the costs and benefits of preconception care.

关键词： Preconception care Maternal health Child health causal loop diagram System thinking Scoping review

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Where are the links? Using a causal loop diagram to assess interactions in healthcare coordination for youth experiencing homelessness in Toronto, Canada

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HEALTH RESEARCH POLICY AND SYSTEMS 2024年第1期22卷 19页

作者： Hudani, Alzahra Long, Janet Labonte, Ronald Yaya, Sanni Univ Ottawa Interdisciplinary Sch Hlth Sci Ottawa ON Canada Macquarie Univ Australian Inst Hlth Innovat Ctr Healthcare Resilience & Implementat Sci Sydney Australia Univ Ottawa Sch Epidemiol & Publ Hlth Ottawa ON Canada Univ Ottawa Sch Int Dev & Global Studies 120 Univ Private Ottawa ON K1N 6N5 Canada

BackgroundYouth experiencing homelessness (YEH) suffer from poorer physical and mental health outcomes than stably housed youth. Additionally, YEH are forced to navigate fragmented health and social service systems on their own, where they often get lost between systems when transitioning or post-discharge. Inevitably, YEH require support with health system navigation and healthcare coordination. The aim of this study is to understand interactions within and between the emergency youth shelter (EYS) and health systems that affect healthcare coordination for YEH in Toronto, Canada, and how these interactions can be targeted to improve healthcare coordination for *** study is part of a larger qualitative case study informed by the framework for transformative systems change. To understand interactions in healthcare coordination for YEH within and between the EYS and health systems, we developed a causal loop diagram (CLD) using in-depth interview data from 24 key informants at various levels of both systems. Open and focused codes developed during analysis using Charmaz's constructivist grounded theory methodology were re-analysed to identify key variables, and links between them to create the CLD. The CLD was then validated by six stakeholders through a stakeholder *** CLD illustrates six balancing and one reinforcing feedback loop in current healthcare coordination efforts within the EYS and health systems, respectively. Increasing EYS funding, building human resource capacity, strengthening inter and intra-systemic communication channels, and establishing strategic partnerships and formal referral pathways were identified among several other variables to be targeted to spiral positive change in healthcare coordination for YEH both within and between the EYS and health *** CLD provides a conceptual overview of the independent and integrated systems through which decision-makers can prioritize and guide interventions to str

关键词： Emergency youth shelter Health system Youth Homelessness Hospital Healthcare coordination Endless loop causal loop diagram Variables Links

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Development of a causal loop diagram for bridge resilience 37

Development of a causal loop diagram for bridge resilience

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37th Annual Association of Researchers in Construction Management Conference, ARCOM 2021

作者： Lad, V.H. Patel, D.A. Chauhan, K.A. Patel, K.A. Department of Civil Engineering Sardar Vallabhbhai National Institute of Technology Gujarat Surat395007 India

In recent years, the resilience assessment for bridges has drawn ample attention in the engineering and management community. It has been attempted to evaluate bridge resilience by developing a resilience matrix or single-measure index. However, existing studies overlooked the prevailing interdependency among various physical and social infrastructures. Moreover, the technical, organizational, social, and economic aspects of these infrastructures are of dynamic nature. Therefore, this study develops a causal loop diagram (CLD) of bridge resilience to explore and understand how other infrastructures and their dynamism influence bridge resilience. Total 21 bridge resilience factors are identified based on the literature review. Out of these, 14 bridge resilience factors are shortlisted by using the Delphi method. Along with these 14 shortlisted factors, four properties of resilience (robustness, rapidity, resourcefulness, redundancy) and four infrastructures (bridge, transportation network, other utility infrastructures, and governance system) are considered to develop CLD. Thus, eight causal loops are developed, validated, and presented for improving bridge resilience. Further, the proposed study can help to implement effective policies for improving urban resilience and developing a smart city digital twin (SCDT) system. © 2021 Proceedings of the 37th Annual ARCOM Conference, ARCOM 2021. All Rights Reserved.

关键词： Bridge causal loop diagram Delphi method Resilience

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