Using Group Model Building to Describe the System Driving Unhealthy Eating and Identify Intervention Points: A Participatory, Stakeholder Engagement Approach in the Caribbean

被引:28
作者
Guariguata, Leonor [1 ]
Rouwette, Etienne A. J. A. [2 ]
Murphy, Madhuvanti M. [1 ]
Saint Ville, Arlette [3 ]
Dunn, Leith L. [4 ]
Hickey, Gordon M. [3 ]
Jones, Waneisha [1 ]
Samuels, T. Alafia [1 ,5 ]
Unwin, Nigel [1 ,6 ,7 ]
机构
[1] Univ West Indies, George Alleyne Chron Dis Res Ctr, Jemmotts Lane, Bridgetown BB11115, Barbados
[2] Radboud Univ Nijmegen, Nijmegen Sch Management, Heyendaalseweg 141, NL-6525 AJ Nijmegen, Netherlands
[3] McGill Univ, Dept Nat Resource Sci, Macdonald Steward Bldg,21111 Lakeshore Rd, Ste Anne De Bellevue, PQ H9X 3V9, Canada
[4] Univ West Indies, Inst Gender & Dev Studies, Mona Campus, Kingston 7, Jamaica
[5] Univ West Indies, Caribbean Inst Hlth Res, Mona Campus, Kingston 7, Jamaica
[6] Univ Cambridge, MRC Epidemiol Unit, Inst Metab Sci, Addenbrookes Treatment Ctr, Level 3, Cambridge CB2 0SL, England
[7] Univ Exeter, Sch Med, European Ctr Environm & Human Hlth, Knowledge Spa,Royal Cornwall Hosp, Truro TR1 3HD, Cornwall, England
关键词
NCDs; unhealthy diet; Caribbean; small islands; food sovereignty; systems science; group model building; agricultural development; POLICY;
D O I
10.3390/nu12020384
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Many Small Island Developing States of the Caribbean experience a triple burden of malnutrition with high rates of obesity, undernutrition in children, and iron deficiency anemia in women of reproductive age, driven by an inadequate, unhealthy diet. This study aimed to map the complex dynamic systems driving unhealthy eating and to identify potential points for intervention in three dissimilar countries. Stakeholders from across the food system in Jamaica (n = 16), St. Kitts and Nevis (n = 19), and St. Vincent and the Grenadines (n = 6) engaged with researchers in two group model building (GMB) workshops in 2018. Participants described and mapped the system driving unhealthy eating, identified points of intervention, and created a prioritized list of intervention strategies. Stakeholders were also interviewed before and after the workshops to provide their perspectives on the utility of this approach. Stakeholders described similar underlying systems driving unhealthy eating across the three countries, with a series of dominant feedback loops identified at multiple levels. Participants emphasized the importance of the relative availability and price of unhealthy foods, shifting cultural norms on eating, and aggressive advertising from the food industry as dominant drivers. They saw opportunities for governments to better regulate advertising, disincentivize unhealthy food options, and bolster the local agricultural sector to promote food sovereignty. They also identified the need for better coordinated policy making across multiple sectors at national and regional levels to deliver more integrated approaches to improving nutrition. GMB proved to be an effective tool for engaging a highly diverse group of stakeholders in better collective understanding of a complex problem and potential interventions.
引用
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页数:20
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