Co-creating a systems map with adolescents: combining participatory research and systems thinking in YoPA Denmark

A large number of adolescents, particularly adolescents from underserved neighborhoods, often fail to meet physical activity (PA) guidelines, increasing their risk of developing noncommunicable diseases. Physical inactivity among adolescents is considered a complex problem driven by multiple, interrelated factors, and participatory action research is a valuable approach for exploring and improving the systems that influence adolescents' PA behaviors from the perspective of adolescents themselves. By using the Youth-Centered Participatory Action Denmark project, conducted in two youth clubs in underserved neighborhoods, as a case example, the aim of this paper was to demonstrate how participatory action research and systems thinking can be applied in practice to co-create a systems map on adolescents' outdoor PA. The adolescents participated as co-researchers, actively using their lived experiences and priorities to shape the research. Five key drivers of outdoor PA were identified from the system map: sense of belonging, maintenance of outdoor space, peer influence, accessible and attractive spaces, and the role of youth club staff. These drivers highlight the complexity of promoting outdoor PA and underscore the need for interventions that address multiple aspects and levels of the system. By combining participatory action research and systems thinking, this study provides insights into the mechanisms that shape adolescents' outdoor PA, from the perspective of adolescents themselves. The developed system map will serve as a starting point for co-developing interventions to increase outdoor PA among adolescents, in close collaboration with the adolescents themselves.