Participatory systems mapping: a review of population health research practice

Participatory systems mapping (PSM) methods are increasingly applied in population health research to understand and address complex challenges. Despite their growing use, there remains limited understanding of how these approaches are implemented in practice. This systematic scoping review aimed to explore the application of PSM in population health research, identify methodological gaps and highlight opportunities for advancing methods development and reporting standards, with particular attention to participatory approaches.

A systematic search of OVID MEDLINE and Scopus identified peer-reviewed papers published in English between January 2000 and September 2023 that: (1) applied and presented the results of PSM related to population health or health improvement questions and (2) incorporated a participatory design. Two reviewers screened and assessed papers, extracting data on study characteristics, participatory approaches, map features and integration of conceptual frameworks and methods not directly related to PSM.

In the 123 included studies, involving stakeholders in building causal loop diagrams was the most commonly used approach. Variability was evident in geographical focus, study design, application and reporting. Participant involvement was mostly limited to map building, with less engagement in map validation. Significant gaps in reporting study samples and procedures were identified. A small number of studies involved end users or people with lived experiences in mapping processes. Only a few studies evaluated stakeholders' experience with participatory processes. Lessons learnt on participatory processes include: PSM in population health benefits from cross-disciplinary, inclusive collaboration and capacity-building efforts that support meaningful involvement, shared ownership and trust among diverse stakeholders. Adaptability in the design of PSM approaches, continuous reflection and long-term partnerships are essential to maintaining relevance, enhancing impact and fostering systemic change over time.

To advance participatory systems mapping in population health, there is a need for further methodological innovation, stronger stakeholder engagement and more transparent, reflexive reporting practices. Building capacity through training, practical guidance and cross-disciplinary communities of practice will also be essential to support rigorous and inclusive application of these methods.