Harnessing Systems Science to Strengthen Community-Based Childhood Obesity Prevention: An Overview of the Literature

Addressing the obesity epidemic requires understanding the complex and multilevel dynamics that shape it. Systems science can help researchers and practitioners move beyond linear causal logic. This overview identifies empirical studies using explicit systems science methods or broader systems-informed approaches to design, implement, or evaluate community-based childhood obesity prevention efforts. We report how systems methods have been applied, their contributions to tackling obesity, challenges, and opportunities.

We searched Web of Science for English-language publications reporting empirical applications of systems thinking, systems science methods, or systems-informed ecological and participatory approaches in community-level childhood obesity prevention. Three reviewers screened 273 records, assessed full texts, and extracted data.

Ninety-eight articles met inclusion criteria. Systems approaches were used most often during intervention design (n = 50; 51.0%), followed by implementation (n = 23; 23.5%) and evaluation (n = 14; 14.3%), with some spanning multiple stages (n = 11; 11.2%). Participatory methods such as group model building deepened understanding of structural and relational drivers, and supported context-specific adaptation and cross-sector coordination. The use of systems approaches for evaluation was limited, though emerging methods (e.g., ripple-effect mapping, longitudinal network analysis, and agent-based modeling) signal growing opportunity. Barriers included limited infrastructure for cross-sector collaboration, funding misalignment, and a lack of shared or validated metrics.

Systems science has strengthened the field's ability to visualize complexity and align stakeholders in interventions' design and implementation. Its application in evaluation and scale-up remains limited. Sustained investment in participatory capacity, longitudinal infrastructure, and systems-informed implementation is needed to strengthen community-based childhood obesity prevention.