Background: In 2019, Public Health England published guidance to support local governments to design and implement a systems approach for obesity prevention. This guidance represented a step change in how local governments could create healthier weight environments, with an estimated 50% of local areas adopting it. Now, five years later, we wanted to determine how prevalent these approaches were at the local level, understand what they look like, explore which sectors are engaged (or not), and identify potential challenges facing their design and implementation.
Methods: We co-designed the Systems Approach Survey in collaboration with local policy stakeholders. The survey comprised 41 questions (27 mandatory) and took 40-60 minutes to complete. Participants could complete the survey individually or collaboratively. It was widely disseminated, via multiple avenues, to all public health teams in the UK. To determine what the approaches look like in practice, we adapted the 10 conditions from the Sport England conceptual framework (Shearn et al., 2024). This talk provides a preliminary analysis of current data (survey closes October 31st 2024).
Results: To date, 50 local public health teams have completed the survey from across England, Wales, Scotland and Northern Ireland. The approaches all had co-ordinating groups, ranging from one to 12 people, with Public Health departments leading. They frequently engaged Children’s Services, Leisure and Park Services, Town Planning, the Voluntary and Community Sector, and Education. The approaches were purposefully designed to align with physical activity-, food insecurity-, poverty-, and mental health- agendas. Findings pertaining to the 10 conditions reveal that there are significant opportunities for future development. Support requirements include approaches to evaluation, shared learning between local areas, the establishment of a community of practice, and the urgent need for national leadership.
Conclusions: Local governments are in a unique position to help re-shape the environments in which their communities reside. The Public Health England guidance can be implemented in practice, albeit that it often required tailoring to the local context. This study, so far, suggests that a systems approach can engage a wide range of sectors and can concurrently benefit multiple agendas (i.e. double / triple duty actions). Further support is required to strengthen the design, implementation, and sustainment of these approaches.