This paper reports on a complex environmental approach to addressing 'wicked' health promotion problems devised to inform policy for enhancing food security and physical activity among Māori, Pacific and low-income people in New Zealand. This multi-phase research utilized literature reviews, focus groups, stakeholder workshops and key informant interviews. Participants included members of affected communities, policy-makers and academics. Results suggest that food security and physical activity 'emerge' from complex systems. Key areas for intervention include availability of money within households; the cost of food; improvements in urban design and culturally specific physical activity programmes. Seventeen prioritized intervention areas were explored in-depth and recommendations for action identified. These include healthy food subsidies, increasing the statutory minimum wage rate and enhancing open space and connectivity in communities. This approach has moved away from seeking individual solutions to complex social problems. In doing so, it has enabled the mapping of the relevant systems and the identification of a range of interventions while taking account of the views of affected communities and the concerns of policy-makers. The complex environmental approach used in this research provides a method to identify how to intervene in complex systems that may be relevant to other 'wicked' health promotion problems.
Interest in evaluating complexity appears to be on the rise. Increasing application of systems thinking and complex systems methodologies to evaluation can be seen in contents of journals and evaluation conferences. To date there has been little systematic examination of experiences of this application. This research considers the experience of 41 key informant participants with experience of complexity and systems approaches in evaluation. The results highlight institutional, political and social science factors that provide opportunities for further application. The following are identified as barriers to application: multiple definitions of complexity, the dominance of existing approaches, the purpose of evaluation and perception of resources required to apply complexity and systems approaches in evaluation. Where increasing the use of complexity and systems methodologies is a desired goal, this research suggests action regarding: how these methodologies are communicated; and evaluation training.
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