Stubborn rates of obesity suggest that existing services are not being delivered to optimise impact. Whole system approaches (WSA) may offer one way to deliver more effective, adaptable and sustainable services. With Local Authorities (LA) increasingly charged to deliver effective obesity-related services, this focuses attention on how well they integrate their services and approaches. To work to help them, researchers need to deploy effective approaches that are not only compatible with, but also enhance, existing LA approaches. Appreciative Inquiry offers a way to address WSA while also enhancing the functioning of that system and the people in it.
Through the Whole Systems Obesity project, this exciting research will address WSA through a case study approach to each of four LA. This project therefore provides an opportunity to add to the growing body of knowledge in this area of service improvement, as well as to develop relevant research that has a sustainable impact in Public Health and wellbeing.
Contemporary rates of obesity and overweight question the effectiveness of existing management and preventive services. Due to the financial limitations associated with post-recession recovery, and a concern for better return on existing investment into health services, attention is increasingly turning to refine services to deliver better patient- and client-centred outcomes. This places local authorities, and the processes they use to refine services, at the heart of a drive to enhance Public Health provision. However, even though it is widely accepted that obesity is driven by multiple factors, integration of services (both formal and informal) remains elusive.
Systems-based approaches focus on how elements within any system influence one another. Within this, a holistic whole system approach (WSA) offers one way to achieve more efficient and effective delivery. WSA has been used to develop public services, and there is a long history of applying system approaches in many scientific and academic domains.
Instead of addressing improvement in isolated services, WSA focuses on how well elements of services work together. By exploring participation at every level of the organisation (and their constituencies of networks, collaborations, social movements and/or markets), WSA seeks to identify daily practice and the scale and methods of integrating service users. This places structure, change and processes as core concerns.
The flux in contemporary Public Health may help to explain why WSA has not been widely deployed. Lack of engagement with WSA has also contributed to making it difficult to investigate. A further challenge is to find an acceptable, purposeful process that (i) helps system ‘insiders’, (ii) enhances provision of local, bespoke, services and (iii) successfully integrates ‘outsiders’.
Appreciative Inquiry (AI) represents a paradigm shifting approach that may address these problems. AI focuses on the strengths of the existing system, making it a creative, energising and integrative experience for participants. As a co-creative approach, AI builds on the creative imagination of every organisation and its employees. Importantly, AI is compatible with investigating how systems can be refined to identify and, potentially, address previously unacknowledged ‘blind spots’.
Given the compatibility between WSA and AI, the broad aim of the current PhD study is to address how the respective elements of AI are used to develop WSA approaches to obesity prevention and management in local authorities.
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Please contact Professor Jim McKenna for further details
Email: [email protected]
Tel: +44(0)113 81 27483