Danique M Heemskerk, Vincent Busch, Jessica T Piotrowski, Wilma E Waterlander, Carry M Renders, Maartje M van Stralen
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引用次数: 0
Abstract
Background: Healthy sleep is crucial for the physical and mental wellbeing of adolescents. However, many adolescents suffer from poor sleep health. Little is known about how to effectively improve adolescent sleep health as it is shaped by a complex adaptive system of many interacting factors. This study aims to provide insights into the system dynamics underlying adolescent sleep health and to identify impactful leverage points for sleep health promotion interventions.
Methods: Three rounds of single-actor workshops, applying Group Model Building techniques, were held with adolescents (n = 23, 12-15 years), parents (n = 14) and relevant professionals (n = 26). The workshops resulted in a multi-actor Causal Loop Diagram (CLD) visualizing the system dynamics underlying adolescent sleep health. This CLD was supplemented with evidence from the literature. Subsystems, feedback loops and underlying causal mechanisms were identified to understand overarching system dynamics. Potential leverage points for action were identified applying the Action Scales Model (ASM).
Results: The resulting CLD comprised six subsystems around the following themes: (1) School environment; (2) Mental wellbeing; (3) Digital environment; (4) Family & Home environment; (5) Health behaviors & Leisure activities; (6) Personal system. Within and between these subsystems, 16 reinforcing and 7 balancing feedback loops were identified. Approximately 60 potential leverage points on different levels of the system were identified as well.
Conclusions: The multi-actor CLD and identified system dynamics illustrate the complexity of adolescent sleep health and supports the need for developing a coherent package of activities targeting different leverage points at all system levels to induce system change.
期刊介绍:
International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) is an open access, peer-reviewed journal offering high quality articles, rapid publication and wide diffusion in the public domain.
IJBNPA is devoted to furthering the understanding of the behavioral aspects of diet and physical activity and is unique in its inclusion of multiple levels of analysis, including populations, groups and individuals and its inclusion of epidemiology, and behavioral, theoretical and measurement research areas.