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TL;DR
Thirty-four semi-structured interviews were conducted with policy advisors, care professionals, practice professionals, and citizens across five Dutch municipalities.
PLOS ONE · 9 authors, 4 centres
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Thirty-four semi-structured interviews were conducted with policy advisors, care professionals, practice professionals, and citizens across five Dutch municipalities.
Thirty-four semi-structured interviews were conducted with policy advisors, care professionals, practice professionals, and citizens across five Dutch municipalities. An inductive thematic analysis was performed using the Action Scales Model, which examines four interconnected system levels: events, structures, goals, and beliefs. Three main leverage point themes were identified: HWA organization structure (municipal processes, diversity of themes and activities, network, communication strategies), collaboration between professionals (linking pins, motivation and commitment, stimulating others to act), and citizen participation (reaching the target group, citizens' motivation and customization). Upper system levels events and structures occurred most frequently and were explained by underlying goals and beliefs. The study is limited by its focus on stakeholder perceptions rather than observed system dynamics, potential exclusion of additional professionals mentioned by participants, and generalizability constrained to five municipalities in one Dutch region. The authors suggest that leverage points within these themes could help stakeholders implement systems thinking and improve healthy weight approaches.