• Andrew D Brown, Jillian Whelan, Kristy A Bolton, Phoebe Nagorcka-Smith, Joshua Hayward, Penny Fraser, Claudia Strugnell, Tiana Felmingham, Melanie Nichols, Colin Bell, LeHa N DHNDGlobal Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Australia; Deakin Health Economics, Institute for Health Transformation, School of Health and Social Develo, and Steven Allender.
• Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Australia. Electronic address: andrew.brown@deakin.edu.au.
• Am J Prev Med. 2022 May 1; 62 (5): 786-794.

IntroductionApplying systems science in public health trials is a recent innovation in childhood obesity prevention. This paper aims to use systems science conventions to propose a theory of change for community-based interventions aiming to build capacity and use exemplars from systems science for obesity prevention to describe how this approach works.MethodsParticipants were community-based researchers. A dynamic hypothesis was created in workshops conducted in 2020 and 2021 by identifying variables critical to building community capacity for systems thinking. These were used to develop stock and flow diagrams representing individual causal relationships, feedback loops, and the overall theory of change.ResultsThe resultant model identified 9 stocks and 4 pairs of central balancing and reinforcing feedback loops. These represented building commitment through relationships, mutual learning, strengthening collaboration, and embedding capacity. The model is described using examples from 3 trials involving 25 communities across Victoria, Australia.ConclusionsThis nonlinear and practice-based model illustrates the process of community-based obesity prevention. The model integrates >20 years of community-based intervention implementation experience, providing an overarching theory of how such interventions work to create change and prevent obesity.Copyright © 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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