DOI
https://doi.org/10.1111/josh.12961

Summary
BACKGROUND Frameworks such as the WSCC model provide evidence-based guidance for addressing school health at the school, district, and regional level. However, frameworks do not implement themselves; they require the mobilization and collaboration of stakeholders within communities and an understanding of the unique resources and barriers within each context. Furthermore, addressing school health presents a complex systems problem. METHODS Community-based system dynamics (CBSD) is a participatory approach for engaging communities in understanding and changing complex systems. We used a descriptive multiple case study design to evaluate how and why CBSD was used as a tool for stakeholders to engage with the complexity of school health. RESULTS We analyzed 3 cases to understand how these methods were used to enhance collaboration, analysis, and community action at multiple levels, including in 2 school districts, with a city-wide stakeholder committee, and with a group of high school students. CONCLUSIONS Community-based system dynamics presents a promising approach for building shared language and ownership among stakeholders, tailoring to local community contexts, and mobilizing stakeholders for action based on new system insights. We close with a discussion of unique opportunities and challenges of expanding the use of CBSD in the field of school health.

Relevance for Complex Systems Knowledge
The challenge of understanding and acting to promote school health has been conceptualized as a complex systems problem with features such as interventions that are community context dependent. These include  delays and gaps in information flows, formal and informal feedback mechanisms balancing and resisting change, and a pattern of learning, change, and evolution that mean that what may work at one point in time may be obsolete at another. This article is a response to calls systems modeling tools to formally represent and design policy interventions.

The system dynamics perspective explores complex system behavior through a feedback lens, conceiving a school system or a community as an interconnected set of parts, components, stakeholders and functions that are structured in such a way to create behavior—in this case student health—over time. Community-based system dynamics (CBSD) is one approach that employs participatory methods for system dynamics modeling. CBSD has an explicit emphasis on the development of system dynamics and systems thinking capabilities among participants around the use of system dynamics-models, their assumptions, and limitations. The structured CBSD process includes extensive documentation of participant-generated artifacts and detailed minutes from ongoing meetings with
participants. Through the structured CBSD process, the resulting causal loop diagrams (CLDs) and models function as a socially constructed hypothesis of the structure underlying the success or failure of school health initiatives. These models function as boundary objects that allow for each stakeholder perspective to see their mental model reflected in the map, while maintaining the ability to modify and critique that map.

Point of Strength
The article shows how a participatory approach can be used to study complex systems, and how that in turn can help interventions in school health to success. Being very descriptive of the applied method, the article can inspire replication of Community Based System Dynamics also in other fields.