Addressing Complexity in Chronic Disease Prevention Research

Melanie Pescud, Lucie Rychetnik, Sharon Friel, Michelle J. Irving, Therese Riley, Diane T. Finegood, Harry Rutter, Ray Ison, Steven Allender

Research output: Contribution to journalArticlepeer-review

1 Citation (SciVal)


There is wide agreement on the need for systems thinking to address complexity in chronic disease prevention but there is insufficient understanding of how such approaches are operationalised in prevention research. Ison and Straw propose that to address complexity, the right balance must be struck between ‘systemic’ and ‘systematic’ paradigms. We examined the nature and characteristics of this relationship in a series of six qualitative case studies of prevention research. Data comprised 29 semi-structured interviews with 16 participants, and online documents. The analysis combined inductive methods from grounded theory with a theoretically informed framework analysis. Systemic and systematic ways of working varied across each case as a whole, and within the dimensions of each case. Further, the interplay of systemic and systematic approaches was described along a dynamic continuum of variable proportions, with greater emphasis on systemic aspects balanced by less focus on the systematic, and vice versa. By expanding the boundaries for exploring prevention research, we gained empirical understanding of the potential and scope of systemic and systematic paradigms for addressing complexity in prevention research. There is inherent value in being more explicitly conscious and bilingual in both systemic and systematic paradigms so that their respective value and strengths may be utilised. Our findings propose a coherent theoretical frame to better understand existing approaches for addressing complexity in prevention research.
Original languageEnglish
Article number332
Issue number7
Early online date27 Jun 2023
Publication statusPublished - 31 Jul 2023

Bibliographical note

This research was funded by The Australian Prevention Partnership Centre, which is supported through the NHMRC partnership centre grant scheme (Grant ID: GNT9100003) with the Australian Government Department of Health, ACT Health, Cancer Council Australia, NSW Ministry of Health, Wellbeing SA, Tasmanian Department of Health, and VicHealth. It is administered by the Sax Institute.

Data Availability Statement
The data supporting this study are available on The Australian Prevention Partnership Centre website in the form of peer-reviewed publications, reports, findings briefs, and project pages. See The Australian Prevention Partnership Centre. Available online: (accessed 7 May 2023). Interview transcripts are not available due to ethical approval conditions.


  • complexity
  • systems thinking
  • systems
  • systematic
  • systemic
  • prevention research
  • chronic disease prevention


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