Learning from the CO-CREATE project: A protocol for systems thinking across research (STAR)

Cécile Knai, Natalie Savona, Diane Finegood, Anaely Aguiar, Laurence Blanchard, Kaitlin Conway-Moore, Arnfinn Helleve, Knut-Inge Klepp, Nanna Lien, Aleksandra Luszczynska, Ioana Vlad, Alfred Mestad Rønnestad, Harry Rutter

Research output: Contribution to journalArticlepeer-review

1 Citation (SciVal)


The CO-CREATE project aimed to work with young people to create, inform, and disseminate obesity-preventive evidence-based policies using a complex systems perspective. This paper draws lessons from this experience and proposes a protocol for embedding systems thinking within a research project. We first draw on existing systems thinking frameworks to analyze how systems thinking was translated across CO-CREATE, including the flow and relationship between the work packages and in the methods used. We then take the lessons from CO-CREATE and the principles of existing systems thinking frameworks—which focus on various points of intervention planning and delivery but not on research projects as a whole—to formulate a protocol for embedding systems thinking across a research project. Key lessons for future planning and delivery of systems-oriented research projects include incorporating “boundary critique” by capturing key stakeholder (adolescent) values and concerns; working to avoid social exclusion; ensuring methodological pluralism to allow for reflection and responsiveness (with methods ranging from group model building, Photovoice, and small group engagement); getting policy recipients to shape key questions by understanding their views on the critical drivers of obesity early on in the project; and providing opportunity for intraproject reflection along the way.

Original languageEnglish
Article numbere13624
Number of pages11
JournalObesity Reviews
Issue numberS2
Early online date27 Sept 2023
Publication statusPublished - 30 Sept 2023

Bibliographical note

Funding Information:
The CO‐CREATE project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No. 774210. The content of this paper reflects only the authors' views, and the European Commission is not liable for any use that may be made of the information it contains.


  • adolescents
  • complex projects
  • research planning
  • systems thinking


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