The use of participatory systems mapping as a research method in the context of non-communicable diseases and risk factors: a scoping review

Context: Participatory systems mapping is increasingly used to gain insight into the complex systems surrounding non-communicable diseases (NCDs) and their risk factors. Objectives: To identify and synthesize studies that used participatory systems mapping in the context of non-communicable diseases. Design: Scoping review. Eligibility criteria: Peer-reviewed studies published between 2000 and 2022. Study selection: Studies that focused on NCDs and/or related risk factors, and included participants at any stage of their system’s mapping process, were included. Categories for analysis: The main categories for analysis were: (1) problem definition and goal-setting, (2) participant involvement, (3) structure of the mapping process, (4) validation of the systems map, and (5) evaluation of the mapping process. Results: We identified 57 studies that used participatory systems mapping for a variety of purposes, including to inform or evaluate policies or interventions and to identify potential leverage points within a system. The number of participants ranged from 6 to 590. While policymakers and professionals were the stakeholder groups most often included, some studies described significant added value from including marginalized communities. There was a general lack of formal evaluation in most studies. However, reported benefits related mostly to individual and group learning, whereas limitations described included a lack of concrete actions following from systems mapping exercises. Conclusions: Based on the findings of this review, we argue that research using participatory systems mapping would benefit from considering three different but intertwined actions: explicitly considering how different participants and the power imbalances between them may influence the participatory process, considering how the results from a systems mapping exercise may effectively inform policy or translate into action, and including and reporting on evaluation and outcomes of the process, wherever possible.