Undertaking ‘soft’ and ‘whole’ Systems Approaches in Realistic Policy Contexts: a Comparative Case Study

The past 20 years have seen a growing interest in the use of ‘soft’ and ‘whole’ systems approaches within various public health policy domains. Two of the most prominent of these topics are healthy weight/obesity and physical activity promotion. This paper reports on grounded evaluations of two concurrently delivered systems-based projects in these domains and was structured in a comparative case study form using survey, non-participant observation and focus group methods. Beyond the affirmative consensus that exists around systems approaches, it critically explores three areas related to its manifestation in these contexts: the role of foundational systems theories, specifically the articulation between ‘hard’ systems and ‘soft’ systems; expectations of systems-derived outputs; and ultimately, their fit with existing policy circumstances. It indicated that the project facilitators were conscious of theory and implicitly accommodated it in their approaches. It also showed that the systems elements identified were highly heterogeneous and contested. By means of advancement and derived from grounded inquiry from the workshops, it suggests the need for a more ‘context-conscious’ orientation within systems approaches. It offers three specific pointers: a typology of varied approaches that can used locate any specific systems-based project; the suggestion of the need to see systems-related developments in a staged, progressive and long-term way; and mapping of these potential positions, ranging from a modest mapping exercise of what is already happening in any domain through to the systems-based processes being used to foster novel and potentially innovative ‘cross cutting’ actions.