Abstract
Wicked problems and system thinking require solutions that are about changing the system dynamics in favourable ways. Randomized controlled trials (RCT), which traditionally have been seen as the 'gold standard' in evaluation research, are not the solution for this type of problem, as they are merely suited to evaluate single and multi-component interventions in a controlled setting. With system thinking, we recognize the complexity of the problem with multiple, interacting factors that are adaptive and dynamic over time. Crucial is participation of the target population.
Participatory action research (PAR) is an approach to research in communities that emphasizes participation and action of the target group. PAR increases feasibility and validity of research, and eventually the chance of designing successful interventions, as they are more likely to meet the target population specific needs and to change local practices. In addition, it contributes to personal development and self-efficacy among the stakeholders by prompting them to reflect on their lives and take shared action.
We will present three examples of lived experiences assessed by PAR, with a focus on childhood obesity. In the first project, we aim to develop, implement and evaluate an integrated action programme for 10-14-year-old adolescents in Amsterdam at the level of family, school, neighbourhood, health care and city, based upon a detailed insight into the characteristics of the population at stake (LIKE). The second project (Food4Smiles) aims to give children in their first 1000 days a good start in life regarding food, exercise, sleep and overall wellbeing. In this project, we work together with parents, grandparents and healthcare providers. The third project focuses on the healthcare for children with obesity. Goal is to understand which factors contribute to successful self-management behavior in children with obesity and their family and how youth nurses can empower and support this behavior.