Stakeholder Workshop to Drive Systematic Innovation for Health Experiences

On Wednesday, July 3, 2024, Dr. Marzena Nieroda of GBSH hosted a workshop on System Innovation for Healthy Lived Experiences, funded by the Innovation and Enterprise Faculty Innovation Fund. This was a follow-up to the initial session on the topic held on April 9th. 

This event brought together experts to explore the complex interplay of systemic factors shaping human behaviour, particularly in health and weight management. The workshop considered how place-based system structures and dynamics could influence various choices and create equitable (or inequitable) opportunities.

The workshop began with a keynote address by Professor Vivienne Ming of Socos Labs, who introduced the concept of subjective utility—the personal value individuals assign to outcomes based on their preferences and experiences. Professor Ming emphasized that understanding subjective utility is key to decoding why people make certain choices, especially in health-related decisions. She highlighted the role of AI and technology in revealing these deep-seated motivations, arguing that aligning health interventions with individuals’ subjective utility could make them more effective.

Dr. Dania Hernandez from UCL, in collaboration with Dr. Nieroda, presented research from a survey of 543 UK residents. The study examined how various stakeholders impact people's weight-related goals and behaviours.

Of the participants, 49% aimed to improve their diet, and 37.8% focused on physical activity. Other areas of change included alcohol consumption, stress management, smoking cessation, and sleep improvement, with each of these categories receiving less than 6% of the participants' focus.

Participants highlighted the complex interactions with system elements when trying to make these changes, with nearly 70% emphasizing the importance of understanding the link between behaviour (enabled by a system stakeholder) and health outcomes.

Various system stakeholders were mentioned by participants as either enabling or hindering the desired change.  For example, 11% found the physical activity industry motivating, but 1.5% reported negative gym experiences. The food industry was seen as both facilitating healthy foods access (5.5%) and a barrier, with issues such as availability of tempting unhealthy food (10.5%), fast food convenience (5.7%), cost (1.8%), and the taste of unhealthy foods (2.2%).

A series of expert contributions followed, each offering unique perspectives on these systemic challenges. Helen James from VCSE Nutriri critiqued traditional approaches to ‘obesity’, arguing that current solutions have not yielded positive health outcomes, often worsening over time and not always being cost-efficient. Helen advocated for moving away from weight-centric metrics, to co-create stigma-informed systems that promote a more holistic approach to health and well-being. She emphasised the need for better communication within the healthcare workforce about weight, urging a shift in the conversation, and help transition to a model that simply measures health instead of weight. Nutriri’s focus on psychosocial support rather than weight change prioritises overall well-being and sustainable lifestyle changes over mere numbers on a scale.

Dr. Anthony Renshaw from International SOS discussed the complex determinants of health, highlighting the role of various system elements, including the workplace, in influencing health outcomes. He pointed out that obesity control has only recently become a strategic priority for many organizations. He criticized corporate health initiatives that focus solely on “know-your-numbers” campaigns, advocating instead for integrating weight management programs into the overall corporate vision. Measuring the impact of health initiatives was deemed crucial, with Dr. Renshaw emphasizing the importance of techniques like nudges and choice architecture in influencing behaviour. He underscored the value of multi-sectoral action and referenced a WHO paper calling for comprehensive approaches to health, stressing the need for evidence-based wellness initiatives and behavioural science in corporate health management.

Andre Ribeiro Coutinho from GoFW discussed the role of decentralized engagement platforms, mission-oriented innovation, and equitable finance in promoting sustainable development and trust within communities. He emphasized the importance of quality interactions through engagement platforms, which lead to greater impact. Andre highlighted Web 3.0 and the concept of decentralized communities or “islands of trust.” He advocated for mission-oriented innovation and a cross-stakeholder approach to sustainable development.

The workshop culminated in a panel discussion skilfully led by Dr. Nicky Keay and Dr. Julie Lanigan, featuring voices like Dr. Vivienne Ming, Ro Huntriss of Simple App, James Jennings of UCL, Dr. Rodrigo Rodriguez-Fernandez, Dr. Anthony Renshaw of International SOS, and André Ribeiro Coutinho of GoFW. The discussion covered a range of topics, including the complexity of motivating behaviour change, the controversy surrounding BMI as a health metric, and the importance of language in healthcare communication.

Dr. Rodrigo Rodriguez-Fernandez argued that individual choice is often a “fake choice” heavily influenced by the surrounding environment. He used Saudi Arabia as an example, citing its rapid increase in obesity rates correlating with its increase in national wealth and environmental changes associated with it. The beauty of language and persuasion was raised as a tactic that can enable better and healthier choices.

Ro Huntriss emphasized the need for personalized approaches, noting that one solution doesn’t fit all. She mentioned the opportunities of using AI to develop coaching apps that can adapt to different user preferences and communication styles.

James Jennings elaborated on his experiences with developing community-based interventions, mentioning a past project in Lewisham addressing high obesity. He highlighted the importance of considering different body types, especially for people of colour, and emphasized the need for culturally sensitive approaches and considering lived experiences.

Speaking on equity in health choices, Dr. Rodriguez-Fernandez pointed out the environmental constraints on individual choices, and Helen James raised concerns about equity, highlighting that not everyone has access to healthy options.

The panel discussed the challenge of balancing individual choice with public health interventions. They debated the ethics of restricting unhealthy food advertisements versus promoting healthier options.

The workshop concluded with group discussions on identifying collaborative approaches to support weight management. These discussions reinforced the need for strategic, multi-stakeholder collaboration to create systems that support healthy lived experiences.