Abstract
BACKGROUND: Healthy diet is an essential component of good health, yet many areas of the UK struggle with high burdens of diet-related diseases. Efforts to address diet-related diseases in the London Borough of Newham have had limited success so far, possibly due to the lack of engagement with Newham's distinct local context. Newham is ethnically diverse and within the 20% most deprived areas of England. To engage residents in public health action and encourage approaches that tackle the underlying causes of poor-quality diets, systems approaches were used to co-design healthy diet interventions with residents in Newham. The specific aims of the project described in this paper were to understand residents' perceptions of the determinants of unhealthy diets and identify their desired areas for action. METHODS: Twelve online Group Model Building workshops were conducted with 33 Newham residents from six Community Neighbourhoods. Participants reflected the ethnic and religious diversity of Newham's population. The first workshop explored residents' views of what is causing people to have unhealthy diets. Participants identified areas for action and brainstormed solutions to improve diets in the second workshop. RESULTS: Each workshop produced a neighbourhood-specific systems map of 'what's causing people in Newham to have unhealthy diets'. Residents identified multiple and connected political and economic, physical environment, social environment, and individual level causes of unhealthy diets. Suggested action included increasing food and nutrition education, addressing the unhealthy influence of social media, alleviating poverty and improving food business practices. CONCLUSIONS: Online Group Model Building activities represent a comprehensive yet low cost and low burden method for engaging communities in identifying areas for action to improve diets. The systems maps created in this project with Newham residents have been used to co-develop context-specific food interventions with Newham Council that focus on improving the food environment.