Abstract
OBJECTIVE: This study aimed to develop a shared understanding about the drivers of nutrition security in Puerto Rico (PR) from the collective perspective of multi-sector stakeholders in the agri-food, environmental and the health/disease systems. DESIGN: A participatory community-based system dynamics approach (group model building) engaged stakeholders during one 4-h workshop March 2023 (followed by two 2.5-h member checking sessions). SETTING: San Juan, PR. PARTICIPANTS: Stakeholders (n 22) in PR representing the agri-food, environmental and health/disease systems from multiple sectors (commercial food retail and technology, food production, public servants, academia and civil society) participated in the workshop. RESULTS: Stakeholders collectively framed nutrition security as an outcome of six interconnected subsystems exacerbated by climate change: (1) governance and public policy; (2) demographic change and rural disinvestment; (3) climate change and adaptive capacity; (4) local food production economy; (5) food culture; and (6) nutrition security and health. Stakeholders identified leverage points mostly focused on strengthening information flow within and across subsystems and expanding cross-sectoral collaboration (systems structures and elements). We identified three paradigms that have the potential to transform the system structure and function: ecological conscience, traditional and healthy food culture, and social cohesion. CONCLUSIONS: These findings deepened the collective understanding of systemic interdependencies that drive nutrition security as stakeholders identified locally feasible leverage points.