Table 1.

A brief review of articles linking CBPR and systems science

Author	Summary
BeLue et al. (2012) [6]	The authors posit that systems science tools can help CBPR stakeholders to (a) visualize and specify the complex and dynamic characteristics of problems faced by community residents and (b) identify intervention targets or “tipping points” by which communities can transform their health conditions. The authors describe the use of causal loop diagrams by the Clinton County Healthy Communities Community Health Outreach Coalition (CCHC), a community coalition engaged in CBPR activities regarding youth drinking reduction and prevention. The CCHC is a partnership between local county-level agencies and the Clinton County Cooperative Extension and is affiliated with the 2006 Pennsylvania Department of Health State Improvement Plan. The CCHC coordinates community agencies to address issues related to substance abuse, teen pregnancy, and the social determinants of health. The CCHC meets monthly and consists of a volunteer board and subcommittees. The authors suggest that causal loop diagrams can provide an initial basis for simulation modeling in which multiple futures can be explored and leverage points can be identified. They further argue that behavior over time graphs and concept mapping may be helpful tools for CBPR partnerships. They note that training CBPR stakeholders in the proper use of systems science tools is needed.
Silka (2010) [2]	The author argues for the alignment between scholars that are using CBPR in health with the work of systems (sustainability) scientists. Both orientations are focused on addressing challenges that result from “nonparticipatory research.” She suggests that CBPR and systems science are focused on the coproduction of knowledge that offers solutions to complex problems, and both approaches may be criticized by “traditional” scientists because of their problem focus and lack of a positivist approach. The author suggests that concepts and tools from systems science such as wicked problems or agent-based modeling may be helpful in CBPR efforts. The author highlights the activities of the University of Main Sustainability Solutions Initiative (SSI), which “brings together multiple disciplines and many stakeholders to work on a range of coupled problems that must be solved if Mainers’ way of life is to be sustained economically, environmentally, and culturally” in order to identify challenges in stakeholder-engaged research in systems (sustainability) science, which can then help CBPR researchers see their challenges in new ways. The examples illustrate the use of structured dialogues, futures, and agent-based modeling, and using GIS to inform scale up of strategies and solutions. She introduces the concept of “wicked problems” in SSI discussions, which she defines as complex problems “in which stakeholders are likely to hold conflicting interpretations of what the real problem is and what the causes are, and they bring to the problem different values, goals, and life experiences.” In contrast to “tame problems” which can be addressed by gathering data, in addressing wicked problems it may never be clear when sufficient data has been amassed to point to a workable solution. Silka uses various examples to highlight how CBPR may need to shift from a focus on addressing inequalities in power to one focused on a problem-centered approach; she argues that practitioners will need new tools to deal with the complexity of community problems even when power issues have been addressed. Additionally, Silka argues that incentive structures need to change in order to support actual impact of research on practice, rather than just publication in “high-impact” journals.
Frerichs et al. (2016) [3]	The authors posit that CBPR and systems science can help address lingering questions about racial and socioeconomic health disparities. They summarize the history and principles of systems science and CBPR and highlight five synergistic properties of integrating these approaches: (1) paradigmatic, (2) socioecological, (3) capacity building, (4) co-learning, and (5) translational. Specifically, they describe how qualitative techniques (e.g., building “mental models” through causal loop diagrams or creating stock and flow diagrams) and computational techniques from systems science (e.g., using agent-based modeling or network analysis) may be useful to CBPR.
Raymaker (2016) [1]	This manuscript describes what one approach to systems thinking, critical systems thinking (CST), might be able to use from CBPR to inform emancipatory practices and methods for generating more equitable practices. The author provides a brief review of CST and CBPR approaches and highlights the complementary aspects of these orientations, noting that they are “general approaches to social inquiry, methods-agnostic, and use systematic (in CBPR, ‘ecological’) lenses in their approach to identifying, understanding, and intervening in social problems” and they share a focus on emancipatory practices, holism, underlying pragmatism, and focus on “wicked problems” or “mess” areas. Raymaker describes a hybrid approach used by her team to align CST and CBPR principles in the development and operation of Academic Autism Spectrum Partnership in Research and Education (AASPIRE). AASPIRE first formed in 2006 with a primary purpose to “conduct academic research studies in collaboration with the Autistic community and its allies.” Raymaker describes organizational and management practices used to support engagement and decision making as informed by CBPR and Senge’s concept of the learning organization and the “five disciplines.” Raymaker identifies four ways in which CBPR principles were operationalized: communication processes, material translation, shared decision-making processes that account for power, and using a cyclical and iterative process. She illustrates the use of Senge’s five disciplines, including: shared vision, team learning, mental models, personal mastery, and systems thinking.

CBPR, community-based participatory research.