Table 1.

Common features of reductionist and systems mindsets

	Reductionist mindset	Systems mindset
Purpose of action	… align with a reductionist paradigm. Action seeks to influence an isolated element of the system (if the system is acknowledged).	… understand that actions operate within a complex system, with the action seeking to influence how the system functions. Recognise that many coherent actions are required across the system. Difficult to isolate effect to individual actions.
Focus of action	… target specific causal factors (e.g. individual lifestyle behaviours).	… considers the patterns, structures and drivers which give rise to a system behaviour (i.e. the factors which cause a problem to occur).
Relationships between stakeholders	… likely to be transactional in nature whereby a provider is commissioned to deliver a specified service.	… understand that collaborative relationships and trust are imperative between stakeholders when seeking action.
Longevity of action	… anticipate that the system will remain static over time. The action will continue to create the same outcomes overtime and in different contexts.	… anticipate that the system is dynamic and adaptive, evolving over time in response to actions. Each complex problem is unique and therefore a shared understanding of the problem is required by involved persons. Actions will be highly context specific and dependent on the system boundaries.
Availability of an evidence base	… have an extensive empirical evidence base for discrete interventions. Often have well-funded research streams.	… may have a limited evidence base. Evidence may be more theoretical or hypothetical.
Evaluating action	… are easily measurable in isolation (e.g. have a number of key performance indicators). Indicators tend to be focused on the main outcome and the reach of interventions. Evaluation aims to prove effectiveness.	… assess impact in the context of the system. Determine whether the action is helping to change the functioning of the system in the anticipated direction. Focus on proxy measures of success. Aim to improve effectiveness.
	Along a spectrum