A scoping review of whole-of-community interventions on six modifiable cancer prevention risk factors in youth: A systems typology

Ann M. Essay, Chelsey R. Schlechter, Carrie A. Mershon, Alissa V. Fial, Jennie Ellison, Richard R. Rosenkranz, David A. Dzewaltowski

Research output: Contribution to journalReview articlepeer-review

Abstract

Whole-of-community interventions delivered across entire geospatial areas show promise for improving population health for youth cancer prevention. The aims of this scoping review were to synthesize the whole-of-community intervention literature on six modifiable risk factors in youth for cancer prevention (alcohol use, diet, obesity, physical activity, sun exposure, tobacco use) and to develop and apply a typology describing the inclusion of fundamental control system functional characteristics. A systematic search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO, and Scopus for studies published to the end of 2019. Eligible studies included a geospatially defined whole-of-community intervention; youth 0–18 years; and at least one of the six cancer risk factor outcomes. An iterative process was undertaken to create a typology describing the functions for whole-of-community interventions guided by systems theory, and the typology was used to code the included interventions. A total of 41 interventions were included. Most interventions (43.9%) assessed multiple cancer risk factors. Few interventions provided fundamental functions necessary for community system coordination: sensor, controller, effector. Although communities are a patchwork quilt of microsystems where individuals interact in geographically bounded places nested within larger whole systems of influence, a control systems approach has not been used to frame the literature. Whole-of-community interventions can be characterized by the fundamental system functions necessary for coordinating population health improvement. Future whole-of-community intervention efforts should draw on fundamental knowledge of how systems operate and test whether adoption of the key functions is necessary for whole-of-community population health improvement.

Original languageEnglish (US)
Article number106769
JournalPreventive Medicine
Volume153
DOIs
StatePublished - Dec 2021

Keywords

  • Cancer prevention
  • Population health
  • Scoping review
  • Systems
  • Whole-of-community interventions
  • Youth

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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