{
  "abstract": "Background The use of systems science approaches is increasing in public health research. This includes systems mapping and ripple effects mapping, methods that have existed for a long time, but which have only recently been applied to population health evaluation research. ActEarly (2019–2025) was a UKPRP funded consortium that focused on the health and well-being of children and families in two areas with high levels of deprivation, Bradford in West Yorkshire, and Tower Hamlets in London. We present two case studies detailing pragmatic systems methods development work that was part of the wider evaluation of ActEarly.Methods The first case study describes findings from a study exploring the reach of ActEarly projects across the system by mapping on to an existing Child Health Map (CHM) by Jessiman et al., and contrasting this with our published Core Outcome Set for Early Years (COS-EY). The second case study presents our adapted approach to Ripple Effects Mapping (REM) which we applied to the large network of ActEarly activities across the two study sites, requiring adaptations to existing REM approaches. Data visualisations were created in Neo4J using iGraph and R.Results ActEarly projects were mapped onto the CHM and the COS-EY using a matrix. This allowed us to overlay ActEarly activities on the existing map and generate visualisations that highlighted areas where ActEarly was active vs. inactive. Our adapted approach to REM resulted in combining elements of both the Chazdon et al. and the Nobles et al. adaptations, as well as a novel addition of ‘anchoring’ the REM timeline to the events before generating the computerised visualisations. We used additional information sources such as documentary analysis to solve inconsistencies. This was done to 1) improve ripple accuracy, 2) allow merging of multiple REM maps describing the same events to aid reflection on key impacts, 3) generate a ‘meta-map’ to showcase ripples running across two study sites, and 4) to remove erroneous nodes from the timeline (e.g., backwards arrows indicating going backwards in time).Conclusion One of the challenges of applying systems approaches to public health evaluations is the lack of adaptations of the existing methods that are pragmatic and fit different complex contexts. To improve open research and transparency, our two case studies of method development explain the rationale behind the adaptations that were made as part of the ActEarly evaluation, acknowledging that these methodological choices ultimately also influence our interpretation of ActEarly’s impact.",
  "authors": [
    {
      "affiliations": [
        "Hull York Medical School, University of York, York, UK",
        "Department of Health Sciences, University of York, York, UK"
      ],
      "name": "Liina Mansukoski"
    },
    {
      "affiliations": [
        "Department of Health Sciences, University of York, York, UK"
      ],
      "name": "Louise Padgett"
    },
    {
      "affiliations": [
        "Hull York Medical School, University of York, York, UK",
        "Department of Health Sciences, University of York, York, UK"
      ],
      "name": "Maria Bryant"
    },
    {
      "affiliations": [
        "Department of Health Sciences, University of York, York, UK"
      ],
      "name": "Patience Gansallo"
    },
    {
      "affiliations": [
        "School of Business and Society, University of York, York, UK"
      ],
      "name": "Philip Garnett"
    }
  ],
  "title": "P58 Pragmatic systems methods development – two case studies from the UKPRP ActEarly consortium",
  "uid": "1edf0ec2-6bda-5361-8d0a-246b01d53749"
}