Collaboration in Complex Systems: Multilevel Network Analysis for Community-Based Obesity Prevention Interventions.

Community-based systems interventions represent a promising, but complex approach to the prevention of childhood obesity. Existing studies suggest that the implementation of multiple actions by engaged community leaders (steering committees) is of critical importance to influence a complex system. This study explores two key components of systems interventions: (1) steering committees; and (2) causal loop diagrams (CLDs), used to map the complex community-level drivers of obesity. The interactions between two components create an entangled, complex process difficult to measure, and methods to analyse the dependencies between these two components in community-based systems interventions are limited. This study employs multilevel statistical models from social network analysis to explore the complex interdependencies between steering committee collaboration and their actions in the CLD. Steering committee members from two communities engaged in obesity prevention interventions reported on their collaborative relationships with each other, and where their actions are situated in a locally developed CLD. A multilevel exponential random graph model (MERGM) was developed for each community to explore the structural configurations of the collaboration network, actions in the CLD, and cross-level interactions. The models showed the tendency for reciprocated and transitive collaboration among committee members, as well as some evidence of more complex multilevel configurations that may indicate integrated solutions and collective action. The use of multilevel network analysis represents a step toward unpacking the complexities inherent in community-based systems interventions for obesity prevention.