Group model building for addressing dietary inequalities: a participatory systems approach

Socioeconomic inequalities in diet and health remain a major public health challenge across Europe, particularly in post-industrial urban settings. This study presents the application of Group Model Building (GMB) as a participatory systems method to explore drivers of dietary behaviours among socioeconomically disadvantaged populations and to inform locally relevant policy development.

The research was conducted in a deprived urban district in Poland within the FOODPATH project. Two GMB workshops were carried out with community members (n = 20) and professionals (n = 19), enabling stakeholders to collaboratively identify key factors influencing dietary behaviours and map their interconnections. The process resulted in causal loop diagrams reflecting shared and group-specific perspectives. These system maps were further analysed using network metrics to identify central variables and potential leverage points. The GMB approach indicate that dietary behaviours are shaped by a complex interaction of economic, social, cultural, and political factors. Key determinants included income level, food prices, availability of unhealthy food, marketing practices, and nutritional knowledge. Nutritional knowledge and harmful marketing emerged as critical leverage points within reinforcing feedback loops. While both groups shared a systemic understanding of the problem, community members emphasized material constraints and access barriers, whereas professionals highlighted social norms and structural determinants. This workshop also resulted in a set of multi-level policy recommendations, including financial incentives for healthy food, regulation of marketing practices, expansion of nutrition education, and strengthening access to dietary support services. The findings highlight the importance of combining structural and behavioural interventions and underline the value of participatory systems approaches in designing locally relevant and socially acceptable public health policies.

Key messages

• Unhealthy dietary behaviours in disadvantaged groups are driven by interconnected systemic factors, not individual choices alone-requiring integrated, multi-level policy responses.

• Participatory systems mapping identifies key leverage points (e.g. nutritional knowledge and marketing), enabling the development of context-sensitive and socially acceptable policy recommendations.