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Health CASCADE Workshop: Co-producing complex systems interventions for public health

Sep 30, 2022 | Blog

By Brian Castellani, Professor of Sociology (University of Durham)

30th September 2022 (originally published on the Sociology and Complexity Science Blog, reproduced with permission)

On 28 and 29 Sept 2022, I had the opportunity to present on Co-producing complex systems interventions for public health, as part of the Health CASCADE three-day workshop in Amsterdam on co-creation.

It was a lot of fun and a really brilliant group of faculty and students. Thanks again to Mai Chin A PawKunshan Goh and the rest of the team for organising the event, and to Sebastien Chastin for the invite, and to everyone that attended the event. I really enjoyed the discussion and I hope the ideas we discussed prove somewhat useful.


Before turning to my talk, here is a bit more about Health CASCADE. It is a brilliant project and something others should explore and promote! It is very much at the leading edge of co-creation for health.

Health CASCADE is a Marie Skłodowska Curie Innovative Training Networks project funded by the European Union (H2020 MSCA ITN) (Project number 956501).

The aim of Health CASCADE is to foster the next generation of highly trained research leaders to develop evidence based guiding principles, novel tools, and new technologies to make co-creation an effective tool to fight complex public health problems through a European Joint Doctoral Programme.

Global health challenges confront us all as individuals and communities – from obesity to pandemics, cancer to dementia – magnified by climate change and increasing inequality. These challenges are complex problems arising from multiple interconnected factors and feedback loops, resistant to existing public health programmes. We need new ideas and new approaches such as co-creation. By bringing together citizens, academics, businesses, and civil organisations, the project aims to co-create effective solutions to these complex problems.


This two-day workshop explored the value of integrating complexity science and co-production for developing effective, evidence-based tools for addressing complex public health problems. (HERE IS THE LINK to the PDF of my Presentation)



A complex systems approach has been proposed as a powerful toolkit for addressing complex public health problems, including the important role of place. In turn, co-creation has gained traction for addressing the complexities of public health policy, practice, and promotion, particularly around issues of inequality and inequity. While both approaches offer vital strategies for addressing complexity in public health, researchers are only beginning to explore their integration. Hence the purpose of this workshop.


Day 1 provided a framework for thinking about complexity in public health. To develop this framework, we began with an introduction to the complexity sciences, including a map of its present-day trajectories. From there we examined the current challenges the field faces. Particular focus was given to the failure of most complexity science approaches – particularly in terms of computational modelling – to effectively engage stakeholders in the model building process, as well as the development or evaluation of public health policies and practices. Given our public health focus, the COVID-19 pandemic was used as our case study. We ended the day highlighting some examples where progress has been made in integrating complexity science and co-production, particularly participatory systems mapping and case-based complexity – which attendees got a chance to explore.

Day 2 involved a series of break-out, small-group discussions. The first explored, from both an epistemological and practical level, which approaches to co-creation and complexity science might work best together (or not), or critically inform or challenge one the other, including different methods and tactics. The second session explored what sorts of methods or research projects, or case studies participants could develop to advance the integration of these two approaches to address complex public health problems.

HERE IS A KEY POINT – WHICH WE SOUGHT TO ARRIVE AT, BUT STILL HAVE LOTS TO DO TO GET THERE. Co-creation emerged of late in response to the limitations of science and policy and practice. Those same limitations are often found in the complexity sciences. How can co-creation address those similar limitations in the complexity sciences? In turn, given its focus on collective decision making, co-creation struggles with complexity and systems thinking. How can the tools of complexity science help? Be it systems mapping, computational modelling, or network analysis?


  • Here is an open-access book by Barbrook-Johnson and Penn that is the gold standard on practical guidelines for doing systems mapping, including participatory systems mapping.
  • Here is an open-access article by me and my colleagues that used participatory systems mapping to develop a co-created policy agenda for air quality and brain health and dementia.
  • Here is the link to COMPLEX-IT, the software package my colleagues and I developed for helping evaluators, civil servants, healthcare experts and public and third-sector
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