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<article article-type="review-article" dtd-version="1.1" xml:lang="en" xmlns:xlink="http://www.w3.org/1999/xlink"><front><journal-meta><journal-id journal-id-type="publisher-id">RSH</journal-id><journal-title-group><journal-title>Perspectives in Public Health</journal-title></journal-title-group><issn pub-type="ppub">1757-9139</issn><issn pub-type="epub">1757-9147</issn><publisher><publisher-name>SAGE Publications</publisher-name><publisher-loc>Sage UK: London, England</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1177/17579139211006747</article-id><article-id pub-id-type="publisher-id">10.1177_17579139211006747</article-id><article-categories><subj-group subj-group-type="heading"><subject>Peer Review</subject></subj-group></article-categories><title-group><article-title>The Action Scales Model: A conceptual tool to identify key points for action within complex adaptive systems</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8574-4153</contrib-id><name><surname>Nobles</surname><given-names>James D</given-names></name><xref ref-type="corresp" rid="corresp1-17579139211006747"/><aff id="aff1-17579139211006747">The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, NIHR ARC West, 9th Floor, Whitefrairs, Lewins Mead, Bristol BS1 2NT, UK</aff></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3458-7201</contrib-id><name><surname>Radley</surname><given-names>Duncan</given-names></name><aff id="aff2-17579139211006747">Centre for Applied Obesity Research, Leeds Beckett University, Leeds, UK</aff></contrib><contrib contrib-type="author"><name><surname>Mytton</surname><given-names>Oliver T</given-names></name><aff id="aff3-17579139211006747">MRC Epidemiology Unit, University of Cambridge, Cambridge, UK</aff></contrib><contrib contrib-type="author"><collab>The Whole Systems Obesity programme team</collab><aff id="aff4-17579139211006747">Centre for Applied Obesity Research, Leeds Beckett University, Leeds, UK</aff></contrib></contrib-group><author-notes><corresp id="corresp1-17579139211006747">James D Nobles, The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, NIHR ARC West, 9th Floor, Whitefrairs, Lewins Mead, Bristol BS1 2NT, UK Email: <email>james.nobles@bristol.ac.uk</email></corresp></author-notes><pub-date pub-type="epub"><day>15</day><month>5</month><year>2021</year></pub-date><volume>142</volume><issue>6</issue><fpage>328</fpage><lpage>337</lpage><permissions><copyright-statement>© Royal Society for Public Health 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder content-type="society">Royal Society for Public Health</copyright-holder><license><ali:license_ref start_date="2021-05-15" xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0/</ali:license_ref><license-p>This article is distributed under the terms of the Creative Commons Attribution 4.0 License (<ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">https://creativecommons.org/licenses/by/4.0/</ext-link>) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (<ext-link ext-link-type="uri" xlink:href="https://us.sagepub.com/en-us/nam/open-access-at-sage">https://us.sagepub.com/en-us/nam/open-access-at-sage</ext-link>).</license-p></license></permissions><abstract><sec id="section1-17579139211006747"><title>Background:</title><p>Systems thinking is integral to working effectively within complex systems, such as those which drive the current population levels of overweight and obesity. It is increasingly recognised that a systems approach – which corrals public, private, voluntary and community sector organisations to make their actions and efforts coherent – is necessary to address the complex drivers of obesity. Identifying, implementing and evaluating actions within complex adaptive systems is challenging, and may differ from previous approaches used in public health.</p></sec><sec id="section2-17579139211006747"><title>Methods:</title><p>Within this conceptual article, we present the Action Scales Model (ASM). The ASM is a simple tool to help policymakers, practitioners and evaluators to conceptualise, identify and appraise actions within complex adaptive systems. We developed this model using our collective expertise and experience in working with local government authority stakeholders on the Public Health England Whole Systems Obesity programme. It aligns with, and expands upon, previous models such as the Intervention Level Framework, the Iceberg Model and Donella Meadows’ 12 places to intervene within a system.</p></sec><sec id="section3-17579139211006747"><title>Results:</title><p>The ASM describes four levels (synonymous with leverage points) to intervene within a system, with deeper levels providing greater potential for changing how the system functions. Levels include events, structures, goals and beliefs. We also present how the ASM can be used to support practice and policy, and finish by highlighting its utility as an evaluative aid.</p></sec><sec id="section4-17579139211006747"><title>Discussion:</title><p>This practical tool was designed to support those working at the front line of systems change efforts, and while we use the population prevalence of obesity as an outcome of a complex adaptive system, the ASM and the associated principles can be applied to other issues. We hope that the ASM encourages people to think differently about the systems that they work within and to identify new and potentially more impactful opportunities to leverage change.</p></sec></abstract><kwd-group><kwd>complexity</kwd><kwd>systems science</kwd><kwd>leverage points</kwd><kwd>complex intervention</kwd><kwd>health policy</kwd><kwd>complex adaptive systems</kwd></kwd-group><funding-group specific-use="FundRef"><award-group id="award1-17579139211006747"><funding-source id="funding1-17579139211006747"><institution-wrap><institution>national institute for health research collaboration for leadership in applied health research and care north west coast</institution><institution-id institution-id-type="FundRef">https://doi.org/10.13039/501100015509</institution-id></institution-wrap></funding-source></award-group><award-group id="award2-17579139211006747"><funding-source id="funding2-17579139211006747"><institution-wrap><institution>Public Health England</institution><institution-id institution-id-type="FundRef">https://doi.org/10.13039/501100002141</institution-id></institution-wrap></funding-source><award-id rid="funding2-17579139211006747">Whole Systems Obesity programme</award-id></award-group></funding-group><custom-meta-group><custom-meta><meta-name>typesetter</meta-name><meta-value>ts1</meta-value></custom-meta></custom-meta-group></article-meta></front></article>