Assessing changes in community readiness in two Danish communities after implementing a participatory systems approach targeting childhood mental health

The underlying causes of mental health problems are complex and thus call for complex solutions. Participatory systems approaches are increasingly being applied to tackle complex health problems through building capacity and changing the system from which the problem occurs. The Community Readiness Model is frequently used to assess a community’s readiness to change for a given health problem. This study aims to examine 2-year changes in readiness to change in two Danish communities applying a participatory systems approach targeting childhood mental health. The use of the Community Readiness Model was carried out by conducting 18 stakeholder interviews, nine pre (2021/2022) and nine post (2023/2024) the participatory systems approach. The communities’ overall readiness to change and six dimension-specific scores (range 1–9) were calculated based on these interviews. The overall readiness to change scores increased in the two local communities from pre (mean 3.41 and 4.06) to post (mean 4.96 and 4.72) the participatory systems approach. All (Community efforts; Community knowledge of the efforts; Community climate; Community knowledge of the issue; Resources related to the issue) but one (Leadership) dimension score increased 2 years after implementing a participatory systems approach in both communities. Our findings indicate that applying a participatory systems approach resulted in a positive shift in the communities’ readiness to address childhood mental health. The Community efforts dimension showed the greatest progression, suggesting a participatory systems approach is especially effective for improving community planning and implementation of initiatives. Clinical trial number: Clinical trial number 1-10-72-283-21.