Table 1 A summary of the steps taken during our GMB workshops

Room preparation for each GMB workshop (30 min)

This activity was used to create an inviting and conducive environment for GMB participants before the GMB session begins

Members of both the in-person and online facilitation teams prepared the physical venue, equipment and tools, and Zoom call.

(Logistics and Room Set Up)

Phase-1 GMB workshops

Welcome, overview and introductions (30 min)

These activities were used to welcome the participants, warm the room, introduce the project and defined key terms.

The gatekeeper introduced the facilitation team and communicated the team’s expectations for this workshop.

(Introduction to the project)

Participants introduced themselves to each other and the team.

Project team (1) introduced MIAIF using local official prevalence data, (2) defined MIAIF and food systems and prompted participants to think the underlying drivers of malnutrition to shift the focus from individuals to the wider food systems, (3) presented a rationale for using a system approach, outlined project aim, and anticipated benefits of the project to the pilot city.

Draw ‘Graphs over Time’ (75 min)

These activities were used to engage participants with the problem, describing the reference mode for the workshop and eliciting factors,

Project team (1) engaged participants with the reference mode (the healthiness level of the food environments over time), (2) instructed participants on drawing ‘Graphs Over Time’, and (3) prompted participants to identify factors that can contribute to at least two different forms of malnutrition.

(Presenting the Reference Mode, Graphs Over Time, Variable Elicitation)

Participants individually identified factors, drew anticipated changing trends of each factor, and identified factors that can contribute to at least two forms of malnutrition.

Participants shared, discussed and prioritised factors based on their importance in small groups.

One representative of each small group shared the identified factors with the full group, and all factors (colour coded to indicate which forms of malnutrition they influence) were entered to STICKE.

Tea break (10 min)

This activity was for participants to have a break. It also allowed the local facilitation team to get acquainted with participants and allowed the remote facilitation team to review and act promptly on timing and IT issues.

Connections between variables (60 min)

These activities aimed to facilitate consensus-based group discussion about the connections of identified factors, and to create a preliminary CLD.

Participants identified, discussed and agreed on the connections between different factors.

(Creating Causal Loop Diagram from Connection Circles)

Research team entered collectively agreed connections to STICKE to generate a preliminary CLD

Reflection, next steps and closing (5 min)

These activities were used to summarise and close the GMB session and explain the next phase for the participants.

Project team summarised the activities and outputs of the Phase-1 GMB workshop.

(Next Steps and Closing)

Project team and gatekeeper expressed their appreciation for the participants’ contributions during the workshop and invited them to the next phase GMB workshop.

Phase-2 GMB workshop

Welcome, overview and introductions (10 min)

These activities were used to welcome participants, and to link up the current workshop with the previous workshop.

The gatekeeper introduced the facilitation team and communicated the team’s expectations for this workshop. Participants were invited to re-introduce themselves.

Project team reflected on Phase-1 workshops by summarising the activities and outputs.

Project team presented the agenda of Phase-2 workshop.

Preliminary CLD presentation and reflection (50 min)

These activities were used to summarise dynamic insights and stories, clarify unclear ideas, capture additional information about model structure, and receive feedback from participants after causal structures have been developed.

Project team presented the preliminary CLD.

(Modelling Project Community Presentation)

Facilitator reminded the participants how the current CLD was produced by highlighting the input of the different groups (sectors).

Project team invited participants to share their initial, general feedback on the existing factors and connections.

Tea break (10 min)

This activity aimed to give time for participants to have a break, for local facilitation team to get acquainted with participants, and for remote facilitation team to review and solve IT issues.

Review of CLD (55 min)

These activities were used to continue the modelling reviews, identify (and close) open loops if appropriate, and refine the CLD.

Participants reviewed the CLD in smaller groups of 3-6 people.

(Model Review)

Participants reviewed the CLD together as a whole group. The representatives of the small groups were invited to share group feedback (new factors and connections) with the entire group in turns.

Participants were invited to identify and close open loops if needed by suggesting additional factors.

Reflection, next steps and closing (25 min)

These activities were used to explain the next workshop and close the GMB session.

The project team outlined the expectations for the final workshop.

(Next Steps and Closing)

Participants were provided with guidance on how to choose and recruit front-line professionals and community representatives for the final GMB workshop.

Phase-3 GMB workshop

Welcome, overview and introductions (10 min)

These activities were used to welcome participants, share work that was completed after the last workshop (improving the visual presentation of the CLD and a meeting with the city’s Deputy Mayor), and link up the current workshop with the previous workshops.

The gatekeeper introduced the facilitation team and participants.

Project team summarised the activities and outputs of Phase-1 and Phase-2 GMB workshops.

Project team shared the highly supportive feedback on the current CLD and information on the city’s strategic development priorities from the city’s most senior leader for health promotion (Deputy Mayor).

Project team outlined the agenda of the final workshop.

Presentation and discussion of the full CLD (50 min)

These activities were used to disseminate information about the modelling project and elicit feedback from front-line professionals and community-representatives on the current CLD.

Project team presented the developed and reviewed CLD for the enlarged group by unfolding the story theme by theme.

(Modelling Project Community Presentation, Model Review)

Participants reviewed the CLD in small groups.

Participants reviewed and optimized the CLD as a whole group.

Tea break (10 min)

This activity was for the participants to have a break. It also allowed the local facilitation team to get acquainted with participants, and for remote facilitation team to review and act promptly on timing and IT issues.

Action idea (45 min)

These activities were used to identify and prioritise intervention actions after the model has been developed and reviewed.

Participants identified and prioritised intervention themes in small groups and shared ideas with the entire large group.

(Action Ideas)

Participants were invited to identify and describe potential intervention ideas with as much detail as possible in writing.

Participants were invited to prioritise these potential interventions through individual voting and collective discussions until a consensus was made on the ranking of the identified intervention ideas. Participants were asked to prioritise by considering the potential impact and feasibility of potential interventions as well as the city’s long-term objectives.

Conclusion and closing (5 min)

(Next Steps and Closing)

These activities were used to review today’s workshop, identify the next steps and close the GMB session.

Project team summarised the activities completed at the workshop.

Project team communicated the plan for forming an official Local Action Group immediately after the final workshop and expressed their appreciation for the participants’ contributions so far.