Abstract for: Diabetes, Health-Promoting Policies and Sugary Drinks Consumption in Barbados: A model based on the Escalation Archetype

We focus on sugar-sweetened beverage (SSB) consumption in Barbados, a setting in which SSB consumption levels are four times the global average, contributing to elevated rates of diabetes. Over the last decade, the government has introduced a tax on SSBs and a ban on SSBs in school to reduce consumption and related non-communicable disease (NCD) risk. We developed a causal loop diagram (CLD) based on a two-day group model building process conducted with 20 stakeholders, including representatives from ministries of health, finance, education and commerce, as well as civil society organizations, the media and representatives of the private sector. From the detailed CLD, we identified similarities with the escalation archetype and used this to develop a more abstracted CLD, highlighting differences in the time-responsiveness of industry on one hand and government and civil society on the other. We developed a stock and flow diagram and a simulation model in Vensim. We used epidemiological data to inform the model, and conducted dimensional consistency, integration error and behaviour reproduction tests. We intend to continue model testing, including model boundary and structure testing, parameter assessments, extreme conditions, sensitivity analyses and finally assess any change in the mental models of participants.