Transcript Social Ecological Models
Social Ecological Models
How can we begin to understand all of the factors that influence health?
Ecological Model
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Individual
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Interpersonal Institutions Community Population/Policy
What is an Ecological Perspective?
A framework that enables us to consider the influence of individual
and
environmental factors on health & health-related behaviors Fall 2006
Why the ecological framework?
Health & health problems are complex Health problems are influenced by multiple variables These variables interact with each other Multiple levels are relevant for understanding & changing: – – Human behavior Complex environments Fall 2006
By focusing on factors beyond the individual, we are…
Less likely to ‘blame the victim’ More likely to address the underlying determinants of health & health behavior Fall 2006
By focusing on factors beyond the individual, we are…
Better able to see where action is needed Upstream action vs. Downstream approaches What do we mean by up/down stream approaches?
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Ecological Framework helps us with…
Problem analysis Intervention design Intervention evaluation Fall 2006
Problem analysis
Public Health Problem Determinants Fall 2006 Population Community Organizational Interpersonal Individual
Individual
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Interpersonal Institutions Community Population/Policy
Youth Smoking Determinants
Population/Policy Lack of law enforcement for selling to minors Community Positive attitudes toward smoking Organizational Easy availability of cigarettes at stores Interpersonal Popular kids smoke/parents smoke Individual Lack skills/self efficacy to ‘just say no’ Fall 2006
Intervention Design
Prevent or ameliorate existing problems Interventions, at their best are… – Intended to Identify & shape solutions Specifying goals, objectives, activities – Theory-based – Designed by multi-disciplinary teams – – Targeted at multiple levels Able to maintain a broad (ecological) scope Fall 2006
Individual Level Interventions
Target of change Individual Person Focus on characteristics of the individual – E.g., knowledge, attitudes, skills, beliefs… Fall 2006
Individual Level Interventions
What types of strategies might we use at this level?
What type of individual level intervention would be useful in youth tobacco prevention?
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Interpersonal Level Interventions
Target of change Social influences – E.g., family, work group, friendship networks… Focus on nature of social relationships – E.g., social norms, access to diverse & supportive networks/influences Fall 2006
Interpersonal Level Interventions
What types of strategies might we use at this level?
What type of interpersonal level intervention would be useful in youth tobacco prevention?
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Organizational Level Interventions
Target of change – Organization/Institution E.g., worksites, schools, agencies, churches… Focus on organizational culture – E.g., norms, rules & regulations, incentives & benefits, structures Fall 2006
Organizational Level Interventions
What types of strategies might we use at this level?
What type of organizational level intervention would be useful in youth tobacco prevention?
Fall 2006
Community Level Interventions
Target of change Social environment Focus on community norms, values, attitudes, & power structures Fall 2006
Community Level Interventions
What types of strategies might we use at this level?
What type of community level intervention would be useful in youth tobacco prevention?
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Population Level Interventions
Target of change Local, state, & national laws & policies Focus on government regulations & other regulatory processes, procedures, or laws to protect health Fall 2006
Population Level Interventions
What types of strategies might we use at this level?
What type of population level intervention would be useful in youth tobacco prevention?
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What types of health issues or health behaviors lend themselves to using the social-ecological model?
Are there any issues that don’t?
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Challenges to ecological interventions
A lot of work – involving several sectors of society Difficult to evaluate change at environmental level Challenge to translate interest in change into social norms and public policy – – – Powerful norms are hard to change Budget cuts – so difficult to undertake wide-range interventions Difficult to get certain health issues on public policy agenda Still, it’s being done!
E.g., nutrition guidelines, tobacco, fitness, elder transportation Fall 2006
So…
The ecological framework emphasizes: – Relationships among behaviors, socio-political structures & health – Applying this framework allows us to: Determine & describe public health problems Move beyond solely focusing on (& blaming) the ‘individual’ Assess multi-level determinants of health & how to address them Design, implement, & evaluate interventions Fall 2006