1. Social Ecological Models

2. How can we begin to understand all of the factors that influence health?
Ecological
Model
Fall 2006

3. Individual Interpersonal Institutions Community Population/Policy
Fall 2006
Population/Policy

4. 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

5. 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

6. 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

7. 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?
Fall 2006

8. Ecological Framework helps us with…
Problem analysis
Intervention design
Intervention evaluation
Fall 2006

9. Public Health Problem Determinants
Problem analysis
Public Health Problem Determinants

Population
Community
Organizational
Interpersonal
Individual
Fall 2006

10. Individual Interpersonal Institutions Community Population/Policy
Fall 2006
Population/Policy

11. 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

12. 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

13. Individual Level Interventions
Target of change  Individual Person
Focus on characteristics of the individual
E.g., knowledge, attitudes, skills, beliefs…
Fall 2006

14. 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?
Fall 2006

15. 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

16. 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?
Fall 2006

17. 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

18. 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

19. Community Level Interventions
Target of change  Social environment
Focus on community norms, values, attitudes, & power structures
Fall 2006

20. 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?
Fall 2006

21. 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

22. 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?
Fall 2006

23. Are there any issues that don’t?
What types of health issues or health behaviors lend themselves to using the social-ecological model?
Are there any issues that don’t?
Fall 2006

24. 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

25. 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