Core Principles of the Ecological Model

The Social Ecological Model is a framework put in place in order to understand the multifaceted levels within a society and how individuals and the environment ... Skiptomaincontent ModelsandMechanismsofPublicHealth Chapter3:SocialEcologicalModel Searchfor: CorePrinciplesoftheEcologicalModel MultipleInfluencesonaSpecificHealthBehavior Amongamyriadofpublichealthissues,STDsareanespeciallynotoriousprobleminpublichealth.Theirsignificanceisnotonlylimitedtotheirvarietyandhighincidencebutalsototheirsequelaeandtheirrateoftransmissionamongpopulations.Theresearcharticle,“GlobalEstimatesofPrevalenceandIncidenceofFourCurableSexuallyTransmittedInfectionsin2012BasedonSystematicReviewandGlobalReporting”concludesthat,“…theglobalprevalenceandincidenceofurogenitalchlamydia,gonorrhea,trichomoniasis,andsyphilisinadultmenandwomenaged15to49yearsremainhigh,withnearlyonemillionnewcasesofcurableSTIacquiredeachday”(Newman-Temmermanetal.,2015).Aswithalotofhealthissuesweface,wecanusetheSocio-EcologicalModeltodevelopapracticalsolutiontoreducetheeffectofSTDsinsociety. TheSocio-EcologicalModeltakesintoconsiderationtheindividual,andtheiraffiliationstopeople,organizations,andtheircommunityatlargetobeeffective.Therearefivestagestothismodel–Individual,Interpersonal,Organizational,Community,andPublicPolicy. Theindividuallevelisconcernedwithanindividual’sknowledgeandskills.Knowledgeaboutadiseasehelpstheindividualunderstandmoreaboutit.Ithelpsinformthemabouthowsusceptibletheyaretothedisease,howseriousthediseaseis,andtheoverallthreatofthedisease.Knowledgeisnotenoughtochangeattitudesmostofthetimebut,ithelpsagreatdealbyinfluencingkeyattitudesanddecisionsindividualsmake. Theinterpersonallevelhastodowithaperson’srelationshipswithotherpeople–family,friends,andsoon.Atthislevel,theparentsoftheindividualcanhaveregulartalkswiththeirchildrenaboutsexandgoforhealthscreeningfromtimetotime.Makingcondomsavailablefortheirkidsmightalsobeagoodideasincetheycannotcontroltheirkids’everymove. Theorganizationallevelhastheopportunitytoreachmorepeopleindifferentsectorsofthecommunity.Organizationslikeschools,andworkplacescantakeituponthemselvestokeepemployeesandstudentssafefromSTDs.SchoolscandothisbymakingcondomsavailableatschoolclinicslikeUniversityatBuffalodoes.Inadditiontothat,anorganizationcanprovidecounsellingandimmunizationservices,coupledwitheffectiveinsuranceplansforworkers.Makingaffiliatesoforganizationsawareofthesebenefitsisalsoveryimportant. Inthismodel,acommunityreferstotheculminationofthevariousorganizationsinanarea.Theseorganizationscanpoolresourcesandideastogetherinordertoimprovecommunityhealth.Forexample,ahospitalagreestohavesomeofitsnursesteachsexeducationinanearbyschool.OrganizationsinanareacouldcoordinatehealtheventsdesignedtoeducateandequipaffiliateswithknowledgeandmaterialstohelppreventthespreadofSTDsinthecommunity.JustlikeLoveCanalhadaHomeownersAssociation,acoalitionoforganizationsinacommunityhaveloudervoicesandmorefunds. Atthefinallevel–PublicPolicy–thegoverningbodiesareinchargeofthepreventioneffort.TheydothisbyestablishingagenciesandlawsateverylevelofgovernmenttodoresearchonthespreadofSTDsandfigureoutmoreeffectivewaysofdealingwiththeproblem.Thegovernmentshouldsetthelawsandenforcethoselaws.ThisleveloftheSocio-ecologicalModelisimportantbecauseitaffectsalargerportionofthepopulationthantheotherlevels.Forexample,alawthatensuresthatpeopleareimmunizedbeforejoininganorganizationor,alawthatprovidesfundingtotheavailabilityofcondoms. InteractionofTheDifferentLevelsofTheModel TheSocialEcologicalModelisaframeworkputinplaceinordertounderstandthemultifacetedlevelswithinasocietyandhowindividualsandtheenvironmentinteractwithinasocialsystem.Differentfactorsanddeterminantsexistatalllevelsofhealth,makingprevention,control,andinterventionmosteffectivewhenthemodelisaddressedfromalllevels.Manydesignsofthemodelaremadesothatthedifferentlevelsoverlap,illustratinghowonelevelofthemodelinfluencesthenext.AccordingtotheCentersforDiseaseControlandPrevention,inordertopreventcertainriskfactors,itisnecessarytotakeactionwithmultiplelevelsofthemodelatthesametime(CDC,2018).Whenapproachingapotentialproblem,ithasbeenproventhatinordertobestsustainpreventionefforts,actionshouldbetakenatmultiplelevelsofthemodelatthesametime. TheWorldHealthOrganizationaddedthispiecefromaglobalcampaignaddressingviolencepreventionandtheSocialEcologicalModel: Theecologicalframeworktreatstheinteractionbetweenfactorsatthedifferentlevelswithequalimportancetotheinfluenceoffactorswithinasinglelevel.Forexample,longitudinalstudiessuggestthatcomplicationsassociatedwithpregnancyanddelivery,perhapsbecausetheyleadtoneurologicaldamageandpsychologicalorpersonalitydisorder,seemtopredictviolenceinyouthandyoungadulthoodmainlywhentheyoccurincombinationwithotherproblemswithinthefamily,suchaspoorparentingpractices.Theecologicalframeworkhelpsexplaintheresult—violencelaterinlife—astheinteractionofanindividualriskfactor,theconsequencesofcomplicationsduringbirth,andarelationshipriskfactor,theexperienceofpoorparenting(TheWorldHealthOrganization,2018). Thisspecificcampaignshowshowinteractionbetweenthedifferentlevelsofthemodelisnecessaryinordertoproperlydealwithcomplicatedsituationsthatoftentimeshavedifferentcircumstancesandcomponentsthatconstitutethem.Therewasastudydonetitled,“FactorsWithinMultipleSocio-EcologicalModelLevelsofInfluenceAffectingOlderSNAPParticipants’AbilitytoGroceryShopandPrepareFood,”whichgoesontoexplainfactorswithinmultiplelevelsoftheSocialEcologicalModelandhowtheywereeffectiveinexplainingSupplementalNutritionAssistanceProgram(SNAP),aswellastheparticipantsabilitytogroceryshopandpreparefoodasolderadults.Thestudystatedhowmultiplelevelsofinfluencewereevidentinexplainingtheolderadult’sabilitytogroceryshopandpreparefoodsuchasphysicalandemotionalwell-being,self-reliance,finance,housing,familyandfriendinteractions,socialsupport,andfoodaccess.Withallofthesedifferentfactorsbeingevidentinthisparticularstudy,thestudyaddresseshowimportantitistoactuponmultiplelevelsofthemodelinordertoeffectivelyinfluencetheolderSNAPparticipants. TheSocialEcologicalModelhasproven,inmanydifferingsituations,thatinordertogetthebestresultsoutofpeopleatrisk,itisbesttoapproachthesituationwhileaddressingalllevelsoftheframework.Manysituationscanbecomplicatedondifferentlevels,makingamulti-facetedapproachthebestwaytoconqueraproblematalldifferentangles. MethodsofBehavioralChange Healthbehaviorsaredeterminedbyanindividual’srelationshipsandtheenvironmentinwhichtheylive.TheserelationshipsandenvironmentsfallwithinoneofthefivelevelsoftheSocialEcologicalModel.ThevariouslevelsoftheSocialEcologicalModelcanbeutilized,aspartofinterventionstrategies,tomanipulatehealthbehaviors.Behaviorchangecommunication,socialchangecommunication,socialmobilization,andadvocacyarethestrategiesoftenusedasbehaviormodificationtechniques. Attheindividuallevel,onlybehaviorchangecommunicationisused.Behaviorchangecommunicationandsocialchangecommunicationarebothusedattheinterpersonallevel.Atthecommunitylevel,socialchangecommunicationisutilized.Socialmobilizationisusedattheorganizationallevel,andatthepolicy/enablingenvironmentlevel,advocacyisutilized.Varioushealthbehaviormodificationtechniquesareusedduetothevaryingnatureoftheparticipantgroups.Thedifferentinterventionstrategieshavespecificfeatures,whicharedesignedtotargetthespecificparticipantgroups. BehaviorChangeCommunication Behaviorchangecommunicationisanapproachusedaloneattheindividuallevel,andalongwithsocialchangecommunicationattheinterpersonallevel.Thistypeofinterventionworksthroughinterpersonalcommunication.Thissystemcanworkviadirectcommunicationwithanotherindividual,butitcanalsoworkthroughmasscampaigns,suchassocialmedia,whichtargetmanyindividualsatonce.Participantgroupsinvolvedinbehaviorchangecommunicationincludeindividuals,families,andsmallgroups.Inordertoformappropriateinterventions,researchofthepopulationmustbecompleted.Interventionsaretailoredtotheexactpopulationtheywishtotarget.Thepopulation’sinitialknowledge,attitudes,beliefsandbehaviorsmustbeunderstoodinordertoeffectivelyinterveneandpromotebehaviorchangetoimprovethehealthofthepopulation.Behaviorchangecommunicationworksbyraisingawarenessabouttheproblem,increasingknowledgeaboutthehealthbenefitsofthetargetedhealthbehaviorchange,promotingattitudechangesinfavorofthehealthierbehavior,reducingstigmasurroundingthehealthybehavior,creatingdemandforthehealthintervention,promotingservicesforthepreventionandcontrolofthehealthproblem,andimprovingskillsofself-efficacyfortheindividualsinvolved.Behaviorchangecommunicationisanimportantapproach,whichisusedattheindividualandinterpersonallevelsoftheSocialEcologicalModel. SocialChangeCommunication Socialchangecommunicationisused,incombinationwithbehaviorchangecommunication,attheinterpersonalleveland,alone,atthecommunitylevel.Thistypeofapproachencouragesparticipation,anditusessuchparticipationinordertotargetlargescalebehaviorchanges.Behaviorstargetedbythisapproachincludesocialnormsandculture-specificpractices.Thistypeofinterventionalsoutilizessocialnormsandculturalpracticesinordertostrategicallydevelophealthinterventionsthatthetargetedpopulationwillbemostreceptiveto.Interventionscanincludemass-mediacampaigns,social-mediacampaigns,orinformationcommunicationtechnologystrategies,whichcanactascatalystsforhealthbehaviorchange.Oncethepopulationisawareofthehealthproblems,thecommunitycanbegindevelopinghealthinterventions.Thesystemofsocialchangecommunicationisbuiltontheideathatanindividualcommunityhastheabilitytochangeunhealthysocialnorms,culturalpractices,environmentalfavors,andpoliciesontheirown.Thecollectiveefficacythesepopulationsgainfromsuchsocialchangecommunicationcanenablethemtomakeadditionalhealthbehaviorchangesinthefuture. SocialMobilization SocialMobilizationisusedattheorganizationallevel.Individualsandentirecommunitiesusethisapproachinordertoraiseawarenessofahealthproblem.Then,thisapproachisadoptedtoengageandmotivatenationalandcommunityleaders,publicandprivatepartners,andcommunityorganizationstomakehealthchanges.Thecatalystofthesehealthchangesisthecommunity.Byusingthesocialmobilizationapproach,theyareempoweredtomaketheirownhealthchanges.Thisalsoallowsthecommunitytohelpwiththedevelopmentofappropriatehealthinterventions,implementationofsuchchanges,andmonitoringofthechanges.Inordertoeffectivelydevelopbehaviorchangeinterventions,interventionsatotherlevelsoftheSocialEcologicalModelshouldalsobeused. Advocacy Advocacyisusedatthepolicy/enablingenvironmentlevel.Thisapproachconsistsofwell-thoughtoutandorganizedefforts.Theseeffortsaredesignedtoconvinceindividualsinleadershiproles,suchaspolicymakers,programplanners,andcommunityleaders,tomakehealthchangesatthepolicylevel.AccordingtoUNICEF,“Thepurposeforadvocacyis(1)topromotethedevelopmentofnewpolicies,changeexistinggovernmentalororganizationallaws,policiesorrules,and/orensuretheadequateimplementationofexistingpolicies(2)toredefinepublicperceptions,socialnormsandprocedures,(3)tosupportprotocolsthatbenefitspecificpopulationsaffectedbyexistinglegislation,normsandprocedures,and/or(4)toinfluencefundingdecisionsforspecificinitiatives”. Withintheadvocacylevel,therearethreedifferenttypesofadvocacy,whicharecalledpolicyadvocacy,communityadvocacy,andmediaadvocacy.Policyadvocacyencourageslegislative,social,andinfrastructuralelementchangesviapolicychanges.Communityadvocacyencouragesindividualswithinacommunitytodemandpolicychangeswithintheenvironmentinwhichtheylive.Mediaadvocacyencouragesthemediatopushpolicymakerstowardschanges,whichmaketheenvironmenthealthier.Allofthesechangesareachievedbymotivatingdecisionleaderstomakepolicylevelchanges. Interventions,atalllevelsoftheSocialEcologicalModel,playanimportantroleinhealthbehaviorchange.Behaviorchangecommunication,socialchangecommunication,socialmobilization,andadvocacyallcontributetothechangeofhealthbehaviorsatoneormoreleveloftheSocialEcologicalModel;however,themosteffectiveapproachtochanginghealthbehavioristotargettheSocialEcologicalModelatmultiplelevelssimultaneously.Multilevelinterventionsarethemosteffectiveatpromotinglong-termbehaviorchange,andifpossible,multilevelinterventionsshouldbeutilizedwhenpromotinghealthbehaviorchange. Source:https://www.healthypeople.gov/2010/hp2020/advisory/phasei/summary.html LicensesandAttributions CClicensedcontent,OriginalAuthoredby:KaliAronica,ElizabethCrawford,ErinLicherdell,andJoshOnoh.Locatedat:https://courses.lumenlearning.com/suny-buffalo-environmentalhealth/.Project:ModelsandMechanismsofPublicHealth.License:CCBY-NC-SA:Attribution-NonCommercial-ShareAlike Previous Next