Week one Discussion Board posts should be at minimum 150 words.
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WEEK ONE DISCUSSION 2
Ecological Models of Health Behavior
Choose a specific health problem/outcome and population of your choice (e.g., reducing fatal traffic accidents among adolescent boys in the United States). Do NOT select one of the health conditions discussed in detail in Chapter 3 (physical activity, tobacco use, obesity).
Using the ecological model framework (Chapter 3), describe an intervention to reduce this problem. Be sure to mention an intervention at EACH LEVEL of the framework (i.e., individual, interpersonal, organizational, community, public policy).
Your initial post should use APA formatted in-text citations when you are paraphrasing or directly quoting information from outside sources (including the textbook). You should also include APA formatting reference(s) at the end of your post. It is suggested that these posts be at least 150 words.
Ecological Framework Application Example
To see how the Centers for Disease Control adapted the ecological framework to represent the Colorectal Cancer Control Program’s (CRCCP) multi-level approach to colorectal cancer prevention, see: https://www.cdc.gov/cancer/crccp/sem.htm
Or access this site by following these instructions:
2. Click on the “Diseases and Conditions” drop down menu
3. Click on “Cancer”
4. Under “Cancer Home” click on “Types of Cancer”
5. Click on “Colorectal Cancer”
6. Click on “Colorectal Cancer Control Program”
7. Click on “About the Program”
8. Click on “Social Ecological Model”
Ecological Models of Health Behavior
COH604: Theories of Health Behavior
Overview
Historical Context and Overview
Five Principles of Ecological Perspectives
Applications of the Ecological Perspective
Strengths and Limitations
Future Directions
Origins of Ecological Models
Ecology comes from biological science and refers to the relationships between organisms and their environments
Ecological models
Shift from idea that perceptions of environment are important to the idea environments have direct effects on behaviors
See Table 3.1 for a comprehensive overview of historical influences on ecological models.
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Origins of Ecological Models
Bronfenbrenner (1979)
Micro, meso, exo environment
McLeroy et al. (1988)
Five sources of influence: interpersonal, interpersonal, institutional, community, and policy
See Table 3.1 for a more comprehensive overview of historical influences on ecological models.
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Overview of Ecological Models
Multiple levels of influence impact health behaviors
Framework for integrating other theories and models
Comprehensive approach to study design and/or interventions
Ecological models recognize that all levels of influence are important. It takes a combination of both individual and environmental/policy-level interactions to change and maintain health behaviors.
Ecological models provide an framework for integrating other theories into the model, including individual, interpersonal, and macro theories. They can be considered meta-models that organize other models and theories into a whole.
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Public Policy
Community Factors
Organizational Factors
Intrapersonal Factors
Interpersonal Factors
Five Principles of Ecological Perspectives
Multiple levels of influence
Environmental contexts determine behavior
Interactions across levels
Behavior-specific
Multi-level interventions probably most effective
These are the five key principles outlining how ecological perspectives influence health behaviors, each is discussed in more detail in the subsequent slides.
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P1: Multiple Levels of Influence
Factors at multiple levels influence health behaviors
Intrapersonal, interpersonal, organizational, community, public policy
Distinguishes ecological models from other theories that focus on one or two levels
P2: Environmental contexts determine behavior
Behaviors may be better predicted by environmental contexts than by individual characteristics
Environmental context: social and physical environment
a.k.a. behavior settings
Responsible for restricting or promoting certain actions
Ex: Increased tobacco advertising increased availability of individual cigarettes for purchase
P3: Interactions Across Levels
Variables interact to influence behavior
Typically include variables at multiple levels of ecological models
Ex: Physical activity promotion may be most effective with combination of physician counseling, insurance discounts, increasing safe sidewalks
Interaction does not refer to statistics explicitly, although statistical interactions or moderator effects can be studied to measure interactions.
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P4: Behavior Specific
Ecological models require tailoring to specific health behaviors
Applies to research and intervention
This is a key difference from other theories that have constructs (e.g. self-efficacy) that can be applied across multiple behaviors
P5: Multi-level Interventions Are
Likely Most Effective
Interventions targeting multiple levels promote long-term change and affect more people
Especially organizational, environmental, and policy level interventions
Individual-level interventions show small and short-term effects by comparison
Ecological Model: Tobacco Control
Smoking prevalence has decreased drastically in industrialized countries
Below 20% in many countries
What interventions may be responsible for the reduction in smoking prevalence?
Ecological Model: Tobacco Control
Systematic studies have identified the following as probable effective components of tobacco control:
Clinical smoking cessation
Mass media campaigns
Regulations to restrict smoking opportunities
Price increases of cigarettes
Example of Principle 5: Multilevel interventions are likely most effective
Tobacco control efforts have resulted in lessons that can be applied to other health behaviors:
Focusing change efforts solely on educating and motivating individuals is unlikely to result in population change (see: group-based smoking cessation programs);
For some behaviors and groups, certain levels of influence are particularly powerful. In the case of tobacco control true for pricing policies;
Even when health risks are well understood and severe, widespread changes in social norms and support for environmental and policy initiatives can take decades to develop.
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Strengths & Limitations
Strengths
Reach large number of people
Result in sustained behavior change
Increased options for intervention
Limitations
Expensive, time consuming, and/or impractical to implement
Lack of specificity about most important influences/interactions
Not applicable across health behaviors
Some variables can not be manipulated by researchers
Future Directions
Investigate how and which variables interact, resulting in explicit and quantitative models
Build models with multi-level data to test how interactions predict empirical outcomes
Implement to target critical health problems
Tobacco use, obesity, diabetes, poor diet, alcohol use, violence, HIV/AIDS, etc…
References
Bronfenbrenner, W. (1979). The ecology of human development. Cambridge, MA: Harvard University Press.
Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.). (2015). Health behavior: Theory, research, and practice (5th ed.) San Francisco, CA: John Wiley & Sons.
McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15, 351-377.
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