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:

1. Go to
https://www.cdc.gov/

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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