Ecological_Lecture_2006Web.ppt
- 2. Fall 2006 How can we begin to understand all of the factors that influence health? Ecological Model
- 4. Fall 2006 What is an Ecological Perspective? A framework that enables us to consider the influence of individual and environmental factors on health & health-related behaviors
- 5. 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
- 6. 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
- 7. 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?
- 8. Fall 2006 Ecological Framework helps us with… Problem analysis Intervention design Intervention evaluation
- 9. Fall 2006 Problem analysis Public Health Problem Determinants Population Community Organizational Interpersonal Individual
- 11. Fall 2006 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’
- 12. 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
- 13. Fall 2006 Individual Level Interventions Target of change Individual Person Focus on characteristics of the individual – E.g., knowledge, attitudes, skills, beliefs…
- 14. 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?
- 15. Fall 2006 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
- 16. 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?
- 17. Fall 2006 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
- 18. 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?
- 19. Fall 2006 Community Level Interventions Target of change Social environment Focus on community norms, values, attitudes, & power structures
- 20. 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?
- 21. Fall 2006 Population Level Interventions Target of change Local, state, & national laws & policies Focus on government regulations & other regulatory processes, procedures, or laws to protect health
- 22. 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?
- 23. Fall 2006 What types of health issues or health behaviors lend themselves to using the social-ecological model? Are there any issues that don’t?
- 24. Fall 2006 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
- 25. 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