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?
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?
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