Learning Objectives: Share common definitions of community Summarize the importance of applying models to public health intervention design Summarize the application of the Social Ecological Model Describe the components of community that may have a role or influence on health behaviors

1. Social Ecological Model
Review
Acknowledgement: This slide set has been adapted from the Public Health 101 Series slide set created by the Centers
for Disease Control and Prevention.

2. TOPIC 1
How Do You Define Community?
4

3. What is a community?
• Broad definition: A group of people sharing basic values,
interests, and organization
(Rifkin et al, 1988)
 What do we mean by values?
 What is meant by interests?
 What is meant by organization?
4

4. TOPIC 2
The Social Ecological Model (SEM)
11

5. Why Are Models Important in
Public Health?
 They provide guidance or a framework for ways to
change health behaviors
 Using accepted models to support your planning and
development of a program or intervention improves
the evidence-base of the intervention/program
 Applying models in evaluations, policy designs, and
grant proposals will improve the quality of the end
product
12

6. Socio-Ecological Model (SEM)
 The Socio-Ecological Model (SEM) considers the
relationship between individual, relationship,
community and societal factors to understand the
range of influences a person’s decision to do a
behavior
48

7. Socio-Ecological Model (SEM)
50
A Social-Ecological Model for Physical Activity – Adapted from Heise, L., Ellsberg, M., & Gottemoeller, M. (1999)

8. Social Ecological Model (SEM)
Public Policy
Government funding to
provide water buckets
with covers.
Community
Signs at popular places about
covering water in home.
Organizational
Lessons in schools about
preventing mosquito breeding.
Interpersonal
Friends telling friends to
cover standing water in
their home.
Individual
Knowledge about
how mosquito
bites are
dangerous. 51

9. SEM for Public Health Managers
• Why should public health managers use SEM when planning
a program?
 What could be benefits of using SEM?
 What could be challenges of applying SEM?
 Is there a time from your prior experiences where
applying SEM was useful? Or, can you think of a time
when SEM was not applied, but would have been
helpful? How so?
 How do you see yourself using SEM as a public health
manager?
3

10. TOPIC 3
Integrating Community Components
3

11. • Culture
• Race / Ethnicity /
Tribal Affiliation
• Gender and family
• Poverty/disparities/
access
Community
Components

12. Design
• Definition
 A plan or specification for the construction of an object, building,
or system
• Relevance
 Determines how people interact with their environment
 Impacts physical health and community interactions

13. Access
• Definition
 The means or opportunity to approach or enter a place
 Often think of coverage, service cost, timeliness, and quality
• Relevance
 Determines who can enter various spaces
 Relates to how easily one can enter, use, or get services
 Vulnerable groups are typically lack access, thus impacting their
health

14. Connectedness
• Definition
 The state of being joined or linked; the feeling of belonging to or
having affinity with a particular person or group
• Relevance
 Impacts ‘community organizational climate’ (degree to which a
community is involved, engaged, concerned for others,
motivated to change, and takes leadership)
 Enhances community ownership
 Improves community participation, mobilization and
empowerment to carry out health behaviors

15. Culture
• An area of connectedness
• Definition
 The ideas, customs, and social behavior of a particular person,
group or society
 Can include religion
• Relevance
 Improves likelihood that health behavior will be adopted
 Builds trust with community members
3

16. Spaces
• Definition
 Places local people gather and connect, do things together and
pursue shared interests or activities
 Public spaces

17. Activity
• With your group, please walk around this area and observe:
 Design
 Access
 Connectedness
 Spaces
• How are these things affecting your/others behaviors?

18. Race/Ethnicity/Tribal Affliation
• Definition
 Race: major groupings into which humankind was
(subjectively) divided based on physical characteristics and
shared ancestry
 Ethnicity: belonging to a social group that has a common
national or cultural heritage
 Tribe: social division consisting of families or communities
linked by social, economic, religious or blood ties, with a
common culture and dialect
• Relevance
 Fundamental to reducing poor health outcomes for specific
racial and ethnic populations 3

19. Gender and Family
• Incorporating gender and family into public health interventions
3
Gender blind
Ignores:
• Economic/social/political roles of males and females
• Power dynamics between men and women
Gender aware
• Examines and addresses gender considerations
and adopts an approach along the continuum

20. Gender intervention example:
Gender
interventions
• Family
planning for
women and
men
• Women’s
educational
empowerment
Behavioral
outcomes
• Increased use
of family
planning
• Exclusive
breastfeeding
• Uptake of
antenatal care
and PMTCT of
HIV
Gender dynamic
outcomes
• Men’s support
for family
planning
• Men’s support
of antenatal
care, PMTCT
of HIV
• Promotion of
nonviolent
relationships
Gender and Family
3
Improved
Child
Health

21. Poverty/Disparities
• Relevance
 Health is a dimension of poverty
 Poverty and ill health almost always co-exist
 Improving the health of those in poverty improves
long-term economic growth
 Access to healthcare and healthy food sources is
limited among vulnerable populations living in poverty
3

22. 3

23. Poverty/Disparities
• Incorporating poverty/disparities into public health interventions
 Surveillance data
Kenya 2014 DHS Statistics
Wealth Quintile
Percent of children who
slept under mosquito net
last night
Lowest 42.3
Second 57.6
Middle 60.6
Fourth 66.0
Highest 73.8

24. Poverty/Disparities
• Incorporating poverty/disparities into public health
interventions
 Prioritize interventions taking into account major causes of
morbidity and mortality among poor
 Consider poor communities in budgeting
 Inter-sectoral collaborations that benefit the poor in multiple
determinants (ex. education, employment, nutrition)
3

25. Conclusion
• Culture
• Race / Ethnicity /
Tribal Affiliation
• Gender and family
• Poverty/disparities/
access
4

26. Knowledge Check
Select the correct group of answers that best completes
the sentence below.
A community is a group of people sharing basic:
____________, __________, and _______________
A. Values, disorders, and food choices
B. Values, interests, and organization
C. Values, interests, and policies
B. values
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interests organization

27. Knowledge Check
Select the correct group of answers that best completes
the sentence below.
The five levels of the Socioecological Model are:
____________, _______________, _______________, _____________
and _____________.
A. individual, collective, interpersonal, community, political
B. individual, interpersonal, community, organization, society
C. individual, interpersonal, organizational, community,
public policy
individual
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organizational
interpersonal
community public policy