Chapter 3: Ecological Models of Health Behavior Flashcards
ecology
derived from the biological sciences and refers to the interrelationships between organisms and their environments
how are ecological models applied in health science?
ecological models, as they have evolved in the behavioral sciences and public health, focus on the nature of people’s transactions with their physical and sociocultural environments
ecological models can provide a framework for integrating multiple theories and serve as a meta-model to ensure that environmental and policy factors are considered in developing comprehensive approaches to studying and intervening on health behaviors
what is the central proposition of the ecological model in health behavior change?
is that it usually takes the combination of both individual-level and environmental- and policy-level interventions to achieve substantial positive changes in health behaviors that are then maintained
ecological models can integrate multiple theories
the central tenet of ecological models is that all levels of influence are important. thus multilevel studies of crenelates or determinants should be more effective than single level interventions. the weaknesses of ecological al models are
1) that they do not necessarily specify the variables or processes at each level expected to be most influential on behavior
2) they do not specify how such influences may vary for different behaviors
3) it may not be feasible to intervene on all levels
why are they ecological models and not theories?
there is a reason that this textbook refers to ecological frameworks, perspectives, and models instead of theories. theories specify variables and the relations among them. ecological models have heuristic value in prompting investigators to consider multiple levels of influence and intervention, but ecological models do not specify constructs or variables that generalize across behaviors
the lack of specificity of the broader ecological framework can be considered a weakness, but is also a strength that leads to development of behavior-specific models
ecological perspectives on health behavior: principle 1) there are multiple levels of influence on health behaviors
ecological models specify that faros at multiple levels, often including interpersonal, interpersonal, organizational, community, and public policy levels, can influence health behaviors, although the relative influence may vary by target behavior and context
inclusion of all these levels of influence distinguishes ecological models from theories that primarily focus on one or two levels
ecological perspectives on health behavior: principle 2) environmental contexts are significant determinants of health behaviors
inclusion of social and physical environment variables is a defining feature of ecological models. Behavior settings are the social and physical situations in which behaviors take place, and ecological models open the possibility of intervening on these environments
environmental contexts can shape or constrain individual. and interpersonal determinants of health behaviors
ecological perspectives on health behavior: principle 3) influences on behavior interact across levels
because ecological models specify multiple levels of influence, and there are likely to be multiple variables at each level, it may be difficult to discern which of the possible interactions are most important. this a challenge for research is to advance our understanding of these interactions across levels
ecological perspectives on health behavior: principle 4) ecological models should be behavior specific
ecological models appear most useful for guiding research and intervention when they are tailored to specific health behaviors. often, environmental and policy variables are behavior-specific
the availability of condoms in nightclubs has little relevance to dietary behaviors, the presence of cycling trails win suburban neighborhoods is unlikely to affect alcohol intake, and policies related to food subsidies have little relevance to sun protection behaviors
ecological perspectives on health behavior: principle 5) multilevel interventions should be most effective in changing behaviors
the superiority of multi-level interventions over single-level interventions follows from the principle that there are important influences at all levels of influence
educational interventions designed to change beliefs and behavioral skills are likely to work better when policies and environments support the targeted behavior changes. similarly, environmental changes by themselves may be insufficient to change behaviors
putting more fruits and vegetables in all convenience stores may have little impact unless that environmental change is supported by pricing policies and educational and motivational campaigns
what are three broader takeaway from the successful public health campaign against tobacco use?
1) focusing change efforts solely on educating and motivating individuals is unlikely to create population change, as was the case for group-based smoking cessation programs
2) for some behaviors and some groups, there may be levels of influence that are particularly powerful. in the case of tobacco control, this has been observed for pricing policies
3) even when the health risks are well understood and severe, widespread changes in social norms and support for environmental and policy initiatives can take decades to develop
what are some key strengths of ecological models?
their focus on multiple levels of influence, which broadens options for interventions. policy and environmental changes are expected to affect virtually entire populations, in contrast to programs that reach only individuals who choose to participate
policy and environmental interventions establish settings and incentives that can persist in sustaining behavior changes, helping to solve the problem of poor maintenance of many individually directed interventions.
what are some key weaknesses of ecological models?
their lack of specificity about the most important hypothesized influences. this puts a greater burden on health promotion processionals to identify critical factors for each behavioral application
a related weakness - even for behavior-specific ecological models - is the lack of information about how the broader levels of influence operate or how constructs interact across levels. thus, the models broaden perspectives without identifying specific constructs or providing guidance about how to use ecological models to improve research or interventions
how is intervening on multiple levels not always practical?
may be constrained by budgetary and practical limitations, such has policies and environments not being under the control of investigators
challenges of applying and evaluating ecological models
providing ithe typical goal of experimental designs - to isolate a single intervention from the effects of its context - is conceptually at odds with the ecological emphasis on studying how intervention components interact with their context
research based on ecological models is, by definition, more demanding than behavioral research at a single level
the length of time required to change policies and environments is a deterrent to program directors called on to make changes to meet legislators’ schedules or grant timelines. few environmental variables and policies of interest are controlled BY health professionals, and change requires a political process that is unpredictable in timing and outcome
