PU505: Health Behavior Unit 2 Social Ecological Model Flashcards
What is the essence sentence of the Social Ecological Model?
What are the levels of influence?
Factors at many levels influence health behavior.
Levels
Intrapersonal level factors: Characteristics within the person
Interpersonal level factors: Relationships among people
Institutional level factors: Rules, regulations, and policies at the workplace
Community level factors: Social network norms and environmental conditions
Societal level factors: Cultural norms, economic, and other policies
What did Bronfenbrenner, a developmental psychologist, reviews of child development research find which helped put social-ecological model on the map?
From Bronfenbrenner’s extensive review of the literature, he found that the context in which child development research was conducted—in unfamiliar surroundings, with people the child didn’t know, for a short period of time without any of the things or people the child is used to—provided a partial picture because there was a stark contrast between the research environment and the reality in which the child lived.
Thus, an often used quote of his is that “American developmental psychology is the science of behavior of children in strange situations with strange adults”
What was the two propositions that Bronfenbrenner based his theoretical model on?
Human development occurs through a process of complex back-and-forth interactions among things in a person’s immediate environment, and that in order for these interactions to effect development, they must occur fairly regularly over time.
Second proposition is that the effect of these back-and-forth interactions vary depending on the personal characteristics of the child, the environment in which they take place, and the developmental outcome being studied.
What did Bronfenbrenner call the interactions that occur fairly regular over time?
Proximal or close processes. Examples of these processes are found in the parent–child relationship, child–child relationships, and group or solitary play.
What are the two types of factors that can explain health behavior when utilized within its theories and models?
Internal and external. SEM uses both.
Why is SEM unlike other models or theories?
It is a point of view or perspective, and because of this, it does not have constructs per se.
The internal and external factors that hinder or facilitate behavior are presented as levels.
Perceptually, these levels are like concentric circles (Figure 10.1), with the smallest at the center representing the internal or intrapersonal level; then moving to the external levels, which include the interpersonal level; and widening to the community, institutional, and finally the societal level.
What is the basis of SEM?
It is understanding and recognizing of the dynamic interplay among the various factors at different levels that affect behavior.
Because of this interplay between and among the many levels of influence, changing one can have an impact on them all (Spence & Lee, 2003). This concept is similar to reciprocal determinism in social cognitive theory.
What does the institutional level of the SEM factor in?
Factors at the institutional or organizational level that can facilitate or hinder behaviors are the rules, regulations, and policies of these entities.
Examples include work schedules (shift work), availability of employee health services, sick time and vacation/holiday policies, limits on overtime, and safety regulations, to name a few.
What do the social relationships we have at the interpersonal level provide?
Our social identity, make up our social support systems, and define our role within the social structure. Health behavior as well.
For example, in the case of smoking, having parents, siblings, or peers who smoke are among the strongest predictors of this behavior.
The same is true of substance use. The peer group and family have a major influence on whether or not someone will take drugs. (Eddy et al., 2002). In the university setting, having roommates who use drugs can be an initiating factor for the behavior because it’s seen as a way to develop social connections (Beeson et al., 2017).
Another example of the influence interpersonal relationships have on behavior is with bullying. Bullying is a complex and unique type of aggressive interpersonal behavior that is a consequence of individual characteristics and the child’s relationships with peers, family, teachers, neighbors, and society. Factors at the interpersonal level that play a role in the perpetration of bullying behavior include family member gang involvement, lack of parental supervision, emotional support and communication, authoritarian parenting style, parental abuse, and parental or domestic conflict (Swearer & Hymel, 2015). Conversely, parental supervision and involvement and negotiated technology use reduce the likelihood of bullying perpetration (Zych et al., 2019).
Example of Institutional Factors in Behaviors (More on Flipside)
Institutional factors also influence participation in physical activity programs of older adults. For example, scheduling activity programs for older adults during the day assumes that potential participants are retired and available to attend (Boulton et al., 2018). However, this factor hinders the physical activity of those who are still employed and not available during normal working hours.
A variety of institutional factors influence the ability of unmarried fathers to have a formal parental relationship with and play an active role in their children’s lives. In this case, “family” social service and legal aid agencies, in general, do not offer services for fathers. Their services are focused on assisting the mother and providing the resources she needs to care for her child(ren) and become gainfully employed. The father is offered little to no support or access to resources, which hinders his parental relationship with his child(ren) (Caines et al., 2019).
Institutional factors can facilitate food security for homeless youth in transitional housing. Among these factors might be policies that allow residents access to a communal kitchen to cook their own meals or policies that allow refrigerators in residents’ rooms so they can safely store food (Brothers et al., 2020).
On the other hand, some transitional housing policies hinder food security. For example, prohibiting the use of communal cooking utensils in the kitchen or the storage of personal utensils in the kitchen means residents having to store their cooking equipment in their rooms and carry it back and forth to the kitchen for every meal. As a result, they don’t use the kitchen or cook as often as they could (Brothers et al., 2020).
Churches are institutions that often partner with health agencies to provide health promotion activities. Institutional factors that influence the behavior of the people in the congregations/parishes include policies such as allowing announcements to be made about health programs during services or ministry meetings, including information about health programs in the congregation/parish bulletin, permitting presentations at church events, and allotting space for classes and other health activities (Haughton et al., 2015).
Hayden, Joanna. Introduction to Health Behavior Theory (p. 605). Jones & Bartlett Learning. Kindle Edition.
What are some of the factors that influence the behavior of people at the community level?
Factors influencing behavior include social networks, norms, or standards of behavior that exist formally or informally among individuals, groups, or organizations.
The norms of the community are associated with specific behaviors, some health enhancing and some not. For instance, they might include participating in organized sports, volunteering at the local fire department, driving children to school rather than letting them walk, or allowing underage youngsters to drink in the home.
Looking at violent behavior, associated factors at the community level include high population density, people frequently moving in and out, and wide age and income disparity.
Communities with these characteristics have little social glue holding them together and are more prone to violence. Violence is also more likely in communities where there is a local drug or gun trade and a high level of unemployment.
What is the broadest factor in SEM that facilitates or hinders specific behaviors?
Societal Level.
This includes factors such as economics, social policies, social or cultural norms of behavior, and attitudes.
Going back to the violence example discussed previously, factors at the societal level that encourage this behavior include cultural acceptability of conflict resolution through violent means, male dominance over women and children, and social policies that maintain inequalities among people (WHO, 2021).
If we look at smoking behavior from the societal level, as of December 31, 2020, 27 states in the United States have enacted 100% smoke free indoor air laws for all worksites (private and governmental), bars, and restaurants. The ban on smoking in these places is aimed at eliminating nonsmoker exposure to secondhand smoke, which causes more than 40,000 deaths a year (CDC, 2021). Think about how these laws affect behavior and health. Another example is the U.S. Department of Agriculture national school lunch and breakfast program standards. These standards require schools to increase availability of fruits and vegetables, whole grains, fat-free or low-fat milk and to reduce sodium, saturated and trans fats, within children’s calorie requirements (U.S. Department of Agriculture [USDA], 2012). With this one policy, the dietary intake of every child in the country who eats breakfast or lunch at school is affected.
The Affordable Care Act is a good example of a law that impacted the health of millions of Americans. With its implementation in 2014, all health insurance companies, for example, must cover preventative care for adults, including screening for elevated blood pressure, high cholesterol, diabetes, hepatitis B and C, depression, alcohol and tobacco misuse, sexually transmitted infections (including HIV), and breast and cervical cancer, colorectal cancer, lung cancer, obesity, tobacco use, and tuberculosis. In addition, mandatory preventative care services include immunizations, diet counseling, and falls prevention (U.S. Department of Health and Human Services, n.d.). Other social policies and laws that impact health and health behavior include housing subsides, urban renewal projects, welfare to work policies, and minimum wage laws (Osypuk et al., 2014). Think of all the other societal standards affecting health behavior—seat belt laws, driving age, drinking age, age of consent, vaccination requirements for school attendance, Medicare enrollment at age 65, to name a few. In summary, the SEM explains behavior as the result of an interplay between internal and external factors.
