What is the Ecological Model?
- a model that looks at the individual, social, and physical environmental factors that influence a person’s health promoting behaviors, or lack thereof
- many levels of influence, or social environments, enhance or deter behavior
- health behaviors may be chosen because there is influence outside one’s control
Why is it important to use the ecological model in nursing?
We need to look at the changeable health behavior influences and the ones that we need to address/circumvent since they cannot be directly changed
What is the basic assumption of the Ecological model?
- Changes in the social environment will produce changes in individuals, and support of the individual in the population is essential for implementing environmental change
The ecological model eliminates…
Victim Blaming
Victim Blaming
Viewing ill health as personal failure of the person
This is eliminated in the ecological model by looking at the many influences that determine health outcomes
5 Key Factors that Impact our Health Behaviors in the Ecological model
- Intrapersonal Factors
- Interpersonal Factors
- Organizational/Institutional Factors
- Community Factors
- Public Policy Factors
Intrapersonal Level Factors of the Ecological Model
- individual factors that can be changeable or unchangeable (ex: nutrition choices versus genetic makeup/gender)
Nursing interventions at the intrapersonal level should be aimed at…
changing the individual rather than modifying the social environment
In intrapersonal interventions we ____ with clients not ___ ___ ___ ___ ___.
partner with clients not tell them what to do
Targets of Intrapersonal Level Intervention
- Attitudes
- Knowledge
- Skills
- Intentions to comply with behavioral norms
Examples of Intrapersonal Interventions
education
counseling
mass media campaigns or incentives
ex: try to change the attitude of an individual in a maladaptive peer group, not the peer group itself
Interpersonal Level Factors of the Ecological Model
- Factors including the social networks that provide emotional support, information, and access to new social contacts and social roles
ex: Formal social networks, informal ones, social support systems like family/work/friendships
Goal of Interpersonal Interventions are…
to change the nature of the existing social realtionship
Targets of interpersonal interventions
- Change norms of groups
- increase accessibility to favorable groups
- create alternative networks
Institutional/Organizational Level Factors of the Ecological Model
social institutions with organizational characteristics and formal/informal rules and regulations for operations like schools and worksites (institutions we frequently interact with)
Health behaviors are influenced by Institutional/Organizational factors because …
- people spend many hours here church/schools/worksites
- access to food
- availability of exercise equipment
- policies that enhance or inhibit stress management
Interventions at the institutional/organizational level are beneficial because…
- it gives access to a large number of people
- gives social support for behavioral change
Interventions at the institutional/organizational level are challenging because…
- health of workers may not be part of the mission statement
- employer might not see employee health as the responsibility of the employer
Goals of health promotion at the organizational/institutional levels are aimed at…
- changing the corporate culture (make them realize that they can increase profit on insurance payments and have more productive workers for a work setting)
- including health related norms and values as part of the institution’s mission and philosophy
Targets of organizational/institutional interventions?
- Incentives (ex: work group losing most weight get a day off)
- management and supervisor support
- changes in rules and regulations
- changes in benefits (employer saves money if workforce is healthier)
- changes in the structure of work
Community level factors of the Ecological Model
the relationships among organizations, institutions, and informal networks within defined boundaries, and the power structures in community, community health problems, and allocation of resources
Targets of Intervention at the Community Level
- Increase coordination among community organizations
- coalition building (pull together to meet the needs of the community)
Examples of Strategies to Enhance Community Health Promotion
- establish contacts among divergent community networks
- include representation from disadvantaged population on community boards
- community organizing strategies
Public Policy Level of The Ecological Model
- local, state, and national laws and policies
- a major target of the ecological model as it is even more influential in changing behavior than education
- allows for restriction of behavior, behavioral incentives, allocation of program resources
ex: Lowing legal blood alcohol content to .08 for driving
