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Ecological Models

Theory at a Glance: A Guide for Health Promotion and Practice frames the ecological perspective as:

“...the interaction between, and interdependence of, factors within and across all levels of a health problem. It highlights people’s interactions with their physical and sociocultural environments.”

Ecological models recognize multiple levels of influence on health behaviors, including:

  • Intrapersonal/individual factors, which influence behavior such as knowledge, attitudes, beliefs, and personality.
  • Interpersonal factors, such as interactions with other people, which can provide social support or create barriers to interpersonal growth that promotes healthy behavior.
  • Institutional and organizational factors, including the rules, regulations, policies, and informal structures that constrain or promote healthy behaviors.
  • Community factors, such as formal or informal social norms that exist among individuals, groups, or organizations, can limit or enhance healthy behaviors.
  • Public policy factors, including local, state, and federal policies and laws that regulate or support health actions and practices for disease prevention including early detection, control, and management.

Examples of Ecological Models

  • CDC's Colorectal Cancer Control Program (CRCCP) was designed to address multiple factors of influence on colorectal cancer prevention, using ecological model components.
  • Strong African American Families – TEEN (SAAF-T) used an ecological model to design a family-centered, group-level health promotion and disease prevention program to reduce unprotected sex among adolescents. The program offers health information sessions for adolescents and sessions for their caregivers on communication about risk behaviors.

Considerations for Implementation

The ecological perspective is a useful framework for understanding the range of factors that influence health and well-being. It is a model that can assist in providing a complete perspective of the factors that affect specific health behaviors, including the social determinants of health. Because of this, ecological frameworks can be used to integrate components of other theories and models, thus ensuring the design of a comprehensive health promotion or disease prevention program or policy approach.

Programs are most likely to be effective when they are designed to address the multiple levels of influence on health behaviors.

Resources to Learn More

Public Policy Approaches to the Prevention of Heart Disease and Stroke
Describes interventions and models supporting population-wide cardiovascular health through policy, legislation, and environmental change. Focuses on interventions resulting in physical, economic, and social conditions affecting risk for heart disease and stroke. Illustrates the need for different approaches for late-adopter versus early-adopter populations.
Authors(s): Pearson, T.A.
Citation: Circulation, 124(23)
Date: 12/2011

The Social-Ecological Model: A Framework for Prevention
Describes an ecological model for injury prevention highlighting the complex interplay between individuals, groups, community, and the societal factors that shape relationships.
Organization(s): Centers for Disease Control and Prevention (CDC)

Using Ecological Models of Health Behavior to Promote Health Care Access and Physical Activity Engagement for Persons With Disabilities
Explores the amount of treatment and preventive care services, screenings, vaccinations, and physical activity promotion, received by people with disabilities (PWD) in healthcare. Describes implementation strategies informed by the ecological model of health behavior (EMHB) for healthcare professionals when addressing health disparities and promoting physical activity for PWD.
Author(s): Kennedy, W., Fruin, R., Lue, A., & Logan, S.W.
Citation: Journal of Patient Experience, 2021(8)
Date: 7/2021