Jump to Content Jump to Main Navigation

Public Health Ecological Approaches
by
Monica L. Wendel, Kenneth R. McLeroy

Introduction

Social ecology provides a framework for understanding how individuals and their social environments mutually affect each other across the lifespan. Drawing from the ideas of Kurt Lewin’s A Dynamic Theory of Personality: Selected Papers (New York: McGraw-Hill, 1935), which conceptualized this relationship as an equation that yielded behavior, Urie Bronfenbrenner’s The Ecology of Human Development (Bronfenbrenner 1979, cited under History) extended the social ecological perspective to account for the complexity of individuals developing within embedded systems. Bronfenbrenner specified micro-, meso-, exo-, and macro- subsystems, which constitute the settings and life space within which an individual develops. In this model, each of the subsystems influences the individual and the other subsystems. Moreover, Brofenbrenner viewed the individual as moving through time and being influenced by his or her developmental and life course experiences (ontogenic development). McLeroy, et al. 1988 (cited under History), which appeared in Health Education Quarterly as “An Ecological Perspective on Health Promotion Programs,” further defined the social ecological model for health promotion to depict interrelated systems at the intrapersonal, interpersonal, organizational, community, and policy levels, illustrated as concentric circles. The authors subsequently add other levels of analysis, including the physical environment and culture. The social ecological model provides a framework for understanding the factors that produce and maintain health and health-related issues, allowing identification of promising points of intervention and understanding how social problems are produced and sustained within and across the various subsystems. However, the model has also yielded a growing acknowledgment of the complexity of these systems, highlighting the need for more sophisticated intervention and research methods. Social ecological concepts are now widely used within the field of public health and are included in: (1) core competencies for public health developed by the Association of Schools of Public Health that serve as the basis for the public health certification examination; (2) a framework for several of the leading volumes on theory and practice in the field; (3) curricular frameworks for a number of the schools and programs for public health; and (4) other, related frameworks, such as the model proposed for the National Institutes of Health population disparities centers.

History

Much of the research at the foundation of current thinking in social ecology stems from human development, and ecological, community, and health psychology. The works in this section provide a glimpse of the conceptual underpinnings of the social ecological perspective in public health. Bronfenbrenner 1979 extends previous ideas about the interrelation between individuals and their environments, applying an ecological framework to human development. Here, the author lays out the embedded systems in which human behaviors occur: the micro-, meso-, exo-, and macro-systems, and the 2005 volume extends Bronfenbrenner’s ecological framework to include a greater emphasis on systems thinking and systems ideas. The history of the social ecological perspective in public health stems from synthesis of ideas from other disciplines including the author’s early works on human development. McLeroy, et al. 1988 is often cited as one of the initial articles specifically applying an ecological model to public health and health promotion. Winett, et al. 1989 provides an ecological perspective on health psychology and public health with a particular focus on several problem areas, including adolescent pregnancy, dietary change, mental health, and others. Moos 1979 focuses increased attention on the role of the physical environment, environmental psychology, and the influences on human behavior of the natural and constructed environment. Susser and Susser 1996 describes the application of a social ecological perspective to the discipline of epidemiology, likening the multiple levels to nested Chinese boxes. Bronfenbrenner 2005 extends the author’s social ecological model to a bioecological theory of human development and explicates its fit with systems theory.

  • Bronfenbrenner, Urie. 1979. The ecology of human development. Cambridge, MA: Harvard Univ. Press.

    Save Citation »Export Citation »E-mail Citation »

    A thorough explication of the rationale for the systems model in human development with an emphasis on the connection between person and setting (environment). Although historical, when presented, Bronfenbrenner’s theoretical perspective was new in its application. Provides easily understood examples for each theoretical step.

    Find this resource:

  • Bronfenbrenner, Urie, ed. 2005. Making human beings human: Biological perspectives on human development. Thousand Oaks, CA: SAGE.

    Save Citation »Export Citation »E-mail Citation »

    Several chapters in this volume discuss the conceptual foundations of social ecology, its application in human development, and its fit with systems theory. Suitable for undergraduate and graduate students.

    Find this resource:

  • McLeroy, Kenneth, Daniel Bibeau, Allan Steckler, and Karen Glanz. 1988. An ecological perspective on health promotion programs. Health Education and Behavior 15.4: 351–377.

    DOI: 10.1177/109019818801500401Save Citation »Export Citation »E-mail Citation »

    Directs attention to specific circumstances in public health that created demand for a new framework that addresses the complex factors that produce health beyond solely individual behavior. Available online for purchase or by subscription. Also see Theoretical Development.

    Find this resource:

  • Moos, R. H. 1979. Social-ecological perspectives on health. In Health psychology—A handbook: Theories, applications, and challenges of a psychological approach to the health care system. Edited by George C. Stone, Frances Cohen, and Nancy E. Adler, 523–547. San Francisco: Jossey-Bass.

    Save Citation »Export Citation »E-mail Citation »

    Provides insight to emergency of ecological thinking in psychology and its early application to health issues.

    Find this resource:

  • Susser, Mervyn, and Ezra Susser. 1996. Choosing a future for epidemiology: II. From black box to Chinese boxes and eco-epidemiology. American Journal of Public Health 86.5: 674–677.

    DOI: 10.2105/AJPH.86.5.674Save Citation »Export Citation »E-mail Citation »

    A brief discussion historical paradigms and paradigm shifts in epidemiology, highlighting the need to attend to social processes that influence this distribution of disease. Provides a rationale for an ecological perspective as a systematic rather than universalistic paradigm. Presents a concise table of eras in epidemiology with their preventive and analytic approaches.

    Find this resource:

  • Winett, Richard A., Abby C. King, and David G. Altman. 1989. Health psychology and public health: An integrative approach. New York: Pergamon.

    Save Citation »Export Citation »E-mail Citation »

    This volume provides a rapprochement of health psychology and public health through an ecological perspective and applies an ecological perspective to HIV, community health promotion, mental health, teen pregnancy, diet, health in the workplace, environmental health, and aging. Well written and a valuable resource for the application of social ecological concepts.

    Find this resource:

General Overviews

The works in this section provide overviews and introduction to the usefulness of social ecological approaches in health promotion and public health. O’Donnell 1996 provides an overview of social ecology approaches to health promotion, and Green, et al. 1996 provides a brief but thorough description of what an ecological perspective adds to public health as well as its limitations. McLaren and Hawe 2005 presents a user-friendly glossary of terms and constructs relevant to the social ecological approach. Bartholomew, et al. 2006 uses an ecological perspective to frame an intervention mapping approach to planning health promotion programs. Fisher 2008 offers an overview of the seemingly opposing perspectives of individual behavior and contextual influences on health. Lounsbury and Mitchell 2009 and Sallis, et al. 2008 provide overviews of an ecological perspective and the assumptions of such perspectives.

  • Bartholomew, L. Kay, Guy S. Parcel, Gerjo Kok, and Nell H. Gottlieb. 2006. Planning health promotion programs: An intervention mapping approach. San Francisco: Jossey-Bass.

    Save Citation »Export Citation »E-mail Citation »

    Chapter 3 (“Behavior-Oriented Theories Used in Health Promotion,” pp. 82–135) and Chapter 4 (“Environment-Oriented Theories,” pp. 136–192) position common behavioral and environmental theories on health promotion within a social ecological framework. Useful depiction of the multiple social levels and how they apply to health intervention. Suitable for undergraduate and graduate students.

    Find this resource:

  • Fisher, Edwin B. 2008. The importance of context in understanding behavior and promoting health. Annals of Behavioral Medicine 35.1: 3–18.

    Save Citation »Export Citation »E-mail Citation »

    The first few pages of this article present a balanced perspective on contextual influences in health and attempt to reconcile the tension between a view focused on individual cognitions and behavior and one focused on environmental/contextual factors. Available online for purchase or by subscription.

    Find this resource:

  • Green, Lawrence W., Lucie Richard, and Louise Potvin. 1996. Ecological foundations of health promotion. American Journal of Health Promotion 10.4: 270–281.

    DOI: 10.4278/0890-1171-10.4.270Save Citation »Export Citation »E-mail Citation »

    Solid description of the contribution of social ecology to public health as a newer model as well as the limitations of this perspective in health promotion. Available online for purchase or by subscription.

    Find this resource:

  • Lounsbury, David W., and Shannon G. Mitchell. 2009. Introduction to special issue on social ecological approaches to community health research action. American Journal of Community Psychology 44.3–4: 213–220.

    DOI: 10.1007/s10464-009-9266-4Save Citation »Export Citation »E-mail Citation »

    Presents a brief review of the theoretical foundations of social ecology. Suitable for undergraduate and graduate students.

    Find this resource:

  • McLaren, Lindsay, and Penelope Hawe. 2005. Ecological perspectives in health research. Journal of Epidemiology and Community Health 59.1: 6–14.

    DOI: 10.1136/jech.2003.018044Save Citation »Export Citation »E-mail Citation »

    Concise, readable glossary of main constructs within a social ecological approach. Suitable for undergraduate and graduate students.

    Find this resource:

  • O’Donnell, Michael P., ed. 1996. Special issue: Social ecology approach to health promotion. American Journal of Health Promotion 10.4.

    Save Citation »Export Citation »E-mail Citation »

    Offers articles that cover a broad scope of social ecological history, theory, and application. A thorough overview. Articles available online for purchase or by subscription.

    Find this resource:

  • Sallis, James F., Neville Owen, and Edwin B. Fisher. 2008. Ecological models of health behavior. In Health behavior and health education: Theory, research, and practice. Edited by Karen Glanz, Barbara K. Rimer, and K. Viswanath, 465–486. San Francisco: Jossey-Bass.

    Save Citation »Export Citation »E-mail Citation »

    Book chapter provides a brief history and describes key characteristics of ecological models in health promotion. Discusses practical application of ecological models in health research as well as challenges in applying them. Appropriate for undergraduate and graduate students.

    Find this resource:

Theoretical Development

The works in this section each make a contribution to better understanding the social ecological theory as it applies to health promotion. McLeroy, et al. 1988 is often cited as one of the major sources for the introduction of social ecology in health promotion. The article illustrates and explains the ecological model and what it offers for understanding and addressing health issues. Kok, et al. 2008 uses data from health programs identified as ecologic to refine the social ecological model. Burke, et al. 2009 highlights the need for a theoretical approach to social context and an ecological orientation to be integrated to strengthen health behavior theories. DiClemente 2009 highlights new and emerging theories, many of which have an ecological focus. Stokols, et al. 2003 presents an integrated perspective of human capital and environmental context, offering a synthesis of two veins of research relevant to ecological thinking in public health. Trickett 2009 approaches ecological thinking from a community psychology perspective, also emphasizing the importance of context in an ecological model. Richard, et al. 2011 describes the roots of the social ecological model from other disciplines and show which constructs have been included in various iterations of the model in health promotion.

  • Burke, Nancy J., Galen Joseph, Rena J. Pasick, and Judith C. Barker. 2009. Theorizing social context: Rethinking behavioral theory. Health Education and Behavior 36 (Suppl): S55–S70.

    Save Citation »Export Citation »E-mail Citation »

    Thoughtful conceptual piece on the integration of context as an important and oft-neglected component of theories of health behavior. Argues that a social ecological orientation combined with a theoretical approach to social context should be incorporated into health behavior theory to adequately understand and address health disparities. Available online for purchase or by subscription.

    Find this resource:

  • DiClemente, Ralph J., Richard A. Crosby, and Michelle C. Kegler, eds. 2009. Emerging theories in health promotion practice and research. San Francisco: Jossey-Bass.

    Save Citation »Export Citation »E-mail Citation »

    Part 3 of this textbook contains seven chapters under the heading “Ecological Approaches,” each of which addresses a different theory or aspect of applying a theory that is in some way ecological. Provides breadth to the literature on ecological perspectives, and final chapter is integrative of the ideas presented.

    Find this resource:

  • Kok, Gerjo, Nell H. Gottlieb, Matthew Commers, and Chris Smerecnik. 2008. The ecological approach in health promotion programs: A decade later. American Journal of Health Promotion 22.6: 437–442.

    DOI: 10.4278/ajhp.22.6.437Save Citation »Export Citation »E-mail Citation »

    Review of forty-seven “ecologic” health programs against a social ecological framework. De-emphasizes settings and focuses on ecologic levels. Updates (reinforces) theoretical model using program data. Available online for purchase or by subscription.

    Find this resource:

  • McLeroy, Kenneth, Daniel Bibeau, Allan Steckler, and Karen Glanz. 1988. An ecological perspective on health promotion programs. Health Education and Behavior 15.4: 351–377.

    DOI: 10.1177/109019818801500401Save Citation »Export Citation »E-mail Citation »

    Explains the theoretical underpinnings of a social ecological approach and introduces the application of this framework in public health. Presents social levels as broad categories, with examples of each. One of the most cited journal articles on this topic in the field. Suitable for undergraduate and graduate students. Available online for purchase or by subscription. Also see History.

    Find this resource:

  • Richard, Lucie, Lise Gauvin, and Kim Raine. 2011. Ecological models revisited: Their uses and evolution in health promotion over two decades. Annual Review of Public Health 32:307–326.

    DOI: 10.1146/annurev-publhealth-031210-101141Save Citation »Export Citation »E-mail Citation »

    Presents ecological constructs from other disciplines and highlights those that have been integrated into the social ecological model in health promotion. Summarizes four conceptual models for social ecology in the health field. Available online for purchase or by subscription. Also see Nutrition and Physical Activity.

    Find this resource:

  • Stokols, Daniel, Joseph G. Grzywacz, Shari McMahan, and Kimari Philips. 2003. Increasing the health promotive capacity of human environments. American Journal of Health Promotion 18.1: 4–13.

    DOI: 10.4278/0890-1171-18.1.4Save Citation »Export Citation »E-mail Citation »

    Integrates research and practice views of community capacity, which focuses on cultivation of human capital, and environmental perspectives that focus on structural factors in a setting. Discusses the interface of these two perspectives as an ecological framework for better understanding the capacity of particular environments to promote health. Good, balanced treatment of theory and practice; appropriate for audiences interested in either perspective. Available online for purchase or by subscription.

    Find this resource:

  • Trickett, Edison J. 2009. Community psychology: Individuals and interventions in community context. Annual Review of Psychology 60:395–419.

    DOI: 10.1146/annurev.psych.60.110707.163517Save Citation »Export Citation »E-mail Citation »

    Intellectually complex but well thought-out article presents a comprehensive review of efforts to shift the psychology perspective from psychology of an individual to that of an individual within a community context, emphasizing the importance of contextual factors. Suitable for advanced graduate students. Available online for purchase or by subscription.

    Find this resource:

Applicability

The works in this section move the discussion from theory to practice, focusing on a broad array of applications at multiple societal levels. Best, et al. 2003 frames social ecology in terms of systems theory and argues that community partnerships are an effective way to translate theory-based research into practice. Grzywacz and Fuqua 2000 provides a summary of the social ecological perspective in health promotion and highlights specific points of intervention indicated by this model. Simons-Morton, et al. 1989 presents an early application of the social ecological model to understanding and addressing public health issues, highlighting the marriage of PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation) and MATCH (Multilevel Approach to Community Health) within an ecological framework. The special issue of the Journal of Prevention and Intervention in the Community (Jakes and Brookins 2004 presents a review of the history and rationale for the ecological model and its application in community-based prevention, accompanied by four studies examining the use of an ecological approach in design, implementation, and evaluation of community interventions. Green and Kreuter 2005, a classic text on health program planning, adopts an ecological perspective in this edition of the text. Hawe and Riley 2005 applies an ecological perspective to the health of new mothers, while Kelly 2006 includes reprints of previously published articles on an ecological approach within community psychology.

  • Best, Allan, Daniel Stokols, Lawrence W. Green, Scott Leischow, Bev Holmes, and Kaye Buchholz. 2003. An integrative framework for community partnering to translate theory into effective health promotion strategy. American Journal of Health Promotion 18.2: 168–176.

    DOI: 10.4278/0890-1171-18.2.168Save Citation »Export Citation »E-mail Citation »

    Describes systems theory in terms of integration among a variety of perspectives including social ecology. Argues that a gap in the translation of research to practice can be bridged through strategic community partnering in health promotion. Available online for purchase or by subscription.

    Find this resource:

  • Green, Lawrence W., and Marshall W. Kreuter. 2005. Health program planning: An educational and ecological approach. New York: McGraw-Hill.

    Save Citation »Export Citation »E-mail Citation »

    Textbook focuses on the application of an ecological framework to health planning through community participation. Addresses application and includes case studies in multiple settings and for multiple issues. Also provides systematic description of methodologies for the applications discussed.

    Find this resource:

  • Grzywacz, Joseph G., and Juliana Fuqua. 2000. The social ecology of health: Leverage points and linkages. Behavioral Medicine 26.3: 101–116.

    DOI: 10.1080/08964280009595758Save Citation »Export Citation »E-mail Citation »

    Presents summary of social ecological theory in health, followed by explanations of the relationships among different levels and health. Focuses on implications for practice. Also presents criticisms of the limitations of social ecological approaches. Suitable for undergraduate and graduate students. Available online for purchase or by subscription.

    Find this resource:

  • Hawe, Penelope, and Therese Riley. 2005. Ecological theory in practice: Illustrations from a community-based intervention to promote the health of recent mothers. Prevention Science 6.3: 227–236.

    DOI: 10.1007/s11121-005-0008-zSave Citation »Export Citation »E-mail Citation »

    Presents assessment of community-level intervention based on ecological principles. Argues that using an ecological framework for describing programs focuses better on process and sustainability rather than just technical aspects of design and implementation. Available online for purchase or by subscription.

    Find this resource:

  • Jakes, Susan Scherffius, and Craig C. Brookins, eds. 2004. Special issue: Understanding ecological programming. Journal of Prevention and Intervention in the Community 27.2.

    Save Citation »Export Citation »E-mail Citation »

    Introduction to theme issue of the journal; begins with theory underlying ecological prevention programming in communities. Balance of the journal issue presents empirical studies focused on planning, implementation, and evaluation of ecology-based community interventions. Argues that ecological perspectives are valuable but complex in application. Articles available online for purchase or by subscription.

    Find this resource:

  • Kelly, James G., ed. 2006. Becoming ecological: An expedition into community psychology. Oxford: Oxford Univ. Press.

    DOI: 10.1093/acprof:oso/9780195173796.001.0001Save Citation »Export Citation »E-mail Citation »

    Provides reprints of thirteen articles from community psychology that address ecological thinking, research, training, and practice. Suitable for undergraduate and graduate students.

    Find this resource:

  • Simons-Morton, Bruce G., Susan G. Brink, Denise G. Simons-Morton, et al. 1989. An ecological approach to the prevention of injuries due to drinking and driving. Health Education and Behavior 16.3: 397–411.

    DOI: 10.1177/109019818901600308Save Citation »Export Citation »E-mail Citation »

    Applies diagnostic framework to reviewing literature regarding alcohol-related motor vehicle injuries. Systematically outlines application of ecological framework to multilevel intervention planning by marrying PRECEDE with MATCH. Although specific to alcohol-related injury, presents a good early translation of social ecological theory to application in public health. Available online for purchase or by subscription.

    Find this resource:

Child Health and Safety

The works in this section describe the application of social ecological approaches for understanding issues specific to the health of children. Belsky 1980 synthesizes perspectives from various disciplines regarding causes of child abuse and neglect and calls for an integrated ecological perspective for the development of more effective interventions. Earls and Carlson 2001 provides a fairly comprehensive review of published research on factors influencing child health at different levels and calls for more concrete operationalization of constructs.

  • Belsky, Jay. 1980. Child maltreatment: An ecological integration. American Psychologist 35.4: 320–335.

    DOI: 10.1037/0003-066X.35.4.320Save Citation »Export Citation »E-mail Citation »

    Presents an integration of divergent perspectives from different disciplines within an ecological framework (following Bronfenbrenner 1979, cited under History) for understanding the individual, family, and community factors and forces that interact as antecedents to child abuse and neglect. Argues that this integrated perspective is needed to inform more effective interventions. Available online for purchase or by subscription.

    Find this resource:

  • Earls, Felton, and Mary Carlson. 2001. The social ecology of child health and well-being. Annual Review of Public Health 22:143–166.

    Save Citation »Export Citation »E-mail Citation »

    Annual review of evidence on ecological influences on child health. Argues that although useful, conceptualizations and constructs of the theory are not specific enough for adequate application or measurement. Calls for strengthening of the science of applying social ecology to child health. Available online for purchase or by subscription.

    Find this resource:

Adolescent Sexuality

The works in this section provide reviews of a variety of studies regarding factors that contribute to adolescent risky sexual behavior or interventions targeting these behaviors. Corcoran 1999 presents a review of the literature of factors at each social ecological level that contributes to adolescent pregnancy. DiClemente, et al. 2005 synthesizes published research on antecedent factors as well as interventions to prevent sexually transmitted infections in adolescents and argue for a stronger multilevel focus. Shoveller, et al. 2006 reviews thirty-five interventions for preventing sexually transmitted infections to find that most focus solely on individual level factors. DiClemente, et al. 2007 encourages attention to multilevel factors contributing to sexually transmitted infections in adolescents for development of more comprehensive interventions.

  • Corcoran, Jacqueline. 1999. Ecological factors associated with adolescent pregnancy: A review of the literature. Adolescence 34.136: 603–619.

    Save Citation »Export Citation »E-mail Citation »

    Presents a literature review of the factors related to adolescent pregnancy within a social ecological framework. Contains useful summary table that outlines the studies included (ranging in publication date from 1981 to 1995), their design, sample, and key findings.

    Find this resource:

  • DiClemente, Ralph J., Laura F. Salazar, and Richard A. Crosby. 2007. A review of STD/HIV preventive interventions for adolescents: Sustaining effects using an ecological approach. Journal of Pediatric Psychology 32.8: 888–906.

    DOI: 10.1093/jpepsy/jsm056Save Citation »Export Citation »E-mail Citation »

    Responds to documented lack of social ecological perspective in interventions to prevent sexually transmitted infections in adolescents by summarizing research in adolescent sexual risk. Provides useful table summarizing research findings. Encourages attention to the complex multilevel factors that contribute to the issue to develop more effective programming. Available online for purchase or by subscription.

    Find this resource:

  • DiClemente, Ralph J., Laura F. Salazar, Richard A. Crosby, and Susan L. Rosenthal. 2005. Prevention and control of sexually transmitted infections among adolescents: The importance of a socio-ecological perspective—A commentary. Public Health 119.9: 825–836.

    DOI: 10.1016/j.puhe.2004.10.015Save Citation »Export Citation »E-mail Citation »

    Briefly synthesizes research on factors contributing to and interventions targeting sexually transmitted infections in adolescents using a social ecological framework. Argues that many interventions focus mainly on individual factors and that multilevel interventions contribute a broader understanding of the factors and mechanisms that influence sexually transmitted infections.

    Find this resource:

  • Shoveller, Jean A., Joy L. Johnson, Daphné M. Savoy, and W. A. Wia Piertersma. 2006. Preventing sexually transmitted infections among adolescents: An assessment of ecological approaches and study methods. Sex Education 6.2: 163–183.

    DOI: 10.1080/14681810600578859Save Citation »Export Citation »E-mail Citation »

    Review of thirty-five interventions regarding the social ecological level targeted to prevent sexually transmitted infections among adolescents. Finds a strong focus on the individual level and a lack of focus on sociocultural influences. Calls for application of ecological approaches in this area. Available online for purchase or by subscription.

    Find this resource:

Health Issues of Older Adults

With a rapidly growing population of older adults, recent attention has focused on aging and health issues related to aging. The works in this section provide an emphasis on examining the ecological factors related to healthy aging and corresponding points of intervention. Satariano 2006 provides a comprehensive look at research in the epidemiology of aging within an ecological framework across a broad array of health and social issues. Richard, et al. 2008 presents a review of 132 older adult health promotion programs in Quebec, finding few that target multiple ecological levels.

  • Richard, Lucie, Lise Gauvin, Céline Gosselin, Francine Ducharme, Jean-Philippe Sapinski, and Maryse Trudel. 2008. Integrating the ecological approach in health promotion for older adults: A survey of programs aimed at elder abuse prevention, falls prevention, and appropriate medication use. International Journal of Public Health 53:46–56.

    DOI: 10.1007/s00038-007-6099-5Save Citation »Export Citation »E-mail Citation »

    Presents review of 132 programs for older adults in Canada, assessing the ecological orientation of activities situated in organizational and community settings. Finds low integration of ecological principles in this programming and argues that disease prevention and health promotion for older adults would benefit greatly from more comprehensive, multilevel approaches. Available online for purchase or by subscription.

    Find this resource:

  • Satariano, William. 2006. Epidemiology of aging: An ecological approach. Sudbury, MA: Jones and Bartlett.

    Save Citation »Export Citation »E-mail Citation »

    A comprehensive presentation of a substantial body of research from multiple disciplines related to the aging of human populations. Approaches a broad variety of topics from an ecological perspective, ranging from why people are living longer to falls and injury, from the physical environment to social support. Good introduction to aging and health.

    Find this resource:

Nutrition and Physical Activity

Works in this section vary from presentations of theoretical models for designing multilevel interventions to studies of specific interventions to approaches to dealing with methodological issues in this type of research. Glanz and Mullis 1988, although somewhat dated, provides an early review of environment-level interventions to promote healthful diet and provide a good summary of setting-based interventions. Story, et al. 2008 focuses on policy and environmental interventions to promote healthy eating, including a discussion on measurement issues. Brownson, et al. 2005 discusses information on the effectiveness of a multilevel ecological intervention to increase walking for physical activity in rural communities. Sallis, et al. 2006 presents an annual review of research in ecological approaches to promoting active living and argue that multilevel interventions are more effective than single-level approaches. In contrast to Brownson, et al. 2005, Cochran and Davey 2008 offers data on the effectiveness of a multilevel intervention to increase walking in an urban community. With a focus on systematic approaches to planning, implementing, and evaluating ecologically based interventions, Ogilvie, et al. 2011 outlines a process to deal with the challenges inherent in multilevel interventions. Finally, Richard, et al. 2011 describes the tenets of an ecological approach, an overview of ecological models and their evolution over time, and a review of published studies including ecological approaches aimed at improving physical activity and fruit and vegetable consumption.

  • Brownson, Ross C., Laura Hagood, Sarah L. Lovegreen, et al. 2005. A multilevel ecological approach to promoting walking in rural communities. Preventive Medicine 41.5–6: 837–842.

    DOI: 10.1016/j.ypmed.2005.09.004Save Citation »Export Citation »E-mail Citation »

    Presents the results of a quasi-experimental study of a multilevel intervention designed to increase walking among rural-residing adults. Good example of a community-based study using an ecological approach to address sedentary behavior and the limitations inherent in this kind of research.

    Find this resource:

  • Cochrane, Thomas, and Rachel Caroline Davey. 2008. Increasing uptake of physical activity: A social ecological approach. Journal of the Royal Society for the Promotion of Health 128.1: 31–40.

    DOI: 10.1177/1466424007085223Save Citation »Export Citation »E-mail Citation »

    In contrast to Brownson et al., 2005, this article demonstrates a social ecological approach to improve physical activity in an urban population in the United Kingdom. Presents good discussion regarding the challenges of using this type of approach. Available online for purchase or by subscription.

    Find this resource:

  • Glanz, Karen, and Rebecca M. Mullis. 1988. Environmental interventions to promote healthy eating: A review of models, programs, and evidence. Health Education Quarterly 15.4: 395–415.

    DOI: 10.1177/109019818801500403Save Citation »Export Citation »E-mail Citation »

    Presents review of a variety of models and programs utilizing environmental interventions to promote healthy eating. Good overview article. Includes a useful table of programs by setting, including identifying those involved in implementing the intervention as well as the target audience.

    Find this resource:

  • Ogilvie, David, Fiona Bull, Jane Powell, et al. 2011. An applied ecological framework for evaluating infrastructure to promote walking and cycling: The iConnect study. American Journal of Public Health 101.3: 473–481.

    DOI: 10.2105/AJPH.2010.198002Save Citation »Export Citation »E-mail Citation »

    Presents a step-by-step approach to addressing challenges with conceptualizing, designing, and evaluating community-based multilevel interventions for walking and cycling. Offers an original theoretical framework specific to research on the built environment that aims to overcome specific issues in methodology and measurement. Available online for purchase or by subscription.

    Find this resource:

  • Richard, Lucie, Lise Gauvin, and Kim Raine. 2011. Ecological models revisited: Their uses and evolution in health promotion over two decades. Annual Review of Public Health 32:307–326.

    DOI: 10.1146/annurev-publhealth-031210-101141Save Citation »Export Citation »E-mail Citation »

    Review of published studies from three two-year periods regarding ecological approaches to address determinants of physical activity and fruit and vegetable consumption. Indicates an increase over time in the use of multiple ecological levels in addressing these issues. Available online for purchase or by subscription. Also see Theoretical Development.

    Find this resource:

  • Sallis, James F., Robert B. Cervero, William Ascher, Karla A. Henderson, M. Katherine Kraft, and Jacqueline Kerr. 2006. An ecological approach to creating active living communities. Annual Review of Public Health 27:297–322.

    DOI: 10.1146/annurev.publhealth.27.021405.102100Save Citation »Export Citation »E-mail Citation »

    Comprehensive annual review argues the necessity of interventions that target multiple ecological levels to effectively increase physical activity at the population level. Presents useful diagram of the ecological model of four domains of active living and summarizes current research on active living communities. Available online for purchase or by subscription.

    Find this resource:

  • Story, Mary, Karen M. Kaphingst, Ramona Robinson-O’Brien, and Karen Glanz. 2008. Creating healthy food and eating environments: Policy and environmental approaches. Annual Review of Public Health 29:253–272.

    DOI: 10.1146/annurev.publhealth.29.020907.090926Save Citation »Export Citation »E-mail Citation »

    Expands on Glanz and Mullis 1988 to detail an ecological framework for policy and environmental interventions to promote healthy eating. Includes a short discussion on measurement issues for research on the food environment and policies. Available online for purchase or by subscription.

    Find this resource:

Chronic Disease

Works in this section provide a snapshot of how social ecological models are being applied to different types of chronic disease prevention and management. Fisher, et al. 2005 offers a summary of the evidence for intervention at different levels to support a new model of chronic disease self-management that can complement widely used clinical models. Patrick, et al. 2005 presents an interesting case for taking advantage of increasing public access to technology to integrate cancer communication into ubiquitous computing to address multilevel factors that influence specific behaviors. King, et al. 1995 examines policy and environmental approaches to promoting physical activity to prevent chronic diseases such as cardiovascular disease, summarizing characteristics of different settings and opportunities to intervene.

Tobacco Control

Tobacco control is one of the areas in which there has been early and continued interest in the application of ecological models. For example, Abrams, et al. 1991 discusses the integration of individual and public health approaches to tobacco control. Richard, et al. 2004 reports on a study to identify factors facilitating the implementation of ecological tobacco control programming in Quebec, Canada. Sallis, et al. 2008 (cited under General Overviews) also discusses the application of ecological models for physical activity, tobacco control, and diabetes.

  • Abrams, D. B., K. M. Emmons, R. D. Niaura, M. G. Goldstein, and C. B. Sherman. 1991. Tobacco dependence: An integration of individual and public health perspectives. Annual Review of Addictions Treatment and Research 1:331–396.

    Save Citation »Export Citation »E-mail Citation »

    This study integrates individual and public health approaches to tobacco control focused mostly on current users and integrating biological sciences, cognitive-behavioral approaches, clinical treatment, and public health approaches.

    Find this resource:

  • Levesque, Lucie, Luice Richard, and Louise Potvin. 2000. The social ecological approach in tobacco control practice: Health promotion practitioner characteristics related to using the ecological approach. American Journal of Health Promotion 14.4: 244–252.

    DOI: 10.4278/0890-1171-14.4.244Save Citation »Export Citation »E-mail Citation »

    Study of 524 health promotion practitioners examines the cognitive factors and personal characteristics related to the integration of the ecological approach in the everyday practice of tobacco control. Available online for purchase or by subscription.

    Find this resource:

  • Richard Lucie, Pascale Lehoux, Eric Breton, Jean-Louis Denis, Louise Labrie, and Claudine Leonard. 2004. Implementing the ecological approach in tobacco control programs: Results of a case study. Evaluation and Program Planning 27.4: 409–421.

    DOI: 10.1016/j.evalprogplan.2004.07.004Save Citation »Export Citation »E-mail Citation »

    This study identified factors facilitating the implementation of an ecological approach to tobacco control in two public health departments in Québec. The study identifies two distinct configurations of environmental, organizational, and professional characteristics that are related to equally successful implementations of the ecological framework. Available online for purchase or by subscription.

    Find this resource:

Community Interventions and Research

Works in this section are generally more advanced in their theoretical underpinnings as they get at some of the most complex issues in applying and studying multilevel population health interventions. Some of these issues deal with ontology, epistemology, and external validity of research done in specific community contexts. Application of ecological frameworks accounts for unique contexts, making replication and translation of multilevel community interventions challenging. Trickett, et al. 1985 offers a discussion of how the ecological paradigm, developed in community psychology, should influence the topic and methods of community-based intervention and research. Stokols 1992 presents a conceptual argument for a social ecological approach to creating and maintaining environments that promote health and healthy behavior. Goodman, et al. 1996 outlines a triangulation approach to ecological assessment of community coalitions, presenting a case study applying specific measures. Stokols 1996 extends Stokols 1992 by highlighting core principles of the application of social ecological theory into health promotion practice guidelines. Kelly 2006 offers a brief practice piece demonstrating through a mental health example how ecological principles can be applied. Schensul and Trickett 2009a introduces a special issue of the American Journal of Community Psychology (see Schensul and Trickett 2009b) by showing substantial gaps between conceptualization and implementation of multilevel interventions. This special issue offers a variety of conceptual and applied articles that illustrate a social ecological perspective in community-based intervention and research.

  • Goodman, Robert, Abraham Wandersman, Matthew Chinman, Pam Imm, and Erin Morrissey. 1996. An ecological assessment of community-based interventions for prevention and health promotion: Approaches to measuring community coalitions. American Journal of Community Psychology 24.1: 33–61.

    DOI: 10.1007/BF02511882Save Citation »Export Citation »E-mail Citation »

    Discusses application of an ecological approach to intervention at multiple social levels as well as differing stages of community readiness. Argues for a mixed methods approach (triangulation) to ecological assessment. Presents a case study applying this assessment to the development of a community coalition. Includes strategies and tools for evaluation. Available online for purchase or by subscription.

    Find this resource:

  • Kelly, James G. 2006. Practicing ecology: Ideas for community-based preventive programs. In Becoming ecological: An expedition into community psychology. By James G. Kelly, 267–273. New York: Oxford Univ. Press.

    DOI: 10.1093/acprof:oso/9780195173796.001.0001Save Citation »Export Citation »E-mail Citation »

    Short, thoughtful piece using mental health as an example of how ecological principles should be applied in community practice. Contains a useful section on unintended consequences that must be anticipated.

    Find this resource:

  • Schensul, Jean J., and Edison Trickett. 2009a. Multi-level community based culturally situated interventions. American Journal of Community Psychology 43.3–4: 232–240.

    DOI: 10.1007/s10464-009-9238-8Save Citation »Export Citation »E-mail Citation »

    Introduces theme issue of journal highlighting gaps between conceptualizations and implementation of multilevel interventions.

    Find this resource:

  • Schensul, Jean J., and Edison Trickett, eds. 2009b. Special issue: Multi-level community based culturally situated inventions. American Journal of Community Psychology 43.3–4.

    Save Citation »Export Citation »E-mail Citation »

    Journal issue focused on the application of a social ecological perspective to research and practice in community-based public health intervention. Includes conceptual pieces and case studies. Suitable for advanced graduate students. Articles available online for purchase or by subscription.

    Find this resource:

  • Stokols, Daniel. 1992. Establishing and maintaining healthy environments: Toward a social ecology of health promotion. American Psychologist 47.1: 6–22.

    DOI: 10.1037/0003-066X.47.1.6Save Citation »Export Citation »E-mail Citation »

    A thorough and thoughtful conceptual piece that proposes a social ecological framework for creating and maintaining aspects of a health promoting environment. Emphasizes the interactions among physical, social, and environmental factors to produce health. Advocates for multilevel interventions and policy development. Available online for purchase or by subscription.

    Find this resource:

  • Stokols, Daniel. 1996. Translating social ecological theory into guidelines for community health promotion. American Journal of Health Promotion 10.4: 282–298.

    DOI: 10.4278/0890-1171-10.4.282Save Citation »Export Citation »E-mail Citation »

    Presents comparison of behavior change theories, environmental change theories, and social ecological theories highlighting strengths and weaknesses of each. Applies core principles of social ecological theory to design and evaluation of interventions. Enumerates specific guidelines for community-based health promotion activities. Includes several useful tables that summarize key ideas. Available online for purchase or by subscription.

    Find this resource:

  • Trickett, E. J., J. G. Kelly, and T. A. Vincent. 1985. The spirit of ecological inquiry in community research. In Community Research: Methods, Paradigms, and Applications. Edited by E. Susskind and D. Klein. New York: Praeger.

    Save Citation »Export Citation »E-mail Citation »

    Describes how the ecological paradigm should drive the topic and methods of community-based intervention and research. Provides useful outline of ecological principles and discusses how they can be applied.

    Find this resource:

Research and Evaluation

The works in this section focus on ecological approaches in public health research and practice and tools to assess the degree to which ecological principles are integrated. Richard, et al. 1996 presents a new framework comprised of an integration of previous models and demonstrates its utility by applying it to a number of health programs to determine the level of integration of the ecological approach. Diez-Roux 2000 presents a well-organized summary of the rationale for using multilevel analysis, including methods, while acknowledging the practical limitations of these methods. Jakes 2004 presents a different assessment tool for examining the level of ecological thinking evident in community interventions and compares the results to expert reviewers’ findings for the same programs. Espino and Trickett 2008 offers yet another framework for reviewing ecological principles in community interventions with particular attention to the difference in the way in which programs are designed and implemented and the way in which they are presented in the literature. Each of the three assessment strategies offer a useful perspective for understanding how social ecological principles are intended to be put into public health practice. Golden and Earp 2012 reviews twenty years of interventions reported in the journal Health Education and Behavior and the extent to which they reflect an ecological framework.

  • Diez-Roux, Ana V. 2000. Multilevel analysis in public health research. Annual Review of Public Health 21:171–192.

    DOI: 10.1146/annurev.publhealth.21.1.171Save Citation »Export Citation »E-mail Citation »

    Presents rationale for using multilevel analysis in public health research. Summarizes statistical methods and raises issues in theory and methodology for using multilevel approaches. Highlights the difference between understanding multilevel factors that influence health and multilevel interventions and analysis as part of public health research. Available online for purchase or by subscription.

    Find this resource:

  • Espino, Susan L., and Edison J. Trickett. 2008. The spirit of ecological inquiry and intervention research reports: A heuristic elaboration. American Journal of Community Psychology 42.1: 60–78.

    DOI: 10.1007/s10464-008-9179-7Save Citation »Export Citation »E-mail Citation »

    A review of thirty-four intervention studies using ecological inquiry as an analytic framework for assessing published studies of community interventions. Argues that the way community intervention is conducted and the way it is written up differ in attention to context. Suitable for graduate students.

    Find this resource:

  • Golden, Shelley D., and Jo Anne L. Earp. 2012. Social ecological approaches to individuals and their contexts: Twenty years of Health Education & Behavior health promotion interventions. Health Education & Behavior 39.3: 364–372.

    DOI: 10.1177/1090198111418634Save Citation »Export Citation »E-mail Citation »

    A review of twenty years of intervention publications in the journal Health Education & Behavior and the extent to which they reflect an ecological approach or framework. Available online for purchase or by subscription.

    Find this resource:

  • Jakes, Susan Scherffius. 2004. Understanding ecological programming: Evaluating program structure through a comprehensive assessment tool. Journal of Prevention and Intervention in the Community 27.2: 13–28.

    DOI: 10.1300/J005v27n02_02Save Citation »Export Citation »E-mail Citation »

    Presents a study that validates the use of a tool (the Ecological Programming Scale) compared to an expert reviewer to evaluate the extent to which a community intervention program adheres to the principles of an ecological model. Available online for purchase or by subscription.

    Find this resource:

  • Richard, Lucie, Louise Potvin, Natalie Kishchuk, Helen Prlic, and Lawrence W. Green. 1996. Assessment of the integration of the ecological approach in health promotion programs. American Journal of Health Promotion 10.4: 318–328.

    DOI: 10.4278/0890-1171-10.4.318Save Citation »Export Citation »E-mail Citation »

    Provides a review of forty-four federally funded health promotion programs in Canada. Synthesizes McLeroy et al. 1988 (see History) framework, the PRECEDE/PROCEED (Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation/Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development) model and the MATCH (Multilevel Approach to Community Health) model into a systematic model for analyzing the integration of an ecological approach in population intervention. Suitable for graduate students. Available online for purchase or by subscription.

    Find this resource:

LAST MODIFIED: 11/21/2012

DOI: 10.1093/OBO/9780199756797-0037

back to top

Article

Up

Down