A Socio Ecological Model

A Socio- ecological model focuses on the influences on behaviour with focus on the environment and policy and reorientations of organizations such as the health system. The use of e ecological model presents a problem from other models, whereas other models can be specific, ecological model only give domains and does not give specific guidelines as to which domain to use for what specific behaviour. Where as psyco-social models propose a more generalised approach for example self efficacy and behavioural influences in dealing with issues ecological model has to be tailor made to a behaviour and a population. Hence other theories needs to be integrated into the model to aid in specify to deal with the problem at had

Healthy Active Oregon 2003: Socio-Ecological Model–Looking Beyond the Individual http://www.balancedweightmanagement.com/TheSocio-EcologicalModel.htm

The socio-ecological model recognises the interwoven interaction between the individual the environment in which he lives in. although the individual is responsible for maintaining a lifestyle that improves health and reduce risk, the social environment the individual lives in determines behaviour to a large extent, these can hence form a barrier which in a way can affect the community as a whole in achieving a behaviour change. Hence the social ecological approach suggests intrapersonal, interpersonal, community, organizational and public policy in dealing with a problem at hand.

Centers for Disease Control and Prevention. Best Practices for

Comprehensive Tobacco Control Programs-2007. Atlanta: U.S.

Department of Health and Human Services, Centers for Disease Control

and Prevention, National Center for Chronic Disease Prevention and

Health Promotion, Office on Smoking and Health; October 2007.

Social norms play a significant role in shaping beliefs and behaviors in healthy and unhealthy ways.10 For example, survey data from California indicate that adult smokers with strong attitudes about the health effects

and restriction of secondhand smoke are more than twice as likely to have made a recent quit attempt and to have the intention to quit in the next six months.11 Adult smokers who demonstrated strong anti-tobacco industry beliefs were 65% more likely to have made a recent quit attempt and 85% more likely to have the intention to quit in the next six months.11

tobacco control program combines and coordinates community-based interventions that focus on 1) preventing initiation of tobacco use among youth and young adults, 2) promoting quitting among adults and youth, 3) eliminating exposure to secondhand smoke, and 4) identifying and eliminating tobacco-related disparities among population groups. Reducing tobacco use is particularly challenging

Community Programs

A “community” encompasses a diverse set of entities, including voluntary health agencies; civic, social, and recreational organizations; businesses and business

associations; city and county governments; public health organizations; labor groups; health care systems and providers; health care professionals’ societies; schools and universities; faith communities; and organizations for racial and ethnic minority group

State capacity and infrastructure, including clear leadership and dedicated resources, are essential to the development and implementation of a strong strategic plan that includes the identification and elimination of tobacco-related disparities Tobacco control programs need to foster the motivation to quit through policy changes and media campaigns and promote their quitline services.

McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Qarterly, 15(4), 351-377.

McLeroy K R, Steckler Ab, Goodman RM and Burdine JN(1992) Health Education education research: theory and Practises-future direction. Health Education Research, 7:1-8.

Piper S (2009) HEALTH PROMOTION FOR NURSES; theory and practice. Routledge Oxon pp28

Borland R, Chapman S, Owen N and Hill D (1990): Effects of Workplace Smoking Bans on Cigarette Consumption. American Journal of Public Health 80, 2

A survey by Borland et al examined the effect of smoking ban on the behaviour of workers in the workplace of Australia’s largest public service. Before the implementation of the ban publicity was done for a year, there were programs set up to help people quit smoking, control smoking addiction and pre-deadline restrictions were introduced at some worksites. 2,113 workers were surveyed for 2 weeks before the implementation of the ban and six month after the ban was introduced. The survey found out that of the 2113 participants, 492 participants who were smoking at the time of the initial survey had reduced to 471 giving a reduction of 21 smokers after the ban. 57 smokers at the initial survey had given up at follow up whereas 36 non-smokers at initial survey were reported to have started smoking. 58% of those who gave up are reported to have done so following the implementation of the smoking ban.

The study also assessed the effect of the pre-implementation restrictions on the workers. Participants were grouped into those who were allowed to smoke at the work station(43%) and those who were not allowed to smoke at their work stations (57%) . the result showed a 4.5 cigarette pre day consumption difference between those who were not allowed to smoke on site and those who were allowed. After the ban it was also found that there was a 5.2 cigarettes reduction among those who had the pre-implementation restrictions and a 1.9 cigarettes reduction among those who were not restricted. Further the survey explored. The survey further explored the effect on the participants who did not have any restrictions prior to the ban. Participants were grouped into light, heavy and moderate smokers. It was found out that whiles there were no changes in consumption among the light smokers there was an average reduction of 5.8 and 7.9 cigarettes per day among moderate and heavy smokers respectively. However heavy smokers did not appear to smoke more coffee and lunch breaks though they tend to smoke more whiles working outside. There was an average compensated increase of 0.7 cigarettes outside the working environment.

This study is based on the ecological model where a change in the environment causes a change in individual’s behaviour. The socio-ecological model recognises the interwoven interaction between the individual and the environment in which he lives in (Healthy Active Oregon 2003). Although the individual is responsible for maintaining a lifestyle that improves health and reduce risk, the social environment the individual lives in determines behaviour to a large extent; these can hence form a barrier which in a way can affect the community as a whole in achieving a behaviour change (Healthy Active Oregon 2003). Hence the social ecological approach suggests intrapersonal, interpersonal, community, organizational and public policy in dealing with a problem at hand (McLeroy et al, 1988).

Jane Wills (2007) VITAL NOTES FOR NURSES; Promoting Health. Blackwell Publishing Ltd Oxford pp 59

Legislative action is also intended to change behaviour through the state, this includes national policies and provision of supportive systems to aid people to be able to cope with the change and sustain healthy life styles. But this intervention may be met with such resistance and people may be forced to under take smoking undercover making it difficult to actually identify the individuals who are undertaking such acts

Naidoo J and Wills J (2005) PUBLIC HEALTH AND HEALTH PROMOTION; developing practice. Second edition of practising Health Promotion: Dilemmas and Challenges. BAILLIERE TINDALL, LONDON

WHO (1986) Ottawa Charter for Health Promotion www.who.int/hpr/archive/docs/ottawa.html (accessed on 12/02/10)

Bauer J E, Hyland A, Li Q, Steger C & Cummings M K (2005): A Longitudinal Assessment of the Impact of Smoke-Free Worksite Policies on Tobacco Use. American Journal of Public Health, 95(6): 1024-1029.

Stokols D (1996) Translating Social Ecological Theory into Guidelines for Community Health Promotion; American Journal of Health Promotion, 10(4):282-98

Davies M &Macdowall W (2006) Health Promotion Theory; UNDERSTANDING PUBLIC HEALTH. Open University Press, ENGLAND

National Tobacco Strategy (1999): A SUMMARY DOCUMENT TO ACCOMPANY THE STRATEGY

http://www.health.gov.au/internet/main/publishing.nsf/Content/09C1490BFFCC1872CA256F190004478B/$File/tobccstrat1.pdf.

This is part of a national tobacco strategy framework, whose main objective is to improve the health of all citizens of Australia by eradicating or limiting the exposure of tobacco and all it forms.

The key strategies that was set up for the frame work was to improve the control of tobacco through community action, promote cessation of the use of tobacco, limit promotion and regulate tobacco and finally, reduce environmental exposure to the smoke of tobacco.

A community is said to be well-informed when it has adequate information on tobacco to be able to make an informed decision on tobacco use. In the community information such as how to get help and quit, the difference between the use of tobacco and addiction, the effect of tobacco smoke on the environment, the benefits of quitting at any age and sooner than latter and on a whole the effect of tobacco on the society.

It is a well known fact that information alone does not lead to behaviour by individuals in the community. For a community to gain control over tobacco use it has to be involved in the planning and implementation of community based programes for controlling tobacco. Community leaders, parents, schools and youth organiztions can all be involved.

All though the survey does not account how data was collected to assess community participation, can be assumed that since this was part of a national frame work and employees are part of a community it may be possible for the individuals to be involved in some kind of a community based activity.

And the whole employees come together forms a community that can be involved in tobacco control activities and also form a network to support each other.

Egger G, Spark R & Donovan R (2005): HEALTH PROMOTION STRATEGIES AND METHODS. 2nd Edition McGraw-Hill Australia Pty Ltd.

It was reported in the study that 36 people who were non-smokers previously at the initial survey had started smoking at follow up (Borland et al, 1990). This reinforces the notion that knowledge does not motivate an individual to change their behaviour.

Individuals are bombarded with so much information in our current society, but people perceive the information based on their own psychological inclination. People can select what they want to hear and ignores others that is likely to make them change their habits. Also people have their own beliefs and ideologies about what causes disease conditiones. And almost every smoker can point out an old smoker who has not developed cancer or someone who died of lung cancer but never smoked.