An Ecology Perspective on Health Promotion Programs
ABSTRACT During the past 20 years there has been a dramatic increase in societal interest in preventing disability and death in the United States by changing individual behaviors linked to the risk of contracting chronic diseases. This renewed interest in health promotion and disease prevention has not been without its critics. Some critics have accused proponents of life-style interventions of promoting a victim-blaming ideology by neglecting the importance of social influences on health and disease. This article proposes an ecological model for health promotion which focuses attention on both individual and social environmental factors as targets for health promotion interventions. It addresses the importance of interventions directed at changing interpersonal, organizational, community, and public policy, factors which support and maintain unhealthy behaviors. The model assumes that appropriate changes in the social environment will produce changes in individuals, and that the support of individuals in the population is essential for implementing environmental changes.
Full-textDOI: · Available from: Kenneth Mcleroy, Aug 28, 2015
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- "The SEM was chosen because a person's behavior is influenced by social, cultural , economic, and environmental factors. Interventions informed by SEM target multiple levels and are expected to be more effective than those intervening at only one level (McLeroy et al., 1988; Sallis et al., 2002; Stokols, 1996). This study is intervening at 4 levels of the SEM (see the Figure). "
ABSTRACT: The effectiveness of community health workers (CHWs) as health educators and health promoters among Latino populations is widely recognized. The Affordable Care Act created important opportunities to increase the role of CHWs in preventive health. This article describes the implementation of CHW-led, culturally specific, faith-based program to increase physical activity among churchgoing Latinas. This study augments previous research by describing the recruitment, selection, training, and evaluation of CHWs for a physical activity intervention targeting multiple levels of the Social Ecological Model.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.The Journal of ambulatory care management 08/2015; DOI:10.1097/JAC.0000000000000108
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- "Interpersonal factors are defined as interpersonal processes and groups (e.g., family, friends, peers) providing identity and support. Organizational factors include rules, regulations, policies, or structures from churches, stores, or community organizations that could constrain or promote individual behaviors (McLeroy et al., 1988). To the best of our knowledge, this approach has not yet been applied to the study of PAC although variables included in past caregiving research could be organized and studied according to intrapersonal, interpersonal , and organizational factors. "
ABSTRACT: Taking a socioecological perspective, this study assessed the relationship of intrapersonal, interpersonal, and organizational factors to positive aspects of caregiving (PAC) for 642 dementia caregivers by racial/ethnic group from the baseline data of the multisite Resources for Enhancing Alzheimer's Caregiver Health II (REACH II) intervention. Nine intrapersonal indicators, 4 interpersonal indicators, and 12 organizational indicators were used. Blocked-multiple regression analyses by three racial/ethnic groups were computed to examine significant factors related to PAC among caregivers after controlling for memory and behavioral problems. Data showed a significant difference in PAC and significantly different indicators of PAC by racial/ethnic group. Hispanic caregivers reported the highest level of PAC while White participants showed the lowest scores on the measure of PAC. Education, marital status, and using formal transportation services were significant predictors for PAC among Hispanic caregivers; age, education, caregiving duration, and received social support were significant for PAC among African American caregivers; and sex, education, being a spousal caregiver, satisfaction with social support, using help from homemaker and visiting nurse services, and participating in support groups were significant among White caregivers. Findings indicate that PAC varies significantly across the three studied racial/ethnic groups of family caregivers and that intrapersonal, interpersonal, and organizational factors relate uniquely to PAC. Additional investigations of PAC could serve an important role in the development of family caregiving supports and services.Aging and Mental Health 07/2015; DOI:10.1080/13607863.2015.1068739 · 1.75 Impact Factor
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- "Local tailoring is necessary to ensure that local demographic, cultural and environmental circumstances are appropriately addressed, which may result in more effective interventions through better adoption and sustainability (World Health Organization, 2012). CBIs generally use multiple types of strategies across multiple levels of the socioecological model (McLeroy et al., 1988) via partnership mechanisms (Kumanyika et al., 2002; World Health Organization 2002; Simmons et al., 2009) and focus on community engagement, capacity building, policy and environment changes across a whole community. Robust evaluations confirm CBIs effectiveness (Taylor et al., 2008; Johnson et al., 2012; Swinburn and Wood, 2013; Pettman et al., 2014) and cost-effectiveness (McAuley et al., 2010; Moodie et al., 2013). "
ABSTRACT: Community-based initiatives (CBIs) that build capacity and promote healthy environments hold promise for preventing obesity and non-communicable disease, however their characteristics remain poorly understood and lessons are learned in isolation. This limits understanding of likely effectiveness of CBIs; the potential for actively supporting practice; and the translation of community-based knowledge into policy. Building on an initial survey (2010), an online survey was launched (2013) with the aim to describe the reach and characteristics of Australian CBIs and identify and evaluate elements known to contribute to best practice, effectiveness and sustainability. Responses from 104 CBIs were received in 2013. Geographic location generally reflected population density in Australia. Duration of CBIs was short-term (median 3 years; range 0.2-21.0 years), delivered mostly by health departments and local governments. Median annual funding had more than doubled since the 2010 survey, but average staffing had not increased. CBIs used at least two strategy types, with a preference for individual behaviour change strategies. Targeting children was less common (31%) compared with the 2010 survey (57%). Logic models and theory were used in planning, but there was low use of research evidence and existing prevention frameworks. Nearly, all CBIs had an evaluation component (12% of budget), but dissemination was limited. This survey provides information on the scope and varied quality of the current obesity prevention investment in Australia. To boost the quality and effectiveness of CBIs, further support systems may be required to ensure that organizations adopt upstream, evidence-informed approaches; and integrate CBIs into systems, policies and environments. © The Author 2015. Published by Oxford University Press.Health Promotion International 04/2015; DOI:10.1093/heapro/dav024 · 1.94 Impact Factor