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Socio-ecological model: framework for prevention, centers for disease control. Available from the Centers for Disease Control and Prevention (CDC). http://www.cdc.gov/vio lenceprevention/overview/social-ecologicalmodel.html. 4
Source publication
The Socio-Ecological Model (SEM) is a conceptual framework depicting spheres of influence over human behavior that has been applied in public health settings for nearly five decades. Core principles of all variations of the SEM are the multiple influences over an individual's behaviors, the interactions of those influences, and the multi-level appr...
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The COVID-19 pandemic has potentially increased the risk for adolescent depression. Even pre-pandemic, <50% of youth with depression accessed care, highlighting needs for accessible interventions. Accordingly, this randomized-controlled trial (ClinicalTrials.gov: NCT04634903) tested online single-session interventions (SSIs) during COVID-19 in adol...
Citations
... However, such practices cannot be singly intervened, and these practices must also be accompanied by solid social relationship variables, communities, and society that initiate them simultaneously. The approach using the Social Ecology Model (SEM) method was studied by Lee, Bendixsen, Liebman, and Gallagher (2017), Noboru et al. (2020), and Thiagarajan and Jayasingh (2023), which produces several bullying prevention strategies that can be used at every level of the individual, social relations, community, and society at the same time. This method is considered more effective in preventing bullying (Akoto, Nketsia, Opoku, Fordjour, & Opoku, 2022;Patel & Quan-Haase, 2022). ...
This research aims to find out how to reduce cases of violence among elementary school students by uncovering solutions and their implementation. Currently, violence among students is rampant in Indonesia. The 2018 Program for International Student Assessment data show that students who report having experienced violence are above the average for OECD member countries. This research method uses a qualitative approach supported by focus group discussions and in-depth interviews with elementary school teachers and principals. The research results obtained nine themes: oppression as a problem, causes, impacts of oppression, institutional, curricular, cultural, religious, family intervention, current challenges, and recommendations. Curricular factor interventions include educational curricula and behavioral principles based on culture and customs. Extracurricular interventions include the application of values and norms. Additional interventions include socializing anti-violence values and norms to inspire students to be more enthusiastic about learning and increasing the role of parents at home. This research found an ideal combination of curricular and extracurricular activities to prevent cases of bullying at school. The curriculum on cultural values, customs, and institutions also determines the components that will help students have good morals and avoid violence inside and outside school.
... Climate anxiety may manifest in heightened mental health symptoms such as panic, obsessive thinking, and functional impairments that interfere with daily life. (Crandon et al. 2022;Lee et al. 2017) The use of a Climate Anxiety Scale (Clayton and Karazsia 2020) to select our sample ensured that we were talking to youth who were emotionally affected by climate change. To fill an important gap in the current literature, we center the voices of those with lived experience in climate distress, bringing their own words to the forefront. ...
... Once coding was completed, we carried out the thematic analysis by organizing the data according to Crandon et al. 's adapted Social Ecological Model (SEM) for climate distress (Crandon et al. 2022;Lee et al. 2017). This framework was selected as it was specifically focused on youth Table 3. Focus group breakdown for time of school entry and grade level. ...
... Below, we present our findings at the micro-, meso-, and macro-levels of influence based on Crandon et al.'s framework (Crandon et al. 2022). Crandon et al. developed an adapted this SEM (Lee et al. 2017) specific to climate anxiety among children and adolescents after a thorough literature review (Crandon et al. 2022). Figure 2 below provides a summary of multi-level experiences on climate distress based on that SEM. ...
... SEM places individuals and their health behaviors in the broader contexts of interpersonal interactions, social institutions, communities, and public policies. 38 This is not a novel approach; several studies have combined HBM with SEM to understand health behaviors within a cultural context. Authors of a qualitative study about Chinese Americans' attitudes toward obesity risk used this combined framework to identify cultural contributions to obesity prevalence. ...
Objectives
Extended-stay hotels (ESH) are a reliable and accessible housing option for low-income, minoritized renters, who are disproportionately exposed to secondhand and thirdhand cigarette smoke (SHS and THS). This study explores ESH residents’ perceptions of their SHS and THS exposure, harms related to this exposure, their willingness to mitigate these harms, and the contextual factors associated with smoking in hotels.
Methods
Eighty ESH renters from the metropolitan Atlanta region were recruited to complete a survey about the perceived harm and persistence of tobacco smoke, exposure experiences, knowledge, attitudes, self-efficacy, and intentions to protect oneself. Eleven of these participants completed semi-structured interviews, during which they discussed their daily SHS and THS exposure at their ESHs in greater detail.
Results
Of the survey respondents, 62% reported being bothered by their level of smoke exposure, and 77% said they believed smoke particulates remained in their rooms even after housekeeping cleaned them. Approximately half of survey respondents had attempted to stop smoking in the 3 months prior to the study, and 29 of these individuals were still on their smoking cessation journeys. Most interview participants agreed that SHS and THS exposure exacerbated their existing chronic illnesses and could possibly result in death in the long term. Participants agreed with the benefits of smoke-free policies, but also acknowledged other priorities for ESH living—affordability, safety, and proximity to the workplace—that overshadowed their desires for such policies.
Conclusion
Overall, study findings suggest that ESH renters understand the dangers of smoking and SHS/THS and want to decrease their exposure, but the persistence of cultural and contextual factors prevents them from fully engaging with 100% smoke-free policies.
... The socio-ecological model provides a critical conceptual framework to understand the multiple influences on individual health [22]. This model provides a holistic understanding of individual health promotion and focuses on the interconnections between individuals, organizations, communities, and societies [23]. ...
Healthy community assessment standards significantly influence community design and planning and are an important measure of a community’s ability to support health and well-being. Previous studies have mostly focused on built-environment indicators. However, building a healthy community is a complex issue involving multiple dimensions and factors. The consideration of the full range of health promotion factors is the key to determining their potential impact on individuals’ health. It is necessary to consider multiple perspectives to deepen the understanding of community health influences and enhance the effectiveness of the implementation of the assessment standards. The socio-ecological model (SEM) provides a critical framework for understanding the multiple influences on individual health. In this study, a two-dimensional interdisciplinary analytical framework of “socio-ecological factors–development goals” is developed by integrating development goals that summarize building considerations in assessment standards. Contextual analysis is used to examine the provisions of the following assessment standards: Assessment Standard for Healthy Community (ASHC), Assessment Standard for Healthy Retrofitting of Existing Residential Area (ASHRERA), WELL Community Standard (WELL), and Fitwel Certification System of Community (Fitwel). The results show that community and organization factors are used more than interpersonal and policy factors among the four standards. Humanistic constructions lack attention in the ASHC and ASHRERA standards compared with the other standards. The differences between the four standards indicate that there is a need to focus on regional features and develop locally adapted interventions. This study offers a novel exploration of the potential effectiveness of healthy community assessment standards from a multidisciplinary perspective. The results of this study support standard-setters and planners in the development of interventions to improve building healthy communities using intersectionality frameworks.
... Further evidence supports the effectiveness of online interventions for changing attitudes and behaviours within a social network, using a range of behaviour change mechanisms (e.g., social norms, social support, and social learning) [56,57]. These approaches can be understood within the context of the socio-ecological model of human behaviour, which conceptualises behavioural outcomes as stemming from interactions between the individual, their closest social circle, the wider community, and society more broadly [58,59]. According to this model, individuals operate within different social environments (e.g., home, school, workplace, community groups), creating 'spill over' effects, where behaviours, attitudes, and beliefs from one social environment can influence another (or from one social network to another). ...
Background
Farmers face numerous barriers to accessing professional mental health services and instead report a preference for informal support systems, such as lay or peer networks. Farmers also experience barriers to investing time in maintaining or improving their wellbeing, stemming from sociocultural norms and attitudes that are widespread in agricultural communities. The Vocal Locals social network campaign is an ifarmwell initiative that aims to promote conversations about wellbeing and challenge attitudes and behaviours that contribute to farmers’ poor mental health.
Methods
The Vocal Locals campaign was underpinned by the socio-ecological model which explains human behaviour as stemming from interactions between the individual, their closest social circle, the community, and broader society. The campaign ran in Loxton, South Australia, from June to August 2022. Ten community members (8/10 farmers) became ‘Vocal Locals’ and were supported to share ‘calls-to-action’ to encourage people in their social networks to engage in wellbeing-promoting activities. A broader communications campaign reinforced key messages and amplified Vocal Locals’ activities in the community. The intrapersonal and community-level impacts of the campaign were evaluated via pre- and post-campaign surveys of Vocal Locals and community members respectively.
Results
Vocal Locals reported significantly lower psychological distress (p = .014), and higher positive mental wellbeing (p = .011), levels of general mental health knowledge (p = .022), and confidence helping someone with poor mental health (p = .004) following the intervention. However, changes in stigmatising beliefs about mental illness, confidence recognising poor mental health, and confidence and comfort speaking to others about mental health were non-significant. Community members who were familiar with the campaign reported having significantly more wellbeing-related conversations post-campaign compared to before (p = .015). Respondents also reported being more comfortable speaking to others about mental health or wellbeing (p = .001) and engaging more in activities to maintain or improve their wellbeing (p = .012) following the campaign.
Conclusions
The Vocal Locals social network campaign is an example of how science and community can be brought together to achieve meaningful outcomes. The campaign may serve as a model for others who wish to challenge attitudinal or knowledge-related barriers to help-seeking and improve engagement in wellbeing-promoting activities in difficult-to-reach communities.
... The tailoring of occupational safety and health materials for youth should also account for the industrial sectors where most youth work and include relevant and relatable examples. These examples may need to vary by geographic region, especially where agricultural jobs are more common and where young people commonly work on family farms (Kraybill et al., 2012;Lee et al., 2017). Safety Matters is currently being updated with consideration to its relevance for diverse populations to better enable all young workers to obtain the maximum benefit from the program. ...
... The copyright holder for this preprint this version posted January 9, 2024. ; https://doi.org/10.1101/2024.01.08.24300988 doi: medRxiv preprint 6 Studies were grouped by themes that emerged from the individual included studies (12) and 132 contextualised to form a public policy perspective using the socio-ecological model (13). ...
Introduction
Diagnostic delay for endometriosis is a well-established phenomenon. Despite this, little is known about where in the health care system these delays occur or why they occur. Our review is the first attempt to synthesise and analyse this evidence.
Methods
A systematic scoping review with a pre-specified protocol was used to incorporate the global mixed methods literature on diagnostic delay for endometriosis. Four databases (PubMed, MEDLINE, EMBASE, PsychINFO) were searched from inception to September 2023 with a search strategy designed specifically for each.
Results
The search yielded 367 studies, 22 of which met the inclusion criteria. A third of studies has been published since 2020 and 65% were from high income countries. Six were qualitative and 16 were quantitative studies. The average age of onset of endometriosis was 14 years for adolescents and 20 for adults. On average, the diagnostic delay reported for endometriosis across the included studies was 6.6 years (range 1.5 to 11.3 years) but this masked the very wide differences reported between countries such as a 0.5-year delay in Brazil to a 27-year delay in the UK.
Discussion
Health system barriers included access to private healthcare for those with limited finance, physical access for those using public health systems and a general lack of knowledge amongst patients and health care professionals. Women often reported feeling unheard by health professionals. Considering the impact on individuals and the health system, addressing diagnostic delay for endometriosis must remain a priority for researchers, health care providers and policy makers.
What is already known on this topic
Endometriosis is currently difficult to diagnose. This results in delays in diagnosis which negatively impacts those suffering and increases the severity of pain and extent of the disease with increased costs to health systems.
What this study adds
The scoping review methodology included studies using a range of methods. The longest average delay occurs in secondary care. Those seeking public health care experienced longer average delay in diagnosis compared to those seeking private health care. Improved clinical guidelines may reduce diagnostic delay.
How this study might affect research, practice or policy
This is the first known review to explore diagnostic delay for endometriosis and provides an overview of the current literature. Clearer definitions of diagnostic delay for endometriosis are needed to aid in comparisons across countries. Improving education, tracking outcomes through medical records and developing non-invasive diagnostic tools will be crucial to improve women’s health.
... To assess breastfeeding practices and socio-cultural influences, an interview guide was developed using a previously validated survey used in Niger (Hitachi et al., 2019), along with the social-ecological model (SEM) to conceptualize a framework in which the participants, their social networks, and organized groups interact all together and in relation to breastfeeding decisions (Golden et al., 2015). The SEM is a widely used framework in public health research and practice, to help explain behaviors and inform the development of interventions (Lee et al., 2017). The semistructured guide followed a written script and included 8 open-response questions for qualitative data collection and a deeper understanding of the identified research questions. ...
Background Niger has one of the lowest exclusive breastfeeding (EBF) rates in the world. Prelacteal feeding practices may contribute to low EBF rates, but research on the barriers related to EBF in Niger is limited. Objective The purpose of this study was to identify socio-cultural determinants for, and barriers to, EBF during an infant’s first 6 months through maternal perspectives in Niamey, the capital of Niger. Methods Participants were mothers with children aged 0 to 24 months in Niamey, Niger. Participants completed an interview including a 20-item questionnaire on socio-demographics, breastfeeding support and knowledge, a short food security survey, and a 24-hour diet recall. Infant anthropometric data (height, weight, upper arm circumference) was collected from patient records. Results All participants (n=31) breastfed and a majority of the mothers were planning to breastfeed until the child reached 18 months old. No mother among the participants practiced EBF for the recommended 6 months because of the common practice of prelacteal feeding, where solid or liquid foods were introduced before 6 months of age. Most participants stated that they were instructed on how to feed their child by a close relative such as their mother or sister, while health professionals rarely gave such instructions. Conclusions Exclusive breastfeeding is not a common practice among mothers in Niamey. Even though many breastfeed their infant for a relatively long duration, the participants disclosed that they often feed their infants solid and liquid foods before they reach the recommended age for complementary feeding, and sometimes within 48 hours after birth. Study results may inform the development of breastfeeding education components in clinics where mothers attend pre and postnatal consultations.
... 7 Population health approaches based on theoretical models such as the social-ecological approach highlight the importance of influencing behavior at multiple levels, including at the individual, interpersonal, and organizational levels. 8 Developing environmental and cultural supports in the workplace that promote the adoption and maintenance of healthy behaviors can impact employees' overall wellbeing. 9 Culture of health is defined as the combined influences of the social and physical environment on attitudes and behaviors related to health and wellbeing. ...
Objective:
This study aimed to review existing measures of workplace culture of health and to examine the health and wellbeing outcomes associated with workplace culture of health.
Data sources:
PubMed/Medline, Web of Science, and PsycINFO databases searched through February 2022.
Study inclusion and exclusion criteria:
Articles were included if they used a specific measure to assess culture of health in the workplace and were published in English. Articles were excluded if there was no quantitative measure of health culture.
Data extraction:
Data from each article was extracted using a structured template which included study purpose, participants and setting, study design, intervention strategies (if applicable), culture of health measure, and results.
Data synthesis:
We described culture of health measures used and summarized key findings from included articles.
Results:
The search yielded 31 articles measuring workplace culture of health (three validation, two intervention, and 26 observational studies). Nineteen unique measures were used across all articles. Most studies examined culture of health from the employee perspective (n = 23), while others examined it at the organizational level (n = 7). The studies indicated a positive relationship between health and well-being outcomes and a strong workplace health culture.
Conclusion:
There are many different approaches to measuring workplace health culture. Overall, workplace culture of health is related to positive employee and organizational health and wellbeing outcomes.
... The agricultural health and safety literature has largely sought to understand the reasons why farm parents are not adopting these farm safety practices through a focus on their farm safety knowledge and behaviours (Lee, Jenkins, and Westaby 1997;Pickett, Marlenga, and Berg 2003;Westaby and Lee 2003) as well as their social and cultural norms (Neufeld, Wright, and Gaut 2002;Zepeda and Kim 2006;Elliot et al. 2018;Shortall, McKee, and Sutherland 2019). The context in which farm parents make farm safety decisions and the ways in which farm parents make sense of their decisions have received much less attention (Gallagher 2012;Lee et al. 2017;Elliot et al. 2018). Furthermore, we have yet to understand the extent to which farm parents are able and/or willing to use childcare to keep their children safe despite evidence from a range of countries that childcare is costly and/or unavailable (Ogbimi 1992;Shortall et al. 2017;Inwood and Stengel 2020). ...
Scholars have noted persistent high rates of agricultural health and safety incidents and the need to develop more effective interventions. Participatory research provides an avenue to broaden the prevailing research paradigms and approaches by allowing those most impacted to illuminate and work to solve those aspects of their lives. One such approach is photovoice, an emancipatory visual narrative approach. Yet, despite its broad appeal, photovoice can be hard to implement. In this article, we leverage our experience using photovoice for a farm children safety project to describe and reflect on the ethical and methodological aspects broadly relevant to agricultural health and safety topics. We first contextualize the tensions of navigating between photovoice, the research ethics committees (RECs) regulatory frameworks, and competing views on visual representations in agriculture. We then discuss the sources of risks to participants and researchers, how we addressed these risks, and how these risks unfolded during the research phase of the photovoice activity. We conclude with three lessons we (re)learned: the importance of collaborating with RECs, the need to increase preparation to limit psychological risks to participants and researchers, and avenues to augment the emancipatory power of photovoice in a virtual environment.
