An Ecology Perspective on Health Promotion Programs

Department of Public Health Education, University of North Carolina, Greensboro 27412.
Health education quarterly 02/1988; 15(4):351-77. DOI: 10.1177/109019818801500401
Source: PubMed


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.

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    • "Built environmental factors (e.g., sidewalks, crosswalks, crossing lights, benches, lighting ) are important predictors of physical activity, especially for older adults whose daily activities often contract to more immediate surroundings (e.g., home environment, neighbourhood) due to aging-related functional and mobility challenges (e.g., Carlson et al., 2012; Haselwandter et al., 2014; Rosso et al., 2011; de Melo et al., 2010). This study is conceptually informed by the social-ecological perspective of the older adult individual having complex interrelations among the intrapersonal, social and physical environment of a neighbourhood in order to understand health behaviour in older adults (e.g., Locher et al., 2011; McLeroy et al., 1988; Sallis and Owen, 1999; Sylvie and Cohen, 2013; Yeom and Colleen, 2008). Intrapersonal factors related to physical activity include age, sex, socioeconomic status, educational level, marital status, chronic illness, functioning level, self-efficacy, lifestyle factors (e.g., physical inactivity, obesity). "
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    ABSTRACT: Rationale.: The neighbourhood socio-physical environment has effects on health in later life including health behaviours, chronic illnesses, mental health and mortality. Few studies have examined the relationship of both physical environmental features and social aspects of neighbourhood with older adults' physical activity. Objective: This study examined the relationship of neighbourhood physical and social environment with physical activity among older adults. Methods: A cross-sectional telephone survey was conducted with 434 older adults in eight neighbourhoods in greater Vancouver, Canada and Portland, United States. Data included participants' perceptions of their neighbourhood built and social environment factors and levels of physical activity. A logistic regression analysis was conducted to understand the relationship between these factors. Results: Participants engaged in physical activity most frequently at home (87.1%) or in close proximity of home (76.5%). Neighbourhood walkability, presence of amenities and accessibility were not significantly associated with meeting physical activity requirements. Participation in a recreational program with friends was associated with increased likelihood of physical activity. Conclusion: The home and its immediate physical environmental context has potentially important relevance in supporting physical activity in older adults. Also, neighbourhood social aspects have a positive influence on activity levels.
    Full-text · Article · Jan 2016 · Social Science & Medicine
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    • "Our research is grounded on the framework provided by social ecological models of health behavior (McLeroy et al., 1988;Stokols, 1992;Richard et al., 2011). This theory has been widely integrated into the field of public health and used to guide behavioral interventions (Stokols, 1996;Sallis et al., 2008) including promotion of walking and cycling (Saelens et al., 2003;Ogilvie et al., 2011). "
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    ABSTRACT: Walking, as both a major mode of transport and the most common form of every-day physical activity, deserves further attention in health-related transportation studies. In this paper, we focused on the built environmental correlates of walking for errands and leisure in a sample of 4979 adults (Paris, France) through a cross-sectional study based on an internet survey. The main aims were (i) to delineate places with contrasting relationships between the built environment and walking, using geographically weighted regression models and (ii) to determine what differentiated the contexts we uncovered, in terms of both environmental and individual characteristics, using canonical discriminant analyses. Our results showed that the spatial heterogeneity of relationships between walking and the built environment occurred across the entire studied area and concerned the two walking outcomes, with odds-ratios (ORs) ranging from 1.01 to 1.31 and from 1.07 to 1.35 for walking for errands and leisure, respectively. We suggest that the spatial patterning of convergent relationships is due to contextual effects, i.e., the effect of places with specific intrinsic arrangement of environmental and individual features. Data-driven identification of local contexts should be a key step in future contextual analyses of walking and health-related outcomes.
    Full-text · Article · Jan 2016
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    • "Grounded theory guided the way we collected and analyzed the data for our study; it was employed as a means to generate theories directly from the data, which is appropriate for this exploratory small-scale study focused on providing a pragmatic approach to addressing community needs (Denscombe, 2010). The socioecological model provided orientation for the development of our interview questions, as capacity is present across the spectrum of the socioecological model of community , from intrapersonal to public policy levels (McLeroy, Bibeau, Steckler, & Glanz, 1988). "
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    ABSTRACT: Foundations and government agencies have historically played a critical role in supporting community-based health promotion programs. Increased access to health promotion funding may help address significant health issues existing within American Indian (AI) communities, such as childhood obesity, type 2 diabetes, and cardiovascular disease. Understanding the capacity of AI communities to successfully apply for and receive funding may serve to increase resources for health promotion efforts within AI communities in Montana. This exploratory qualitative study completed 17 semistructured interviews across three AI reservations in the state of Montana. Dimensions of community capacity within the context of the funding application process and partnership with funding agencies were identified, including resources, leadership, community need, networks, and relationship with the funding agency. Dimensions of AI community capacity were then used to suggest capacity-building strategies for improved partnership between AI communities in Montana and the funding agencies.
    Full-text · Article · Jan 2016 · Health Promotion Practice
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