Stay On Your Feet® - Ecological model

Context

The Ecological model comprehensively addresses public health problems, such as injury, at multiple levels [47].

These levels highlight the interaction and integration of biological, behavioural, environmental and social determinants of health, as well as the influence of organisations (for example: workplace and schools), other people (for example: family, friends and peers) and public policies, all of which together help individuals make healthy choices in their daily lives [48].

A key feature of the ecological model is that it highlights how health and wellbeing are affected by changes and interactions between all of these various factors over the course of a person’s life [20].

Specific to injury prevention, Hanson et al [48] propose a visual metaphor, the injury prevention iceberg, to assist in understanding the important characteristics of the ecological model.

The three dimensions to this model can be identified as:

  1. the individual and their behaviour
  2. the physical environment
  3. the social environment.

Each dimension can then be analysed at five levels:

  1. intra-personal
  2. inter-personal
  3. organisational
  4. community
  5. society.

The individual and their behaviour is, metaphorically speaking, the tip of the iceberg, as it is the most visible component.  Important determinants of their behaviour and environmental risk are hidden below the waterline [49].

By applying Hanson et al’s ecological model to falls prevention, it can be seen that a fall rarely occurs as a consequence of an isolated failure at only one level.  

Rather, falls result from a combination of hidden failures which may be environmental, organisational or social, including decisions made by builders, designers and managers, along with counterproductive behavioural responses of individuals, such as not staying active.

"The Ecological model provides a complex web of causation and creates a rich context for intervention. It can be used to map the key links in an injury event, identifying upstream latent failures along with the more obvious active failures. Identifying the most strategic links (leverage points) will ensure effective action"[49].

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Example

Example of the ecological model as applied to falls prevention for older people.

 

 Level  Example

Intra-personal:
relates to the "characteristics of the individual, their knowledge, skills, life experience, attitudes and behaviours as they interface with the environment and society" [49]

The personal belief that an older person can maintain a strong degree of independence, free from falls and other injuries if they have a varied diet high in calcium and vitamin D, engage in regular physical activity which includes strength and balance and take appropriate precautions around the home and in public places.

Interpersonal:
relates "to the immediate physical environment and social networks in which an individual lives" [49]

Support by a partner, friend or family members to undertake a new physical activity program, including having safe access and transport to the physical activity program.

Organisational:
refers to "commercial organisations, social institutions, associations and clubs which have structure, rules and regulations enabling them to have pursue specific objectives and have direct influence over the physical and social environments maintained within their organisation" [49]

 Sporting clubs have an active outreach policy seeking to encourage and support as many recreational options as possible for people of all ages and all levels of ability.
Local shopping centres have wide aisles for wheelchairs, all goods and produce are reachable, they offer physical activity program such as mall walking or Tai Chi and other facilities are available for older shoppers such as rest areas and regularly spaced seats.

Community:
"may be defined in both structural and functional terms" [49]

 A Safe Communities approach is adopted by the local council and other key stakeholders which includes a focus on seniors safety.
Free transport options are available for older people to access shopping, recreation and other group activities. A range of suitable and safe venues are available for activities tailored for older people.
All stairs in public places have contrasting strips on the edge of each stair and adequate balustrading.

Society:
refers to a "larger system, often defined along political boundaries, possessing the means to distribute resources and control the lives and development of their constituent communities" [49]

 Older people are treated with care and respect by all segments of society and are actively represented in government, cultural and sporting bodies and community service organisations.
The opinions and ideas of older people are actively sought when developing any relevant policy or program initiative.
Older people are engaged, organised and actively participate in political, social and cultural processes.

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Last updated: 3 October 2013