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The ecological models of health behavior (EM) highlights the correlation between environmental and policy factors of behavior while incorporating the individuals’ interaction with the physical and socio-cultural environment as it is used as an intervention on health behavior. The model also highlights the individuals’ characteristics, their skills, and proximal social influences, such as families and friends (Glanz et al., 2015).

The EM has 5 principles; principle 1 states that there are multiple levels that influence health behavior. These levels are intrapersonal (biological and psychological), interpersonal (social and cultural), organizational, community, and public policy levels which creates inclusivity that distinguishes the EM from other theories and interpersonal models of behaviors that focus on one or two levels. Principle 2 states that environmental contexts are significant determinants of health behavior. This principle focuses on behavior setting which states behavior can be predicted based on the situation (social or physical) the individual is from which makes intervention possible. Therefore, this principle uses environmental factors to shape or restrict individuals and interpersonal determinants of health behavior (Glanz et al., 2015). Principle 3 states that influences on behavior interact across levels. This means behavior change can occur based on the interaction across the multilevel of the EM. Principle 4 states that ecological models should be behavior specific. This means research and intervention methods are more tailored towards specific health behavior. Principle 5 states that multilevel intervention should be most effective in changing behaviors. This means multilevel intervention is more superior and effective than single-level intervention when targeting behavior change. Therefore, a key strength for the EM is its focus on multiple level influence, which gives more options for intervention. However, the EM strength is also its weakness; its span across many levels in an effort to provide many options for behavior intervention, correlating with the lack of specificity of the construct for the interaction across levels, causes issues when trying to improve intervention (Glanz et al., 2015).

This model is effective in tobacco control through many effective components, such as clinical smoking cessation programs (nicotine replacement skin patch), mass media campaigns (television smoking cessation advertisements), and regulatory efforts to restrict opportunities for smoking (age limit 18+). Additionally, economic approaches that make cigarettes more expensive (higher taxation), and comprehensive multilevel programs combining all approaches (principle 5) (Borland et al., 2010) (Mercer et al., 2003). Another model that is effective is the transtheoretical model because it is a commonly used intervention method for smoking cessation by using its stages of change to alter behavioral change. The health belief model can also be used for this behavioral change because the models focus on motivation and self-efficacy (Roberts et al., 2013).

Reference

Borland, R., Young, D., Coghill, K., & Zhang, J.Y. (2010). The tobacco use management system: Analyzing tobacco control from a systems perspective. American Journal of Public Health, 100(7), 1229–1236. DOI: 10.2105/AJPH.2009.165910

Glanz, K., Rimer, B. K., & Viswanath, K. (2015). Health behavior: Theory, research, and practice (5th ed.). San Francisco, CA: Jossey-Bass.

Mercer, S.L., Green, L. W., Rosenthal, A.C., Husten, C. G., Khan, L. K., & Dietz, W. H. (2003). Possible lessons from the tobacco experience for obesity control. American Journal of Clinical Nutrition, 77(Suppl.4), 1073S–1082S. doi: 10.1093/ajcn/77.4.1073S

Roberts, J. N., Kerr, M. S., & Smith, S. (2012). Behavioral Interventions Associated with Smoking Cessation in the Treatment of Tobacco Use. Health Services Insights, 6, 79-85. Doi: 10.4137/HSI.S11092

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