Deck 3: Ecological Models of Health Behavior

Question 1

Which is NOT one of the five core principles of ecological models of health behavior?

A) Influences on health behaviors interact across levels
B) Models should be behavior-specific
C) Multiple levels of influence act on health behaviors
D) Controlled trials are most effective to evaluate multi-level interventions
E) Environmental contexts are important determinants of health

Answer 1

Controlled trials are most effective to evaluate multi-level interventions

Question 2

Which of the following is a strength of multi-level interventions?

A) They are easily evaluated using experimental study designs
B) They are recognized as effective and therefore they are easier to fund than interventions that do not address multiple levels
C) They provide a broad range of options for intervention
D) They are most effective when they target health behaviors in specific and high-risk populations
E) Their specificity facilitates understanding of how constructs interact across the multiple levels

Answer 2

They provide a broad range of options for intervention

Question 3

Ecological model interventions are considered necessary for solving some of the most important public health problems of the 21^st century, however they are not appropriate for all health issues. Which of the following health problems would NOT be easily conducive to an ecological intervention?

A) HIV/AIDS
B) Violence prevention
C) Schizophrenia
D) Diabetes
E) Alcohol use

Answer 3

Schizophrenia

Question 4

Which of the following statements is TRUE about ecological model interventions?

A) Most evidence of effectiveness has come from cross-sectional studies
B) It is difficult to integrate individual level theories into ecological model interventions
C) Although widely used, there is little evidence of their effectiveness in improving health outcomes
D) Individual level changes are likely more effective in promoting sustained behavior change than environmental and policy levels changes
E) Ecological models are widely used and most national funding agencies prefer funding multi-year studies

Question 5

Which of the following statements is FALSE about ecological models?

A) They are meta-models, organizing other models/theories into a coherent whole
B) Each level is considered a variable and there is a clear relationship between each level
C) They can be applied to research design and/or intervention development.
D) Different models must be developed for interventions targeting different health behaviors
E) Interventions are more likely to succeed when multiple levels of the ecological model are addressed

Question 6

Ecological model interventions have proven effective in reducing the prevalence of smoking in industrialized countries. Which of the following is NOT an example of a smoking reduction intervention and corresponding level of the ecological model?

A) Mass media campaigns: community/policy level
B) Clinical smoking cessation: individual level
C) Cigarette taxes: policy level
D) Tobacco warning labels: policy level
E) Smoke-free restaurants and workplaces: intrapersonal level

Question 7

Urban planning, including access to and type of transportation, parks and trails, and building design, is an important foundation for ecological interventions to increase physical activity. Which of the core principles of ecological models is best reflected in urban planning as a component of decreasing sedentary behaviors (choose one)?

A) Environmental contexts are significant determinants of health behaviors
B) There are multiple levels of influence on specific health behaviors
C) Ecological models should be behavior-specific
D) Multi-levels interventions are most effective in changing health behaviors
E) Interdisciplinary approaches are necessary for health behavior change

Question 8

One of the challenges researchers face in using ecological frameworks to is that certain characteristics are difficult to manipulate experimentally. All of the following are examples of characteristics that are difficult to manipulate EXCEPT:

A) Increasing the cost of cigarettes to reduce number of cigarettes smoked
B) Improving housing standards for new homes to reduce asthma attacks
C) Increasing parental knowledge and changing attitudes toward asthma to reduce household asthma attacks
D) Prohibiting smoking in public facilities to reduce second hand smoke exposure
E) Increasing access to safe green spaces to promote physical activity

Question 9

Comparing ecological models implemented across different geographical regions (e.g. international contexts) provides a solution to which difficulty associated with ecological interventions?

A) A lack of variation in beliefs or behaviors among intervention participants
B) Obtaining human subjects (or IRB) approval for ecological studies in the United States
C) Implementing policy-level interventions
D) Large sample size
E) Selection bias of study participants

Question 10

Which is a barrier of implementing ecological model interventions?

A) Multiple levels of intervention broaden options for intervention and slow down the process of selecting appropriate interventions
B) They are typically more expensive and time consuming compared to single-level interventions
C) There is little evidence that they are effective in changing health behaviors or improving health outcomes
D) The World Health Organization and the Centers for Disease Control and Prevention oppose funding ecological interventions

Question 11

Ecological models place greater importance on policy and environmental interventions than on individual and interpersonal interventions.

Question 12

Several national and international health agendas (e.g. Healthy People 2020, WHO Framework Convention on Tobacco Control) reflect the ecological perspective.

Question 13

It is not recommended that individual theories, such as the Health Belief Model, be used in conjunction with ecological models.

Question 14

Ecological models are more useful for research design than for intervention design.

Question 15

One strength of ecological models is that they provide a framework to test the variables most influential in changing behaviors.

Question 16

One limitation of ecological models is that many grant agencies have budgetary and timeline requirements incompatible with ecological research.

Question 17

Scientists are typically able manipulate community and policy level variables, making ecological models appropriate for controlled experiments.

Question 18

Ecological models have proven useful in interventions related to obesity, childhood asthma, and physical activity.

Question 19

Programs targeting one or two levels of the ecological framework are more effective in changing behavior than interventions that focus on three or four levels because resources are more focused.

Question 20

Once an ecological intervention is found to positively influence health behaviors, it is straightforward to identify the most important elements of the intervention.

Question 21

Choose a specific health problem/outcome and population of your choice. Using an ecological model framework, describe an intervention to reduce this problem. Be sure to mention an intervention at each level of the framework.(Ex: Reducing fatal traffic accidents among adolescent boys in the United States). Note: Do not select one of the health conditions discussed in detail in Chapter 3 (physical activity, tobacco use, obesity).

Question 22

Write two-three paragraphs outlining strengths and limitations of an ecological approach to health promotion. Use specific examples.