Using a socio-ecological approach to inform health interventions

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1 Using a socio-ecological approach to inform health interventions Dr Rachel Brown, Research Associate. Brownr14@Cardiff.ac.uk

2 Aims of the session: Understand use of socio-ecological framework to map out influences on a public health problem (alcohol) Understand use of the socio-ecological approach to target health promotion activities Be able to consider your own work from an ecological perspective

3 The whole concept of public health is founded on the insight that health and illness have causes or conditions that go beyond biology and behaviour of the individual human being Midgely, 2006 Ecological approaches in Public Health

4 Adapted from McLeroy, K. R., Steckler, A. and Bibeau, D. (Eds.) (1988). The social ecology of health promotion interventions. Health Education Quarterly, 15(4): Retrieved May 1, 2012, from

5 Potential applications of the socio-ecological approach 1. To understand influences on behaviour 2. To target activities/interventions and define outcomes 3. To understand level of impact of an intervention

6 Influences on alcohol use a. Intrapersonal level beliefs, norms and values, motivation etc. b. Interpersonal level social relationships with family, peers, colleagues c. Institutional/organisational level formal and informal rules in operations. d. Community level structures and services present e. Policy level local and national guidance and legislation

7 Intrapersonal level: Transition to university as cause of anxiety drink to bond Heavy drinkers often report higher levels of satisfaction with social integration Positive drinking experiences more influential than negative Willingness to accept negative consequences

8 Interpersonal level: Drinking together - social lubricant (Seaman & Ikegwuonu, 2011). Parental drinking complex picture? Peers - heavy drinkers like heavy drinkers! Help-seeking behaviour

9 Organisation/structural: Residence halls are a key setting for heavy drinking Pre-loading is the norm among students Frequency of alcohol promotions and advertising is correlated with heavy drinking Freshers student expectations and local benefits

10 Community: More alcohol retail outlets = consumption Lack of data on student access to specialist services Real economic benefit of student drinking in the local area National policy: Pricing cheap off-sales MUP? Healthy FE/HE Framework

11 2. What are you aiming to do?

12 3. Targeting alcohol interventions - examples Intrapersonal drink responsibly. Motivational approaches. Interpersonal designated driver campaigns, take care of your mates. Organisational no below cost selling or promotions Community enforcement of licensing conditions, Night-time economy initiatives National/policy bans on below cost selling, minimum pricing?

13 Barriers to effectiveness: Intrapersonal different beliefs to you Interpersonal - peer group bonding aided by alcohol use Organisational are your practices data driven? Timing and noise of Freshers. Community marketing by local retailers, joined up working National challenging cultural norms is very difficult

14 Any questions? References: McLeroy, K. R., Steckler, A. and Bibeau, D. (Eds.) (1988). The social ecology of health promotion interventions. Health Education Quarterly, 15(4): Retrieved May 1, 2012, from Seaman, P. & Ikegwuonu, T. (2011). 'I don't think old people should go to clubs': How universal is the alcohol transition amongst young adults in the United Kingdom. Journal of Youth Studies 14(7),

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