We Feel Connected Do You

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We Feel Connected Do You?

• Welcome to the Washington Coalition of Sexual
  Assault Programs Prevention Webinar or Dialogue!
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Prevention Webinar Series Frameworks.
2006-2007

• framework freym-wurk (Pronunciation Key)  n.
• A structure for supporting or enclosing something
  else, especially a skeletal support used as the
  basis for something being constructed.
• An external work platform a scaffold.
• A fundamental structure, as for a written work.
• A set of assumptions, concepts, values, and
  practices that constitutes a way of viewing
  reality.

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Training Objectives

• Participants will be able to define an ecological
  model.
• Participants will be able to identify the four
  level social-ecological model.
• Participants will be able to apply the
  social-ecological model to their existing sexual
  violence prevention strategies.

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Model Overview

• Social Ecological Model

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What is an ecological model?

• Ecological Models are comprehensive health
  promotion models that are multifaceted, concerned
  with environmental change, behavior, and policy
  that help individuals make healthy choices in
  their daily lives.

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Comprehensive
comprehensive        (kom'pri-hen'siv)
 Pronunciation Key  adj.   1. So large in scope
or content as to include much a comprehensive
history of the revolution. 2. Marked by or
showing extensive understanding comprehensive
knowledge.
Health Promotion
"Health promotion is the science and art of
helping people change their lifestyle to move
toward a state of optimal health.  Optimal health
is defined as a balance of physical, emotional,
social, spiritual, and intellectual health. 
Lifestyle change can be facilitated through a
combination of efforts to enhance awareness,
change behavior and create environments that
support good health practices.  Of the three,
supportive environments will probably have the
greatest impact in producing lasting change". 
(American Journal of Health Promotion, 1989,3,3,5)
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Defining features

• The defining feature of an ecological model is
  that it takes into account the physical
  environment and its relationship to people at
  individual, interpersonal, organizational and
  community levels.
• The philosophical underpinning is the concept
  that behavior does not occur within a vacuum

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Underlying assumptions

• Behaviors are influenced by intrapersonal,
  social, cultural, and physical environment
  variables
• Variables are likely to interact
• Need to address variables at multiple levels to
  understand and change health behaviors
• There are multiple levels of influence ranging
  from individual, to public policy

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Characteristics

• Influencing behaviors happens on multiple levels.
  Interpersonal factors, social and cultural
  environments, and physical environments can
  influence health behaviors
• Influences rarely affect single levels. To be
  useful in designing studies and interventions,
  the model should predict how the categories of
  behavior determinants interact.
• Environments directly influence behaviors. 
  Environment space outside the individual.
  Ecology interrelations between organisms and
  their environments

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What is a social ecological model?

• An ecological model with a focus on social
  factors
• In traditional ecological environments
  traditionally have referred to ones physical
  environment

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Common depictions

• Five levels
• Individual Intrapersonal factors
• Relationship Interpersonal factors
• Institutional Organizational factors
• Community factors
• Societal/Public Policy

• Four level
• Individual Intrapersonal factors
• Relationship Interpersonal factors
• Community factors
• Societal/Public Policy

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Social ecological model
Societal
Community
Institutional
Relationship
Individual
Five Level
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Social ecological model
Societal
Community
Relationship
Individual
Four Level
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Levels
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Individual level

• Interpersonal
• Encompasses the knowledge, attitudes and skills
  of the individual
• Psychological theories foundational
  implementation

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Relationship level

• Interpersonal
• High level of importance in health related
  behavior.
• Includes family, friends, intimate partners
• Many behaviors are profoundly shaped by families
  particularly those habits learned early in life
• Social networks key

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Institutional

• Organizations
• Strategies will similar to those instituted at
  community and societal spheres (4 step model does
  not include this level)
• Significance in 5 step models attributed to the
  fact that people spend one-third to one-half in
  institutional settings, particularly schools and
  workplaces.

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Community

• Larger community
• Of particular significance in that organizations
  and individuals within a community can work
  together to promote healthy goals
• Community norms influential at this level

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Societal

• Social norms
• Public Policy
• Regulations and limitations on behaviors
• Usually the most explicit and controversial
  measure that, local, state and national
  governments take to promote healthy behavior
• Laws, regulations, restrictions

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Application to sexual violence

• Sexual Violence Prevention Beginning the Dialogue
• Centers for Disease Control

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What is the target level of our interventions
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Individual
Societal
Community
Relationship
Individual

• Individual-level influences are biological and
  include personal history factors that increase
  the likelihood that an individual will become a
  victim or perpetrator of violence. For example,
  factors
• such as alcohol and/or drug use
• attitudes and beliefs that support sexual
  violence impulsive and other antisocial
  tendencies
• preference for impersonal sex
• hostility towards women
• Childhood history of sexual abuse or witnessing
  family violence may influence an individuals
  behavior choices that lead to perpetration of
  sexual violence (Dahlberg and Krug 2002).
• Interventions for individual-level influences are
  often designed to target social and cognitive
  skills and behavior and include approaches such
  as counseling, therapy, and educational training
  sessions (Powell et al.1999).

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Relationship
Societal
Community
Relationship
Individual

• Interpersonal relationship-level influences are
  factors that increase risk as a result of
  relationships with peers, intimate partners, and
  family members. A persons closest social circle
  peers, partners, and family memberscan shape the
  individuals behavior and range of experience
  (Dahlberg and Krug 2002)
• Interventions for interpersonal
  relationship-level influences could include
  family therapy, bystander intervention skill
  development, and parenting training (Powell et
  al. 1999)

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Community
Societal
Community
Relationship
Individual

• Community-level influences are factors that
  increase risk based on community and social
  environments and include an individuals
  experiences and relationships with schools,
  workplaces, and neighborhoods.
• For example, lack of sexual harassment policies
  in the workplace can send a message that sexual
  harassment is tolerated, and that there may be
  few or no consequences for those who harass
  others.
• Interventions for community-level influences are
  typically designed to impact the climate,
  systems, and policies in a given setting.

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Societal
Societal
Community
Relationship
Individual

• Societal-level influences are larger, macro-level
  factors that influence sexual violence such as
  gender inequality, religious or cultural belief
  systems, societal norms, and economic or social
  policies that create or sustain gaps and tensions
  between groups of people. For example, rape is
  more common in cultures that promote male sexual
  entitlement and support an ideology of male
  superiority (Dahlberg and Krug 2002).
• Interventions
• Policy focused interventions typically involve
  collaborations by multiple partners to change
  laws and policies related to sexual violence or
  gender inequality.
• Social norm focused intervention would be to
  determine societal norms that accept violence and
  to identify strategies for changing those norms
  (Powell et al. 1999).

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When do we intervene?
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Points of intervention

• 3 points of intervention
• Primary
• Primary prevention measures include activities
  that help avoid a given health issue
• Secondary
• Early intervention activities for health issues
  with significant risk for negative outcome
  without intervention.
• Tertiary
• Activities focused on providing care to
  individuals experiencing the health issue with
  attempts made to restore to highest function,
  minimize the negative effects

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Primary intervention Examples
Primary
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Secondary tertiary intervention examples
Secondary
Tertiary
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Who is the focus of our intervention?
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Universal, selected and indicated

• Prevention strategies are often developed based
  upon the group for whom the intervention is
  intended. Using this type of differentiation,
  sexual violence interventions can again be
  divided into three categories
• universal Approaches that are aimed at groups or
  the general population regardless of individual
  risk for sexual violence perpetration or
  victimization
• Defined geographically (e.g., entire school or
  school district)
• Defined by characteristics (e.g., ethnicity, age,
  gender)
• selected Approaches that are aimed at those who
  are thought to have a heightened risk for sexual
  violence perpetration or victimization
• indicated Approaches that are aimed at those who
  have already perpetrated sexual violence or have
  been victimized

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Examples of universal strategies
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Examples of selected strategies
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Examples of indicated strategies
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Implications for application

• In applying the socio-ecological model we should
  be clear about the
• Who
• What
• When
• Although there is a specific strategy and focus
  interventions will have broader implications

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The social ecological model supports a
comprehensive public health approach that not
only addresses an individuals risk factors, but
also the norms, beliefs, and social and economic
systems that create the conditions for the
occurrence of sexual violence.
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Questions, Thought Comments

• Lydia Guy
• lydia_at_wcsap.org
• [phone]

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Resources

• Intro to Public Health
• Mary-Jane Schneider
• 2006 Jones Bartlett Publishers
• Sexual violence prevention beginning the
  dialogue
• Centers for Disease Control and Prevention.
• Atlanta, GA Centers for Disease Control and
  Prevention 2004.

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Evaluations

• You will receive an email with the link to
  complete the evaluation