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Ecological Model
The Ecological model comprehensively addresses public health problems such as injury at
multiple levels. [17] These levels highlight the interaction and integration of biological,
behavioural, environmental andsocial determinants, as well as the influence of organisations(eg. workplace and schools), other persons (eg. family, friends and peers), and public policies
all of which together help individuals make healthy choices in their daily lives. [18] A key
feature is that it highlights how health and wellbeing are affected by changes and interactions
between all these factors over the course of one's life. [19]
Specific to injury prevention, Hanson et al proposes a visual metaphor,the injury icebergto
assist understanding of the important characteristics of the Ecological model.
Three dimensions to this model can be identified as:
1. The individual and their behaviour2. The physical environment3. The social environment
Each dimension can then be analysed at five levels:
1. Intra-personal2. Inter-personal3. Organisational4. Community5. Society
The individual and their behaviour is, metaphorically speaking, the tip of the iceberg as it is
the most visible component, with important determinants of their behaviour and
environmental risk hidden below the waterline .
An injury event rarely occurs as a consequence of an isolated failure at one level only. Rather
injuries result from a combination of latent failures which may be environmental,
organisational or social (eg. decisions made by builders, designers, managers etc) along with
counterproductive behavioural responses of individuals (active failures).
"The 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 accident event, identifying upstream latent failures
along with the more obvious active failures. Identifying the most strategic links (leverage
points) will ensure effective action". [21]
Example of the Ecological Model as applied to child injury prevention
Level Examples
Intra-personal: relates to the "characteristics
of the individual, their knowledge, skills, life
experience, attitudes and behaviours as theyinterface with the environment and society"
A person interested in child safety, attending
an information session run by Antenatal
Nurse Educators. The belief that it is anadult's role to protect children from injury.
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[20]
Interpersonal: relates "to the immediate
physical environment and social networks in
which an individual lives" [20]
Support by partner and friends for choice to
purchase a new Australian Standard child
restraint as opposed to picking one up from
the second-hand sector.Organisational: refers to commercial
organisations, social institutions, associations
and clubs which have structure, rules and
regulations enabling them to pursue specific
objectives and have direct influence over the
physical and social environments maintained
within their organisation [20]
Maternity Hospitals that have a policy that
newborns are transported home only after the
midwives checks that they are being
transported in an approved child restraint.
Community: "may be defined in both
structural and functional terms" [20]
The playgroup parents' talk informally about
how they have seen other parents not restrain
their children in a vehicle and how dangerousthat is.
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" [20]
National Road Rules that require children to
be restrained in a vehicle using an Australian
Standard child restraint appropriate for the
child's weight and height.
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