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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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