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 and social 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 iceberg to assist understanding of the important characteristics of the Ecological model. Three dimensions to this model can be identified as: 1. The individual and their behaviour 2. The physical environment 3. The social environment Each dimension can then be analysed at five levels: 1. 2. 3. 4. 5. Intra-personal Inter-personal Organisational Community 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 Intra-personal: relates to the "characteristics of the individual, their knowledge, skills, life experience, attitudes and behaviours as they interface with the environment and society" Examples A person interested in child safety, attending an information session run by Antenatal Nurse Educators. The belief that it is an adult's role to protect children from injury.

[20] Interpersonal: relates "to the immediate physical environment and social networks in which an individual lives" [20] 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] Community: "may be defined in both structural and functional terms" [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. 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.

The playgroup parents' talk informally about how they have seen other parents not restrain their children in a vehicle and how dangerous that is. 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.

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] top of page