Environmental Toxins: Physical, Social, and Emotional

Public Health Action Model for Cancer Survivorship.

In this review, we propose a social ecological constraint model to study inclusion of overweight or obese students in physical education by integrating key concepts and assumptions from ecological constraint theory in motor development and social ecological models in health promotion and behavior. The social ecological constraint model proposes that constraints exist on five different levels and interact within and across levels to affect overweight students’ engagement, learning, and physical activity in physical education. This model can provide a theoretical framework to guide and organize research on the inclusion of overweight students. It can also guide teachers in manipulating these constraints to create a culture for inclusion and provide instruction to meet the needs of overweight or obese students.

Introduction Physical activity is vital for supporting holistic well-being. However, undergraduate university students often report low levels of participation, which has a detrimental influence on psychosocial factors (such as mental health, motivation, and social support). Limited studies have critically applied the Social Ecological Model to understand physical activity participation and psychosocial factors among students. Methods This up-to-date critical narrative review explores the application of the Social Ecological Model to understand undergraduate university students’ physical activity levels and psychosocial factors. Databases (Google Scholar, PubMed, and SPORTDiscus) were searched to identify relevant studies published in English and available in full text, using key terms such as “social-ecological model,” “physical activity,” “exercise,” “psychosocial factors,” “undergraduate,” “university,” and “students.” Articles were selected based on their relevance to the Social Ecological Model framework and physical activity. Results The review highlights key psychosocial factors, including mental health, motivation, and social support. Barriers, such as academic pressures, inadequate resources, and unsupportive environments, are also explored within the Social Ecological Model framework. While the model offers valuable insights into diverse influences on physical activity, this study critiques its limitations, particularly its limited consideration of cultural and technological factors that shape students’ contemporary experiences. Conclusion This review highlights the value of the Social Ecological Model in understanding the factors that influence physical activity levels among undergraduate university students. University policies should adopt a multi-level approach to promote physical activity. Future research should address the model’s gaps regarding cultural diversity and technological influences to refine the model and inform tailored physical activity promotion strategies.

From the public health perspective, the issue of gun violence could be evaluated based on the theoretical framework of social ecological model (SEM) by the Center for Disease Control and Prevention (CDC). The SEM uses four levels of influence to describe a framework that identifies factors that either places a person at-risk for or guards them from being subjected to or causing a health problem such as violence. The levels of influence in the SEM structure include the individual or intrapersonal, relationships or interpersonal, community, and society (see Figure A1 in Appendix). Each level represents a key point in the process of violence, and thereby, offers an opportunity to intervene in violence for prevention. The framework also provides a tool to use in evaluation of public health issues of firearm violence. Controlling gun violence is a complex and formidable task. It is well established that multi-level approach is needed to end gun violence. We provided some suggestions for policymakers and practitioners based on the SEM. The association between violence and the interaction between different factors, from individual to societal, suggest that addressing risk factors or devising prevention plans across various levels of the SEM may lead to decrease in incidences like Sandy Hook massacre and Navy Yard shooting. However, we acknowledge that implementing all these suggestions at a time is practically impossible. Since we don’t have a false proof mechanism to identify and intervene with people who might be potential culprits, the initial step should be to prevent the weapons getting into the hands of these people. This initial steps could be achieved by changing the social norms on guns and implementing some immediately workable policies. As the norm on the propriety of driving has changed over time, there is no reason to believe that norms about guns will not change. One such norm should be keeping the guns in safe and secure places as many perpetrators used guns which were stolen. Some of the policy changes we recommend are stricter provisions in obtaining gun license and its periodic renewal. In addition, people should undergo rigorous background checks and extensive gun safety trainings before obtaining gun. However, the challenges remain and require long term solutions. - See more at: http://journal.frontiersin.org/Journal/10.3389/fpubh.2014.00017/full#sthash.MAIQSRJD.dpuf Language: en

Tobacco use remains the leading cause of preventable deaths worldwide. Despite efforts by many countries to reduce the impact of tobacco products and lower smoking rates, smoking prevalence is higher among people experiencing homelessness. The reasons are complex and go beyond individual choices, including limited awareness about quitting, restricted access to services, and previous negative experiences. This study is a secondary data analysis of qualitative interviews with women experiencing homelessness. The original data were collected in 2021 as part of a study aimed at understanding tobacco behaviours, attitudes towards quitting, and factors influencing engagement for a subsequent randomized controlled trial. This secondary qualitative analysis, conducted in 2025, examines how policy and environmental contexts influence smoking behaviours among women experiencing homelessness using a social ecological model (SEM) framework. Data were categorized and mapped using the five specified categories within the SEM: policy and environment, community contexts, organizations and systems, interpersonal connections, and individual power and resource distribution. The participants show remarkable resilience in overcoming early-life and adolescent environmental and contextual hardships. Gaps in health services emphasize the need for aligned policy and service improvements. Using the SEM framework, which emphasizes the policy and environmental contexts, offers a deeper understanding of the context of women’s lives. The evidence from this study supports the implementation of gender- and age-appropriate holistic approaches to healthcare and tobacco interventions tailored to this community.

To explore, from an emic perspective, the unique socio ecological context in which rural grandparent headed households (GHH) exist, and therefore provide a foundation for the development of culturally-appropriate interventions that might impact their health. This qualitative descriptive study was based on the conduct of in-depth, semi-structured interviews with fifteen grandparents, residing in rural Appalachian Kentucky, who were the primary caretakers for their grandchildren. The interviews were conducted using an interview guide that was based on the premises of the Social Ecological Model (SEM). A basic assumption of this model is that intrapersonal, social-cultural, organizational, and policy factors influence individual health and health behaviors, and that these influences are interrelated and reciprocal. Data was analyzed by the research team using line by line coding of the audio recorded transcriptions of the interviews. GHH experience both barriers and facilitators to maintaining the health of GHH. Many grandparents viewed the experience of belonging to a GHH as a positive one, believing that having their grandchildren in their home improved their health. They relied on formal and informal networks such as extended family and churches to help with caretaking responsibilities. Grandparents experienced notable barriers to health related to having the primary responsibility of their grandchildren, including lack of resources and family tension related to incarceration and/or opioid drug use by biological parents. GHH, one of the fastest growing family constellations in rural Appalachia and the US, may be particularly vulnerable to health threats elevating their risk for many chronic diseases. Effective health related interventions to address this risk should be based on the socio-ecological context in which these families exist.

Chronic obstructive pulmonary disease (COPD) was the third leading cause of death among Americans in 2014. Multiple factors, ranging from proximal (i.e. biological characteristics and behaviors) to distal (i.e. environmental characteristics and policies), have been shown to predict COPD outcomes. The Social Ecological Model (SEM), which specifies that five levels of influence (i.e. intrapersonal, interpersonal, institutional, community, and public policy factors) are implicated in the development of ill health, has not been used in epidemiological studies of COPD prevalence. A better understanding of the community-level correlates of COPD prevalence may improve community health practice. Using several sources of county-level secondary data ( n = 646), changes in COPD prevalence from 2012 to 2014 were predicted from the five levels of the SEM using ordinary least squares (OLS) hierarchical linear regression. The geographic distribution of county-level changes in COPD prevalence was analyzed with a choropleth map. County-level COPD prevalence increased by 4.76% between 2012 and 2014 overall; however, the greatest increases were observed among counties within the Appalachian region (i.e. counties in West Virginia). Results showed that the SEM, with five levels of influence, was a statistically significant framework for examining changes in county-level COPD prevalence, F = 10.21, p < .001, R2 = 0.28. Statistically significant county-level predictors of changes in COPD prevalence included racial composition, ethnic composition, poverty, altitude, air pollution, and smoking policy. COPD prevention may be assisted by the implementation of community-based programs rooted in a multilevel approach.

BackgroundVaccination and screening are forms of primary and secondary prevention methods. These methods are recommended for controlling the spread of a vast number of diseases and conditions. To determine the most effective preventive methods to be used by a society, multi-level models have shown to be more effective than models that focus solely on individual level characteristics. The Social Ecological Model (SEM) and the Theory of Triadic Influence (TTI) are such models. The purpose of this systematic review was to identify main differences and similarities of SEM and TTI regarding screening and vaccination in order to prepare potentially successful prevention programs for practice.MethodsA systematic review was conducted. Separate literature searches were performed during January and February 2015 using Medline, Ovid, Proquest, PubMed, University of Antwerp Discovery Service and Web of Science, for articles that apply the SEM and TTI.A Data Extraction Form with mostly closed-end questions was developed to assist with data extraction. Aggregate descriptive statistics were utilized to summarize the general characteristics of the SEM and TTI as documented in the scientific literature.ResultsA total of 290 potentially relevant articles referencing the SEM were found. As for the TTI, a total of 131 potentially relevant articles were found. After strict evaluation for inclusion and exclusion criteria, 40 SEM studies and 46 TTI studies were included in the systematic review.ConclusionsThe SEM and TTI are theoretical frameworks that share many theoretical concepts and are relevant for several types of health behaviors. However, they differ in the structure of the model, and in how the variables are thought to interact with each other, the TTI being a matrix while the SEM has a ring structure. The main difference consists of the division of the TTI into levels of causation (ultimate, distal and proximal) which are not considered within the levels of the SEM. It was further found that in the articles studied in this systematic review, both models are often considered effective, while the empirical basis of these (and other) conclusions reached by their authors is in many cases unclear or incompletely specified.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3802-6) contains supplementary material, which is available to authorized users.

Acute ischemic stroke (AIS) is one of the main causes of disability in middle-aged and elderly people, and early activity plays an important role in functional recovery. This study aims to understand the factors that affect the implementation of early activity in patients with AIS and to provide reference for promoting early activity implementation and developing intervention strategies for AIS patients. Using purposive sampling, 19 AIS patients and their caregivers who visited at Stroke Center in the Third Xiangya Hospital of Central South University and the Third Hospital of Changsha from June to December 2021, as well as 19 medical staff, hospital administrators, or community workers providing medical health services to stroke patients, were selected as interviewes. A semi-structured interview was conducted based on the social ecological theory model, and the Colaizzi seven-step method was used to analyze the interview data. According to qualitative interview results, the factors affecting early activity in AIS patients were summarized into 4 themes and 12 sub-themes: medical staff factors (insufficient knowledge and skills, insufficient knowledge of early activity, unclear division of responsibilities), patient factors (severity of the disease, lack of knowledge, psychological pressure, fear of falling), social environmental factors (lack of social support, shortage of human resources and rehabilitation equipment, insufficient medical insurance support), and evidence and norms (the evidence for early activity needs improvement, lack of standardized early activity procedures). Early activity in AIS patients is impacted by factors at multiple levels, including medical staff, patients, social environment, and evidence and norms. Developing comprehensive intervention strategies to address these factors can promote early activity implementation in AIS patients.

Social Ecological Model (SEM) is a theoretical framework using a comprehensive approach to assess or change human behavior. This article aims at evaluating the SEM according to Fawcett criteria, and then discusses its appropriateness to be used as a theoretical framework for a study on underage drinking. A comprehensive search was conducted using PubMed, Google Scholar, EBSCO, CINAHL, and Ovid Journal databases. It was found that SEM has a social and theoretical significance in nursing field. It consistently states its concepts and assumptions without redundancy. SEM has been tested by several studies, and the findings of these studies were congruent with SEM’s assumptions. SEM helps in a better understanding of underage drinking, and then tailoring comprehensive prevention programs to tackle this problem.

Background/Objectives: Childhood eating behaviors result from a complex interplay of familial, social, and environmental factors, influenced by socioeconomic and cultural contexts. These behaviors impact dietary habits, nutritional status, and long-term health. Using the Social Ecological Model (SEM), this narrative review synthesizes evidence on key determinants of childhood eating behaviors and proposes a framework for multi-level interventions. Methods: A structured literature search was conducted across PubMed, PsycINFO, and CINAHL, focusing on studies published between January 2014 and September 2024. Keywords related to childhood eating behaviors, familial determinants, and social influences were used to identify relevant studies. Inclusion criteria centered on empirical research examining how social and familial factors impact childhood eating behaviors within the SEM framework. Results: The review highlights critical determinants, including parental feeding practices, home food environments, peer influences, screen time, school meal programs, and socioeconomic disparities. These factors interact across multiple levels, emphasizing the importance of holistic interventions that target both individual behaviors and broader systemic influences. Conclusions: Addressing childhood eating behaviors requires a multi-level approach that integrates caregiver education, peer-led interventions, improved food environments, and supportive policies. Healthcare providers and policymakers play a crucial role in implementing strategies that foster healthier dietary behaviors and mitigate childhood obesity risks.

The term “community-based” can refer to many types of physical activity interventions. The bulk of physical activity research in older adults focuses on changing individual behavior, sometimes in community settings. Addressing the nation’s goal of increasing the proportion of physically active older adults requires more programs to improve contextual factors that support individual behavior and calls for introducing into community settings successful individual-level programs based on solid research. The social ecology model provides an ideal multilevel framework for community-wide efforts. In conjunction with programs to increase the types and levels of physical activity of older adults, changes can be directed at social, cultural, environmental, institutional, and policy contexts for individual behavior change. Guidelines and evaluation methods, including cost analysis of developing, implementing, and sustaining programs, are needed. Recommendations are made to advance community-based strategies for promoting physical activity among adults age 50 and older.

New Latino immigrant populations face challenges and barriers when arriving in new immigrant destinations. To better understand the challenges faced by Latino immigrants in a new immigrant destination by using the Social Ecological Model. This study solicited the perceptions of key informants and Latino immigrant participants through qualitative data collection methods to understand how to address and decrease barriers to healthcare services and community resources. Researchers conducted semi-structured interviews with two groups of respondents: 13 key informants and 30 Latino immigrants. Data were analyzed using thematic analysis and categorized based on the Social Ecological Model. Themes identified at the individual and interpersonal levels of the Social Ecological Model include fear of deportation and stress. Themes at the community level include cultural differences, discrimination, and a lack of exposure of the majority community to Latino immigrants. At the system level, researchers identified language barriers, the cost of healthcare, and housing. At the policy level, researchers identified legal status and occupational exploitation as challenges for this community. Understanding the challenges faced by Latino immigrants requires multi-level interventions to address barriers that prevent new immigrants from accessing community resources.

The social ecological model takes a holistic approach to complex social issues. As such, it might offer important clues as to how prejudices could be overcome. Prejudices are negative attitudes typically directed at individuals and out-groups. An analysis of prejudices reveals that they have their origins in individuals and their social peers. The social ecological model encompasses individual characteristics as well as the social and physical environment in which individuals are raised because these social ecological factors need to be considered when seeking a means of overcoming prejudices. Another important aspect is persuasion because individuals tend to ignore information that contradicts their established attitudes while distorting information so that it fits into preexisting attitudes. According to the Social Judgement Theory, individuals are only persuaded by messages that fall within their latitudes of acceptance. The text proposes a comprehensive approach in line with the social ecological model to overcome prejudices.

Physical activity (PA) can benefit individuals with Parkinson's disease (PD), however, many individuals tend to be sedentary. This qualitative study explored factors influencing PA behaviour for individuals with PD using the social ecological model. Twelve individuals with PD took part in semi-structured interviews. Data were thematically analysed. Results suggest that individuals with PD experience several constraining and facilitating factors to PA behaviour. Intrapersonal constraints revolved around uncertainties that PA is beneficial for individuals with PD, a lack of interest in available PA programs, and disease-specific issues whereas intrapersonal facilitators included prior experiences of enjoyment in PA, seeing improvements, and wanting to maintain independence. Interpersonal constraints related to lacking social support and perceived stigma whereas interpersonal facilitators were, passionate PA program staff, and being active with similar others. Environmental constraints pertained to PA programs failing to adapt program activities, lack of time, and transportation accommodations, whereas environmental facilitators were exposure to non-traditional PA programs, access to resources on PA, and accessibility to community PA programs. Findings highlight the need to address factors influencing PA behaviour for individuals with PD.