Macrosystem Levels Research Articles

Can travel relieve the loneliness of the elderly?

ABSTRACT This paper aims to investigate whether travel can alleviate the loneliness among the elderly. Empirical tests involving data from the China Health and Retirement Longitudinal Study database yielded notable findings. Based on Ecological Systems Theory, we investigated the mediating mechanisms of travel’s impact on loneliness among the elderly. Findings showed that self-evaluated health status and sleep time at the microsystem level, satisfaction with children’s relationships at the mesosystem level, and social interaction at the macrosystem level served as mediators. Subgroup heterogeneity analyses revealed practical implications.

Similarities and Differences Between Bullying and Sexual Harassment in Schools: A Social-Ecological Review of Risk and Protective Factors.

In this conceptual article, the authors provide a narrative review of literature on bullying and sexual harassment in K-12 schools framed through a comparative analysis of risk and protective factors for both forms of violence across the social-ecological spectrum. We find that a greater number of studies of both forms of violence focus on student and microsystem-level factors rather than on higher levels of the ecosystem including school boards, neighborhoods, and broader cultural norms. In addition, the research overwhelmingly identifies more risk factors than protective factors. Finally, we find more similarities than differences in risk and protective factors between the two forms of school-based violence. We identify implications of the findings for theory, research, and policy and suggest that preventing any form of harassment at school will benefit not only students but the entire school community. We argue that the causes of school-based harassment are complex and require comprehensive prevention, intervention, and response approaches that address shared risk and protective factors, particularly those at the community and mesosystem, exosystem, and macrosystem levels. Ultimately, we argue that all community stakeholders must be committed to and engaged in these endeavors for them to be successful.

Education Programs for Informal Caregivers of Noncancer Patients in Home-Based Palliative Care: A Scoping Review.

The literature available on the topic of education programs for noncancer patients' informal caregivers (ICs) is heterogeneous and fragmented in the setting of palliative care (PC). We conducted a scoping review (ScR) to map the literature on educational programs for ICs in home-based PC, considering the available reviews, qualitative studies, observational studies, studies of validation of measurement tools, uncontrolled trials, nonrandomized controlled trials, and feasibility studies. This ScR included 21 eligible records by searching PubMed, Web of Science, Embase, Scopus, and CINAHL databases. The most common types of study designs were literature review (28%), qualitative research (24%), and experimental or quasiexperimental research (19%). A total of 57% of educational interventions or programs were mainly supplied by nurses, alone or with other health professionals; specifically, nurses mostly led supportive intervention (n = 2; 25%), education programs (n = 2; 25%), and app development. Different factors at the microsystem, macrosystem, mesosystem, and exosystem levels might help or hinder the implementation of IC education. Although ICs might more easily access online programs, accessibility and digital exclusion might represent significant barriers. Supportive interventions might positively affect family ICs' preparedness, competence, burden, care outcomes, and experiences related to their role; moreover, it might increase ICs' self-rated competence in all key areas: physical, emotional, psychological, social, informational, and spiritual. ICs can improve their knowledge, confidence, and attitudes toward PC. The literature summary might render the assistance more accessible to ICs to improve the quality of caregiving and nursing care linked to patient and caregiver outcomes. However, robust studies (e.g., randomized controlled trials) are still required to identify and establish the efficacy of each described intervention and, therefore, offer tailored approaches considering the diverse diseases and social and cultural characteristics of patients and ICs.

“If your relationship is a swamp, your sister is like a hand that pulls you out of it”: Sisterhood as a source of support on relationship issues and dating violence

Informal support systems play a crucial role in navigating romantic relations and coping with dating violence (DV), especially in emerging adulthood. Although research indicates that sisters can be an important source of such support, the question of how they communicate and assist each other on relationship issues and violence remains largely unexplored. The present qualitative study, adopting an ecological systems perspective, investigated what roles sisters play in each other’s dating experiences in Turkiye, a traditional and patriarchal sociocultural context with gradually increasing awareness about DV and gender equality among emerging adults. The sample consisted of 5 sister dyads aged 20–25. Data was collected through dyadic interviews and analyzed with an inductive thematic analysis approach. The dyads’ descriptions were categorized under two main themes: (a) protection from boundary violations and violence and (b) co-regulation and guidance in relationship management. The protective role of sisters entailed reminding each other of healthy boundaries and self-worth, checking for safety and warning signs, and showing solidarity. On the other hand, the regulatory role of sisters involved seeking and giving advice on conflict resolution, accompanying negative emotions, and coping with a breakup together. The findings demonstrate that sisters can become an essential source of support in the context of parental disapproval and limited communication about dating at the microsystem level and changing gender norms and socialization, along with the prevalence of gender-based violence at the macrosystem level. The study contributes to a deeper understanding of effective support processes in sisterhood and informal help-seeking for relationship issues and violence from a contextual and developmental lens. The findings point to the need to expand family-based DV prevention programs exclusively targeting parents.

Measuring and Forecasting the Development Concept of the “Green” Macrosystem Using Data Analysis Technologies

A research framework is formed by the semantics of the “green” macrosystem, supported by a methodological approach, data analysis, and forecasting, with a focus on the dynamics of transition to a qualitatively new state. The purpose of the work is to develop conceptual provisions and methodological tools for assessing the implementation of the concept of a “green” macrosystem. Applying methods of system analysis, content analysis, formalization, statistical analysis (technologies of knowledge discovery in databases and time series analysis), and discriminant analysis contributed to achieving the goal. As a result of the research, the categorical apparatus of a “green” economy was clarified by outlining narrow and broad approaches to defining the “green” macrosystem; the author’s method of assessing the implementation of the concept of the “green” macrosystem was modified by expanding the list of factors of greening the economic system, transforming the condition of the “green” corridor to calculate the developed dynamic coefficient of transition to the concept of the “green” macrosystem (DCGM), and adapting the method to the macrosystem level; the regularities of a transition to the concept of a “green” macrosystem were revealed. The novelty of the study lies in the proposal of an integral DCGM indicator, which avoids the problems of normalization, weighting, and loss of relevant data, incorporates the determinants of the “green” economy (natural resources and pollution), and relies on available data. The formulated provisions develop the theoretical basis on which to transform the macrosystem to the “green” concept and can be taken into account in the implementation’s framework of strategic planning documents for the greening of production and economic systems.

An Ecological Understanding of L2 Reading Motivation: The Case of Chinese Tertiary-Level Students in an Elective Extensive Reading Course

Previous studies have identified a range of learner factors and factors within more immediate contexts that affect students’ motivation in L2 extensive reading (ER) programs. However, much remains to be known about the effect of sociocultural factors on L2 reading motivation, especially in instructed ER settings. To address the issue, the paper adopted Bronfenbrenner’s Ecological Systems Theory to investigate factors impacting Chinese undergraduates’ L2 reading motivation in an elective ER course. Data were collected from semi-structured interviews, classroom observation and reading logs. In addition to factors identified by previous studies, our study further revealed that learner factors like characteristics, and contextual factors like past EFL learning experiences at the mesosystemic level, class time and course evaluation at the exosystemic level, collectivism and face concern at the macrosystemic level, and novelty at the chronosystemic level also exerted influence on students’ L2 reading motivation in the ER course. Pedagogical implications were suggested to improve ER instruction and cultivate students’ L2 reading motivation.

Investigating Child Abuse in Sports: An Ecological Systems Perspective.

This study examines child abuse in sports environments through Ecological Systems Theory, revealing the multifaceted nature of abuse and the impact of environmental factors at various levels. With a study design using the phenomenology approach, a qualitative research method, data were collected through semi-structured, in-depth interviews with 11 Turkish participants, including 5 athletes, 4 coaches, and 2 academics with coaching experience in Sports Sciences. Thematic analysis was used to evaluate the data, categorizing findings into four levels: microsystem, mesosystem, exosystem, and macrosystem. Findings show that at the microsystem level, children are exposed to physical, emotional, and sexual abuse, as well as neglect, largely through interactions with coaches and teammates. Physical abuse includes non-contact forms, like dehydration and forced training, and contact abuse, such as violence from coaches and peers. Emotional abuse manifests through psychological pressures and verbal attacks, creating a toxic environment. At the mesosystem level, excessive parental trust in coaches reduces oversight, leaving children vulnerable. In the exosystem, inadequate supervision of coaches and a lack of response to abuse cases by sports clubs worsen the issue. At the macrosystem level, cultural norms and societal attitudes normalize abuse, especially affecting female athletes. The study highlights the need for comprehensive interventions, including family awareness, stricter coach oversight, and robust policies within sports organizations to protect children. By emphasizing the interaction of individual, familial, and societal factors, this research underscores the importance of collective efforts to ensure safer sports environments.

Traditional and Online Bullying Victimization Among School-going Adolescents: The Role of Sociodemographic Factors

Background: Bullying in school is a vital issue as researchers increasingly find that it can be detrimental to students’ well-being and academic excellence. From an ecological systems theory perspective, examining school bullying reveals that numerous psychosocial factors influence student behavior. Hence, the present study aims to investigate the role of sociodemographics—at the individual (age, gender), microsystem and mesosystem (grade level, school type), exosystem (region), macrosystem (socioeconomic status), and chronosystem (shift from traditional to virtual classroom during COVID-19) levels—in the victimization of traditional and online bullying. Methods: After obtaining ethical clearance, an online survey form was deployed to collect sociodemographic information and assess traditional and online bullying victimization among 120 school-going adolescents from the Southern regions of India. Results: A linear regression analysis showed age and region (urban and rural) predicting traditional and online victimization, respectively. Other sociodemographic factors of gender, school type, and grade level did not predict either victimization type. Conclusions: Sociodemographic factors play a significant role in the victimization experiences of students both in traditional and online.

Fostering Sustainable Female Participation in STEM Through Ecological Systems Theory: A Comparative Study in Three African Countries

This study explores factors influencing female engagement in STEM (Science, Technology, Engineering, and Mathematics) fields in Mozambique, Nigeria, and Uganda through Urie Bronfenbrenner’s Ecological Systems Theory. The research collected qualitative data from 81 women across these countries through open-ended surveys. Using content analysis, the results demonstrate the critical role of personal interests nurtured by family, showing how direct interactions with family influence STEM engagement at a microsystem level. The mesosystem level reveals the supportive influence of community and school interactions, emphasizing the importance of relationships between different microsystems, such as family–school collaborations, in fostering female participation in STEM. The exosystem level identifies the impact of positive media portrayals and role models, illustrating how external environments indirectly affect perceptions and aspirations in STEM through media and societal influences. The macrosystem level underscores the persistent cultural norms shaping gender roles, reflecting broader societal and cultural values that influence gender diversity in STEM fields, with 63% of respondents in Mozambique, 57% in Nigeria, and 67% in Uganda indicating that societal views on gender roles discouraged participation. Lastly, the chronosystem level captures the temporal changes and progress in gender diversity in STEM, highlighting the need for targeted interventions and policy reforms to address longstanding gender imbalances. Despite progress, significant gender imbalances remain, necessitating targeted interventions and policy reforms. The study proposes a sustainable, collaborative model to foster early interest and sustained participation of females in STEM, emphasizing the importance of seamless cooperation among families, educational institutions, communities, and government bodies. The findings aid in creating supportive environments for sustaining female STEM participation, promoting economic and social development in Sub-Saharan Africa.

Identification of research gaps to improve care for healthy ageing: a scoping review

ObjectiveSeveral research gaps affect the improvement of care for healthy ageing. Their identification is crucial to developing a specific research prioritisation agenda supporting progress at the micro (clinical), meso (service...

Relationships Between Socioecological Factors and Self-Efficacy to Participate in Physical Activity for Adults With Chronic Musculoskeletal Pain: An Integrative Review.

Self-efficacy for leisure-time or health-promoting physical activity (SEPA) is a psychosocial determinant of physical activity. The socioecological model can provide a robust perspective of SEPA. The objective of this study was to synthesize the evidence on multilevel correlates of SEPA among individuals with chronic musculoskeletal pain. The second aim examined the extent to which socioecological disparities are associated with SEPA among individuals with chronic musculoskeletal pain. An integrative review was conducted. Included studies needed to investigate the relationship between SEPA and socioecological factors at the interpersonal, institutional, community, and/or macrosystem level among adults with chronic musculoskeletal pain (≥3months). Searches in PubMed, EMBASE, PsycINFO, and CINAHL were performed (December 30, 2020, and October 12, 2022), yielding 4047 records after duplicates were removed. Two independent reviewers completed screening, full-text reviews, and data extraction. After title and abstract screening and full-text reviews, 17 studies were included. The constant comparison method included: data reduction, data display, data comparison, and conclusion drawing/verification. Quality of evidence was assessed using the Joanna Briggs Institute appraisal tools. Five themes emerged with respect to relationships between SEPA and socioecological factors: social relations, social comparisons, patient-provider relationship, organizational resources, and accessibility to physical activity. Relationships between interpersonal factors and SEPA were most prominently studied. One study examined and addressed potential disparities in SEPA at the macrosystem level. A spectrum of relationships from supporting to straining SEPA were found at the interpersonal level. Relationships between institutional, community, and macrosystem factors and SEPA were comparably sparse. Gaps in the literature were identified regarding how health disparities present across the socioecological model with respect to SEPA. Clinicians can use this review to evaluate how SEPA can be supported or threatened by factors across the socioecological model. This may be a preliminary step towards examining and addressing health disparities in SEPA.

L’accès aux services de fertilité pour les femmes lesbiennes, bisexuelles ou pansexuelles et les personnes queer, trans ou non-binaires : une revue rapide des écrits scientifiques

<p>Introduction: Lesbian, bisexual, and pansexual (LBP) women as well as transgender, queer, and non-binary individuals (TQNB) often rely on medically assisted reproduction (MAR) to build their families, but do not always have access to these services. Currently, there appears to be no literature that comprehensively reviews, from an ecosystemic perspective, the main factors determining LBP women's and TQNB people's access to MAR.</p><p>Objective: This rapid review aims to identify, from an ecosystemic perspective, the factors described in the scientific literature as influencing LBP women's and TQNB people's access to MAR.</p><p>Methods: A literature search using 11 search engines identified 22 articles presenting results of recent empirical studies (2018-2023) using various methodologies. Relevant results were subjected to thematic analysis, and identified factors were classified within an ecosystemic model.</p><p>Results: The identified factors are (1) at the microsystemic level, support from the social network and healthcare personnel; (2) at the exosystemic level, healthcare personnel's awareness of sexual and gender diversity, adequacy of information and documentation, organizational logic of fertility services, cost of services, legislation; (3) at the macrosystemic level, heterocisnormativity as a cross-cutting influence.</p><p>Discussion and conclusion: To ensure access to MAR for LBP women and TQNB people, a comprehensive and multi-level approach is necessary. Suggestions for health practices and public policies are proposed.</p>

Exploring the Effects of China's Double Reduction Policy on Students Within the Framework of Educational Ecological System Theory

This essay mainly discussed the impact of China's "Double Reduction" policy on students from the perspective of educational ecosystem theory. The "Double Reduction" policy aims to reduce students' excessive homework burden and the burden of out-of-school training, so as to alleviate students' pressure. This paper first introduces the concepts of educational ecosystem theory, such as microsystem, mesosystem and exosystem. It then discusses how the "Double Reduction" policy has changed the educational ecosystem, especially at the macrosystem level. The paper also discusses how the implementation of the "double-decrease" policy affects students through various system levels. In general, the "double-decrease" policy has helped to reduce the pressure on students' development, but it has also brought uncertainty to academic performance and career development. This paper adopts a qualitative research methodology by interviewing students and parents to explore their attitudes towards the "double-decrease" policy and its perceived impacts. It also concludes that if China's unique education system does not change accordingly, the effects of the double-minus policy will be greatly weakened by society, and the long-term impact will be more uncertain.

Why English? Exploring Chinese early career returnee academics’ motivations for writing and publishing in English

To improve their research performance in international league tables, many universities in non-English language dominant settings recruit academic returnees in the hope that they will increase the quantity and quality of articles published in English-medium internationally indexed journals. This study explores Chinese early career returnee academics’ motivations for writing and publishing in English. Utilising ecological systems theory, the findings show that the microsystem is reflected in the early career returnee academics’ interaction with collaborators, while national policies constitute the exosystem. The academic culture has a noteworthy impact at the macrosystem level. This study contributes to the understanding of early career returnee academics’ motivations to write and publish in English which will assist policymakers and university administrators to create a more beneficial environment to promote the accomplishments of academic returnees.

Identifying Features of a System of Practice to Inform a Contemporary Competency Framework for Paramedics in Canada.

Paramedic practice is highly variable, occurs in diverse contexts, and involves the assessment and management of a range of presentations of varying acuity across the lifespan. As a result, attempts to define paramedic practice have been challenging and incomplete. This has led to inaccurate or under-representations of practice that can ultimately affect education, assessment, and the delivery of care. In this study, we outline our efforts to better identify, explore, and represent professional practice when developing a national competency framework for paramedics in Canada. We used a systems-thinking approach to identify the settings, contexts, features, and influences on paramedic practice in Canada. This approach makes use of the role and influence of system features at the microsystem, mesosystem, exosystem, macrosystem, supra-macrosystem, and chronosystem levels in ways that can provide new insights. We used methods such as rich pictures, diagramming, and systems mapping to explore relationships between these contexts and features. When we examine the system of practice in paramedicine, multiple layers become evident and within them we start to see details of features that ought to be considered in any future competency development work. Our exploration of the system highlights that paramedic practice considers the person receiving care, caregivers, and paramedics. It involves collaboration within co-located and dispersed teams that are composed of other health and social care professionals, public safety personnel, and others. Practice is enacted across varying geographical, cultural, social, and technical contexts and is subject to multiple levels of policy, regulatory, and legislative influence. Using a systems-thinking approach, we developed a detailed systems map of paramedic practice in Canada. This map can be used to inform the initial stages of a more representative, comprehensive, and contemporary national competency framework for paramedics in Canada.

Barriers for exiting sex work: an exploration on female sex workers (FSW) in Puducherry, India

Exit is not an easy task for a sex worker. Academic investigations of the reasons and barriers to exit from the sex industry are lacking heavily. Sex work is a stigmatised profession, even though the workers find it difficult to exit the same. The current study attempted to understand the barriers faced by female sex workers in Puducherry, a union territory in the southeast part of India, to exit from sex work. The participants comprise 19 female sex workers (FSW) who work in Puducherry. The data were collected through in-depth interviews. All of the participants had thoughts about quitting. The barriers to exit were identified. The barriers were recognised at the individual, interpersonal (microsystem), and structural (macro system) levels within the framework of Bronfenbrenner’s Ecological Systems Theory, which are discussed in detail in the paper. The study also identified a lack of support systems for the targeted population.

Exploring facilitators and barriers for delivering person-centered care in a socio-economically diverse context: Perspectives of speech-language pathologists and audiologists

ObjectiveThe study aimed to explore facilitators and barriers in delivering person-centered care from the perspective of speech-language pathologists and audiologists in a socio- economically diverse workplace across micro, meso, and macro levels. MethodA national cross-sectional e-survey was conducted among pooled speech-language pathologists and/or audiologists from South Africa. The e-survey included quantitative components to describe participant demographics which was analysed using descriptive and inferential statistics. The qualitative data was analyzed using metaphor and thematic analysis approaches to describe respondents’ perspectives of barriers and facilitators in delivering person-centered care. ResultsThe e-survey was completed by 63 clinicians (36.5% Audiologists; 36.5% Speech-Language Therapists; 27.0% dually qualified Speech-Language Therapists and Audiologists) mostly between the ages of 26 to 35 years old (33.3%). Respondents were working in various settings including the public sector (41.3%), private sector (44.4%) and in academia (14.3%). Facilitators and barriers were identified within all three systems (macro, meso and micro). The metaphor analysis resulted in six categories: uncertainty of Person centered care; its essential nature; associated challenges; relational aspect; analogies referring to animals; and food-related analogies. Thematic analysis of open-ended questions revealed five barriers, with three relating to micro systems; i) clinician factors, ii) client factors, iii) clinician and client interaction, and two related to factors within the meso system; iv) resources, and v) workplace. Only two themes were identified as facilitators towards PCC, clinician factors (mirco) and workplace factors (meso).’ ConclusionsInsights gained from exploring Speech-Language Pathologists' and Audiologists' perceptions of implementing PCC in a socio-economically diverse setting highlight the need to address contextual (meso and macro systems) and personal (micro system) factors to promote and deliver PCC effectively. Notably, for the public sector, resources emerged as a major concern and barrier on the macro system level. Despite these challenges, the investigation revealed two noteworthy facilitators: clinician factors, at the micro level, and workplace factors, at the meso level. This nuanced understanding emphasizes the necessity of tailored interventions targeting both individual and systemic aspects to enhance the successful implementation of person-centered care. Practical ImplicationsStrategies should focus on enhancing clinicians' communication skills, collaboration, and teamwork, as well as addressing resource limitations through the adaptation of tools and implementation of PCC ISO standards.

How does choice of residential community affect the social integration of rural migrants: insights from China

The construction of public space is a new and important way to integrate rural migrants into urban society. Existing studies mainly discussed the factors affecting the social integration of rural migrants from the micro-individual and macro-system levels. Still, they seldom analyzed the differences between rural migrants’ residential communities and the roles these differences play in their social integration, especially from the perspective of residential space. Based on the data of the 2014 China Migrants Dynamic Monitoring Survey, this paper systematically examines the impact of residential community selection on the social integration of rural migrants and its possible effects using OLS, 2SLS, CMP, omitted variable test method, and KHB mediating effect model. It is found that the choice of residential community has a significant positive impact on the social integration of rural migrants, and the social integration of rural migrants living in formal communities has increased by 2.44%-3.20%. To overcome the potential endogeneity problems and selection bias of the empirical model, the study further adopted an instrumental variable estimation approach, combined with the omitted variable method for robustness check; the results still revealed the positive effect of living in formal communities on the social integration of rural migrants. The heterogeneous results showed that living in formal communities has a greater effect on the social integration of women and older-generation rural migrants. The farther the migration range and the longer the residence time of rural migrants, the greater the effect of living in the formal community on their social integration. Further mechanism testing revealed that living in formal communities not only directly enhances the social integration of rural migrants but also indirectly improves their social integration through public resource allocation, human capital accumulation, social status screening, and social network expansion. The indirect effect of capital accumulation is even greater. Therefore, to accelerate the full integration of rural migrants into urban society and achieve real urbanization and citizenship, the study proposes that the government should scientifically plan the layout of rural migrants’ living space and the construction of supporting facilities.

Towards an ecological understanding of student emotions in feedback: a scoping review

Students’ emotions have been increasingly examined in feedback research. Socioculturally positioned research has particularly noted that emotions do not exist in a vacuum but are contextually situated, which also holds true for feedback encounters. In this scoping review, we provide a synthesis of earlier studies on emotions in feedback in higher education (2003–2023, 46 studies). First, we outline the research designs and methods. Second, we analyse the contextual influences on students’ emotions in feedback. We used Bronfenbrenner’s ecological theory as our guiding framework. The findings reveal that self-report methods have been widely utilized. Most studies have investigated emotions either on an individualistic or at the microsystem level, while only a few have considered the wider influence of the macrosystem and chronosystem levels. Future research must consider the macrosystem since emotions are historically, culturally and politically embedded in social interactions. Scholars must take into account the chronosystem level since emotions are dynamic, evolve over time and reflect wider societal changes.

Individual and systems-related factors associated with heart failure self-care: a systematic review

BackgroundHeart failure (HF) is a prevalent condition worldwide. HF self-care is a set of behaviors necessary for improving patient outcomes. This study aims to review and summarize the individual and system-related factors associated with HF self-care published in the last seven years (Jan 2015 – Dec 2021) using the Socioecological Model as a review framework.MethodsAn experienced nursing librarian assisted authors in literature searches of CINAHL Plus with Full Text, Ovid Nursing, PsychINFO, and PubMed databases for peer-reviewed descriptive studies. Inclusion criteria were HF sample with self-care as the outcome variable, and a quantitative descriptive design describing individual and/or system-level factors associated with self-care. Exclusion criteria were interventional or qualitative studies, reviews, published before 2015, non-English, and only one self-care behavior as the outcome variable. The search yielded 1,649 articles. Duplicates were removed, 710 articles were screened, and 90 were included in the full-text review.ResultsA subset of 52 articles met inclusion and exclusion criteria. Study quality was evaluated using modified STROBE criteria. Study findings were quantitated and displayed based on socioecological levels. Self-care confidence, HF knowledge, education level, health literacy, social support, age, depressive symptoms, and cognitive dysfunction were the most frequently cited variables associated with self-care. Most factors measured were at the individual level of the Socioecological Model. There were some factors measured at the microsystem level and none measured at the exosystem or macrosystem level.ConclusionResearchers need to balance the investigation of individual behaviors that are associated with HF self-care with system-level factors that may be associated with self-care to better address health disparities and inequity.