The Socio-Ecological Model: A Framework for Promoting

Healthy Weight

Hillary N. Fouts, Ph.D.

Department of Child and Family Studies

College of Education, Health, and Human Sciences

Outline

• Background and overview of the Socio-Ecological Model (SEM)

• Interconnectedness and interaction between

systems of the model

• Role of culture in the model and implications for promoting healthy weight

Background of SEM

• Urie Bronfenbrenner’s Framework

• A meta-theory from psychology

• Ecological Theory (1970s and 80s)

• Bio-Ecological Theory (1990s and beyond)

• Adapted and applied to many fields

• Social sciences

• psychology, sociology, family sciences, child development

• Social work

• Public health

Bronfenbrenner & Morris (2006); Tudge et al. (2009)

Foundational Properties of the Theory

• Person-Process-Context-Time [PPCT]

Person

Context

Time Process

Nested Systems

Bronfenbrenner & Morris (2006); Tudge et al. (2009)

Context: Nested Systems

• Microsystem • Interpersonal / immediate relationships and interactions

(family, school, neighborhood, etc.)

• Mesosystem • Connections between structures in the microsystem (school-

home relationships, etc.)

• Exosystem• Community and larger social systems (organizations, social

institutions)

• Macrosystem • cultural values, customs, laws, international and global issues

• Chronosystem • Time (timing of significant events, developmental stage, etc.)

Bronfenbrenner & Morris (2006); Tudge et al. (2009)

Societal Structures: local, state, federal

policies; laws;

societal norms

Community: social standards and

norms

Institutions/ Organizations: medical/health

organizations, schools, etc.

Interpersonal:

Family, peers, social networks

Chronosystem: Time

Individu

al: perso

nal cha

racteris

tics, be

liefs, be

haviors

Adapted from CDC (2017), Health Equity Toolkit

Culture Culture

Culture Permeates and Connects

• Integrated set of beliefs and practices

• Shared by social groups

• Socially transmitted

• Dynamic and changes through time

We ALL have culture

• Like the fish that is unaware of water until it has left the water, people often take their own community’s ways of doing things for granted.

(Barbara Rogoff, 2003, p. 13)

• No one is more or less cultural, we all have cultural lenses

• Tendency to be more aware of other people’s

culture and to see your own beliefs and practices as ‘normal,’ ‘fact,’ or ‘truth.’

Rogoff (2003)

Culture is much more than the box you check

• Variation within cultures, regionally, and through time

• Lived experiences and meaning making

• Foundational values and socio-historical context

• Perceptions, expectations, and beliefs about weight

• Customs and preferences related to food; infant and child feeding practices

Applying the Model: Perceptions of Infant Weight

• Thompson, Adair, and Bentley’s (2014) study of low-income African American mothers in North Carolina

• Factors impacting mother’s assessment of infant weight:

• Comparisons to other infants encountered in daily life (family and community)

• Pediatric assessment (organizations; policy)

• Position on growth chart (national; policy)

• Clothing and diaper size (societal)

• Beliefs about size and health (individual and cultural)

Chronosystem: Time

Adapted from CDC (2017), Health Equity Toolkit

Culture Culture

Societal Structures: local, state, federal

policies; laws;

societal norms

Community: social standards and

norms

Institutions/ Organizations: medical/health

organizations, schools, etc.

Interpersonal:

Family, peers, social networks

Individu

al: perso

nal cha

racteris

tics, bel

iefs, beh

aviorsComparisons to family/peers

Pediatric care

Comparisons to infants in

community

Societal norms

(clothing/diaper sizes),

National growth charts

Cu

ltu

ral

valu

es

an

d b

eli

efs

Interconnections and Interactions

Long-held Cultural Beliefs

Societal

norms

Pediatric

care / assessment

Community

norms

Family /

peers

Conclusion

• SEM is a starting point, highlighting important factors to consider when promoting healthy weight.

• Factors don’t occur in isolation, they are mutually interactive and culture pervades the systems.

• Awareness of your position in the systems and the position of the people you serve is key for developing effective prevention / intervention.

• Regardless of where you intervene in the systems, all systems are still at play.

References

• Bronfrenbrenner, U., & Morris, P. A. (2006). The bioecological model of human

development. In W. Damon & R. M. Lerner (Eds.) Handbook of Child Psychology (6th ed.).

Hoboken, NJ: John Wiley & Sons.

• Centers for Disease Control and Prevention, National Center for Chronic Disease

Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity.

(2017). CDC health equity resource toolkit for state practitioners addressing obesity

disparities. Atlanta, GA: U.S. Department of Health and Human Services.

• Rogoff, B. (2003). The cultural nature of human development. New York, NY: Oxford

University Press.

• Thompson, A. L., Adair, L., & Bentley, M. E. (2014). “Whatever average is:” Understanding

African-American mothers’ perceptions of infant weight, growth, and health. Current

Anthropology, 55(3), 348-355. doi:10.1086/676476.

• Tudge, J. R. H., Mokrova, I., Hatfield, B. E., & Karnik, R. B. (2009). Uses and misuses of

Bronfrenbrenner’s bioecological theory of human development. Journal of Family Theory

and Review, 1(4), 198-210. doi:10.1111/j.1756-2589.2009.00026.x