Question

Think about the public health issue of substance abuse.

Draw a logic model of Social Ecologic Model (SEM)

List factors at each of the five levels which influence substance abuse, be thorough. (Intrapersonal, Interpersonal, Organizational, Community, Policy)

Out of all the factors you listed, which would you address through interventions? Why?

Answer 1

The Social Ecologic Model is a model that proposes that behaviour is determined by the interactions of personal and environmental factors. The ultimate goal of the SEM is better health among people by recognising the interplays of these factors.

The SEM draws five levels to understand public health prevention and control. The five levels are:

1) Individual

2) Interpersonal

3) Community

4) Organizational

5) Policy

These levels can be better understood with the given example of substance abuse:

1) Intrapersonal: A person might be influenced to take in a substance because of personal attitudes and beliefs regarding the intake of that particular substance. For example: a person might be into taking a lower-order drug because of the after-effects it gives to him/her which have perceived positively by the person.

2) Interpersonal: Here, the influencers could be family, friends and other people who the person meets at an interpersonal level. For example, a group of friends who are not using the particular drug and influencing the person to stop it.

3) Organizational: Here, the influencers are organizational systems such as health care systems, social institutions, professional organizations, etc. For example, a health care system which provide health care support to the person taking substance.

4) Community: These include community level institutions such as support groups, media, research institutions, etc. For example, if the person joins a support group to speak about his/her experiences of substance abuse, it would reflect community support system as an influencer.

5) Policy: This level involves interpreting and implementing existing policies. For example, the state policies influencing healthy behaviour would discourage the person from substance abuse.

Out of all these factors listed, the Intrapersonal level could be addressed through interventions. This is because, here change would be focused internally on the person and hence behaviour would be modified. In case of substance abuse, an internal change in behaviour is needed in order to modify behaviour. Certain therapies such as Cognitive Behaviour Therapy, Motivation Enhancement Therapy, etc could be used to bring about change internally. In case of substance abuse, change has to be brought in the person first, and only then the other influencers would be able to play a part in behaviour modification and enhancement.