I have spent a considerable amount of time analysing literature that discusses multilevel health approaches and spheres of influence, to glean a deeper understanding of the concepts. What follows is a summary of my observations.

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Health-related spheres of influence, examine the varying levels of influence individuals or institutions have over multiple domains of health (DeCamp et al., 2021). Several models, theories and approaches exist that combine multiple spheres of influence, to examine their impacts on health (Karches, 2021).

 

Multilevel research methods are often used as frameworks to understand and address the social determinants of health and inform health promotion, and disease prevention, because they consider a broad range of complex contributory factors that impact health outcomes (Health Promotion and Disease Prevention Theories and Models - Rural Toolkit, n.d.).

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Multilevel models of health can help us deepen our understanding of complex, multifaceted health issues and inform comprehensive interventions that positively influence health outcomes, especially among disadvantaged groups. As noted by Paskett et.al (2015) ongoing research in this area is therefore vital in modern society, to address population health at a strategic level.

 

Numerous multilevel health models exist that examine two or more spheres of influence, in relation to determinants of health. Here are some examples:

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• Ecological Models examine the intrapersonal, interpersonal, community and public policy spheres of influence.

• The Health Belief Model focuses on individual health beliefs and their impacts on individual health-related behaviors.

• Stages of Change Models (Transtheoretical Models) explore people’s readiness to change their behavior.

• Social Cognitive Theory studies the influence of individual experiences, the actions of others, and environmental factors on individual health behaviors.

• The Theory of Reasoned Action/Planned Behavior explores individual attitudes toward their behaviors and their associated subjective norms.         

 

So far, I have found that ecological models of health stand prominent within literature. This week, to support my learning, I will apply the Social Ecological Model to examine factors that impact physical activity participation in school-aged children and adolescents.

 

Below is a selection of curated resources that have helped me understand  the spheres of influence concept and introduced me to the ecological model of health, and how it can be applied to understand and address health issues.

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Curated Resources

 

Bedoya, D. [@DianaBedoya]. (2020, September 10). Ecological model of health. Youtube. 

 

DeCamp, Matthew, et al. “Ethics and Spheres of Influence in Addressing Social Determinants of Health.” Journal of General Internal Medicine, vol. 35, no. 9, 2020, pp. 2743–45, https://doi.org/10.1007/s11606-020-05973-1

 

 Karches, Kyle, et al. “Spheres of Influence and Strategic Advocacy for Equity in Medicine.” Journal of General Internal Medicine, vol. 36, no. 11, Nov. 2021, pp. 3537–40, https://doi.org/10.1007/s11606-021-06893-4

 

 Marcone, Massimo F., et al. “An Overview of the Sociological and Environmental Factors Influencing Eating Food Behavior in Canada.” Frontiers in Nutrition, vol. 7, 2020, https://www.frontiersin.org/articles/10.3389/fnut.2020.00077

 

 Paskett, Electra, et al. “Multilevel Interventions To Address Health Disparities Show Promise In Improving Population Health.” Health Affairs, vol. 35, no. 8, 2016, pp. 1429–34, https://doi.org/10.1377/hlthaff.2015.1360