population-level approaches aim to understand/change average levels of behaviour in large numbers of people by focusing on awareness and the context of the behaviour.  aim to motivate and support people to understand the consequences of behaviour, feel positive about the benefits of behaviour change, recognise how social factors and physical contexts affect behaviour, and plan change and explicit coping strategies. 

This can include changing aspects of the social and physical environment, BUT only those that relate to that specific person (i.e., changing the social networks and/or environment of that person only).

Advantages of Individual-Level Approaches

• allow for intervention to be tailored to the person and fit their specific needs

• have potential to produce a large magnitude of individual change

• are relationship based

Disadvantages include

• require identification and active engagement with people

• limited reach

• risk individual blaming and stiignatisation (by focusing on the person as the main influence of the behaviour)

• de-emphasise the contextual factors that can influence the behaviour

n contrast, population-level approaches aim to change average levels of behaviour in a community by targeting awareness and the associated context and needs.

Population-level approaches aim to improve aspects of the setting and culture which support desired behaviour, reduce barriers to desired behaviour, and/or increase barriers to undesired behaviour.

interventions at the population level can include

• introducing community wide programs

• restructure of physical environment

• enable access to opportunities for the behaviour

• providing behaviour relevent resources

• use of mass information

• economic strategies

• economic strategies

• policies and regulation

advantages of populaion level approaches include

• does not require active participation

• large reach

• move beyond individual blaming

• potential for radical and powerful change

• acknowledge upstream influences on behaviour

Limitations of population level approaches include

• paternalistic? compromise individual autonomy

• not seen as salient among people in need

• complex and require extensive planning, commitment, resources, coordination, stakeholder liaison

• high level of uncertainty

• low level of control over intervention activities

• loing time for implementation and change

• small magnitude of individual level change

ecological models of behaviour: focus on the inter-relationships between people and their physical and sociocultural environment; also acknowledge the broader environment and policy as influences on behaviour

Multiple influences of behaviour

• Different levels of influence and their importance vary depending on the type of behaviour and the context

• sociocultural and physical influences may apply to more than one level - may be relevant to organisations and the community

Environmental contexts are significant influences on behaviour

Behaviours may be predicted more accurately from the situations people are in than from the individual characteristics of the person. The physical and social situations in which behaviour occurs can promote and/or restrict behaviour. 

Contexts can also impact on individual and interpersonal influences on behaviour.

Influences on behaviour interact across levels. e.g. , attitudes may influence reactions to environmental cues and opportunities. e.g. social support may influence knowledge and skills.

Ecological models should be behaviour specific: Ecological models are most useful when they focus on a specific behaviour. Environmental and policy influences are often behaviourally specific

Multi-level interventions should be most effective for behaviour change: As there are multi-level influences on behaviour, multi-level interventions should be more effective than single-level interventions. 

Using the information Environment to change behaviour

• we can educate, persuade, train, coerce or advocate

• provides information about desired or undesired behaviour

• educational approach can provide awareness, standard, consequence, benefits for change ect.

• persuasion: generate emotional arousal about the behaviour

• advocate: increase awareness of overarching issues

• shaping knowledge: instruction on how to perform the behaviour

• natural consequences: information about health consequences

• natural consequences: anticipated regret

• natural consequences: salience of consequences

Targeting the Physical Environment

The physical environment includes the presence, characteristics and location of facilities and resources relevant to the behaviour, and may focus on attributes such as e.g., availability, accessibility, functionality, structure, quality.

Different components of the physical environment include

• the natural environment  e.g., green/blue space, open space, natural light, temperature, weather

• the built environment  e.g., buildings, structures, facilities

• physical attributes of settings e.g., size, colour, complexity

• housing/community design  e.g., multiple occupancy dwellings, street connectivity, mixed purpose development, density

• exposure  e.g., pollution, sanitation

• physical barriers  e.g., low accessibility

• aesthetics  e.g., cleanliness, attractiveness

targeting the economic and policy environment

This includes costs, procedures, rules and regulations relevant to the behaviour.

Economic environment: costs/affordability of behaviour

i.e. taxes, fines to reduce - financial coercion

discounts, subsidies, rebates, financial rewards to increase - financial enablement

Policy and legislative environment: policies, procedures, rules, regulations that are relevent to behaviour

national, state, local, or organisational/setting

workplace policies:

Population-level approaches to behaviour change which use the information, physical, economic or policy environment can target specific settings such as

• education settings e.g., schools, universities

• workplaces

• service settings e.g., GP practices, hospitals, community clinics

• community contexts e.g., neighbourhoods

Reading

the physical environment: includes the presence, characteristics, and location of facilities relevant to the behaviours being targeted

information environment: sources of information and education that are relevant to understanding and influencing the desired behaviours

policy environment: policies, procedures, rules, regulations relevant to the behaviour

social environment: subjective norms, social connections, and social support provied by a range of people

Schools are a well-established area for behaviour change; behaviours can reach children, adolescents, and their families

Barriers includes, standard curriculum, require support of educational system, school admins, teachers, parents and wider community

an example of targetting at a range of levels

targetting the workplace and work organisations

programs focused on characteristics in the workplace that are relevant to preventing harm and promoting health

barriers:

• productivity loss is perceived

Upstream social determinants refer to the conditions and circumstances in which people are born, grow up, learn, work play and live, relevant to others

• upstream social determinants reflect distribution of power, wealth, and resources