This model has two concepts, 1).Multiple level

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This model backs
to 20th century in the writings of Lewin, Barker, and
Bronfernbrenner among others who started understanding human behavior as an
interplay of individual and the environment.

The ecological
model has been defined as “a model of health that emphasizes the linkages and
relationships among multiple factors (or determinants) affecting health,”
Institute of Medicine, 2003. Many health related studies have adopted
extensively this model as the backbone of their study operations,
implementation and results interpretation. This model provides the foundation
for understanding the various factors affecting behavior and guides the
development of interventions thought to impact the social environment of the
individual, social networks/interpersonal, organizational, community and public
policy on health behavior.  According to
the works of McLeroy et al. (1988), the model has two concepts, 1).Multiple
level i.e. behavior affects and is affected by multiple levels of influence;
2). Reciprocal causation i.e. Individual behaviors shapes, and is shaped by,
the social environment. This model has five stages/levels which includes;
individual/intrapersonal level, social networks/interpersonal level, organizational
level, community and public policy on health behavior. 

The intrapersonal/individual level

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The person’s
level of literacy on biological and personal history characteristics that make
her susceptible to breast or cervical cancer, increases her health literacy
about breast or cervical cancer disease. Some of these individual factors
includes age, level of education, occupation, income levels, substance use, and
history of cancer cases. At this level we are looking onto how individual women
understands and belief, and how they interpret the information given to them by
the health workers to date in regard to breast and cervical cancer diagnosis,
planned treatment and the educational needs.


The social
networks are the links an individual has in the society that may be of support
in addressing challenges of life. The social networks an individual may have,
may increases her understanding and literacy. On this, we are looking at how
social networks may support the woman diagnosed with breast or cervical cancer
in under going all the planned treatment procedures, clinic follow up and her
social life. A person who has had one of her family member diagnosed with
breast or cervical cancers may influence her screening and testing seeking
health behavior for her own and the diagnosis.


Organizational level

At this level we
are looking at the preventive, diagnostic, health literacy and treatment
activities implemented at organizational level addressing the breast and
cervical cancer. When we mean organizational level we are referring to the
health facilities. The activities that are geared towards facilitating
individual behavioral change by influencing screening, diagnosis, treatment, referrals
and follow ups of the patients. Also the understanding of the clinician in
regards to cervical and breast cancer may assist the patient in requesting the
right diagnostic procedure and tests.

Community level

This level
explores the social cultural beliefs, norms and values that surround the
cervical and breast cancers diagnosis, treatment and literacy among the
community members. These social norms can reflect on how individuals in a given
society uptake any given health service as reported by Abdikarim K., Atieno M, & Habtu M. (2017), they found
cervical cancer screen uptake young women is affected by the perception that it interferes with
virginity which many valued most than testing for cervical cancer. In this study
we are going to understand how the social cultural beliefs may affect the women
diagnosed with breast or cervical cancers in influencing diagnosis, treatment adherence
and social interactions in the society.

Public policy level

Policies and laws govern accessibility of
health care and universal health insurance cover frequently define access to
cervical cancer screening, diagnosis, treatment and adherence to planned
treatment. Cancer being an expensive disease to treat and cure; government
policies formulation and implementation would influence the cancer screening
and treatment.

Categories: Relationships


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