Using a social-ecological model in development of treatment progams that target behavior change

Abstract

Horticultural therapy and therapeutic horticulture programs often lack a clearly specified theoretical foundation or conceptual model, thus it is difficult to clearly articulate the outcomes a patient or client may experience from the program. One approach that may help with this challenge is to use a social-ecological model in horticultural therapy programming. Social ecology is the study of the influence of the social context on behavior, including institutional and cultural variables and is used to develop practical guidelines for designing, implementing, and evaluating health promotion programs. The most common models to describe this approach are 5-level (individual, interpersonal, organizational, community, and public policy) or 4-level (individual, relationship, community, and societal) and can be represented by an onion, with one level wrapping around another. For an intervention to be effective it must address multiple levels since, through research, we know that factors at multiple levels affect human behavior. This paper will explain the social-ecological model and provide an example of how it can be used to develop an intervention.