An ecological perspective on health promotion programs

McLeroy, Kenneth R.; Bibeau, Daniel; Steckler, Allan; Glanz, Karen

doi:10.1177/109019818801500401

Cited by 8,502Public Health Policies and EducationCommunity Health and DevelopmentHealth Promotion and Cardiovascular Prevention

An ecological perspective on health promotion programs

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McLeroy, Kenneth R., Bibeau, Daniel, Steckler, Allan, Glanz, Karen·1988·Health Education Quarterly

DOI 10.1177/109019818801500401

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Abstract

During the past 20 years there has been a dramatic increase in societal interest in preventing disability and death in the United States by changing individual behaviors linked to the risk of contracting chronic diseases. This renewed interest in health pro motion and disease prevention has not been without its critics. Some critics have accused proponents of life-style interventions of promoting a victim-blaming ideology by neglecting the importance of social influences on health and disease. This article proposes an ecological model for health promotion which focuses atten tion on both individual and social environmental factors as targets for health promo tion interventions. It addresses the importance of interventions directed at changing interpersonal, organizational, community, and public policy, factors which support and maintain unhealthy behaviors. The model assumes that appropriate changes in the social environment will produce changes in individuals, and that the support of individ uals in the population is essential for implementing environmental changes.

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The socio-ecological model (SEM) was used as the theoretical framework to map and interpret influences on HPV vaccination awareness and uptake among adolescent girls in India.
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Interpersonal factors like parental influence, peer support, and healthcare provider recommendations shaped decisions, though outreach was inconsistent in underserved areas.
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From Barriers to HPV vaccination among adolescent girls in India: A scoping review (2026) · cites this paper as [45]
The SEM recognizes that health behaviors are shaped by interactions across multiple levels: individual, interpersonal, organizational/institutional, community, and policy.
“The SEM recognizes that health behaviors are shaped by interactions across multiple levels: individual, interpersonal, organizational/institutional, community, and policy.”
From Barriers to HPV vaccination among adolescent girls in India: A scoping review (2026) · cites this paper as [47]

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“However, many behaviour change theories, including the Social Cognitive Theory [19], Social-Ecological Model [20, 21], Theory of Planned Behaviour [22] and the Health Belief Model [23], highlight the importance of social factors such as social support (SS) and social connectedness in maintaining and/or initiating beha…”
Background
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Introduction
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Authors: McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K.
Affiliations: University of North Carolina at Greensboro (US)
University of North Carolina at Chapel Hill (US)
Temple University (US)
ORCID: McLeroy, Kenneth R.
Bibeau, Daniel
Venue: Health Education Quarterly
Publisher: SAGE Publications
Published: 1988-12
Volume: 15
Issue: 4
Pages: 351-377
ISSN: 0195-8402 (ISSN-L)
DOI: 10.1177/109019818801500401
OpenAlex: W2158089900
Semantic Scholar: f8154b5adc62485636016c48ebb94a9c8bc9dde8
Cited by: 8,502
References: 125
Citations by year: 2026: 810 · 2025: 739 · 2024: 573 · 2023: 541 · 2022: 569 · 2021: 552 · 2020: 611 · 2019: 420 · 2018: 406 · 2017: 319 · 2016: 344 · 2015: 317 · 2014: 302 · 2013: 299 · 2012: 224
FWCI: 38.84
Type: journal article
Language: en
Open access: green
doi.org
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Health Education Quarterly (publishedVersion)
PubMed (publishedVersion)
University Libraries (University of Maryland) (submittedVersion)
Digital Repository at the University of Maryland (University of Maryland College Park)
Topics: Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
Health Sciences › Health Professions › General Health Professions › Community Health and Development
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords: ecological model, health promotion, disease prevention, lifestyle intervention, social environment, social determinants of health, victim blaming, chronic disease prevention, community-based intervention, public policy, organizational interventions, interpersonal factors
MeSH terms: Community Health Services, Health Promotion, Humans, Social Environment, Health Behavior

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An ecological perspective on health promotion programs

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