Fields of Influence

When I was studying to become a social worker, I was most excited about a concept that we called P-I-E or Person In Environment. It had to do with ecological theory or the ecological perspective which reminds us that people do not exist in vacuums but interact within and affect multiple systems. We have an impact on the environment and it on us. We could go in many directions with that statement alone as I am sure you can see.

For my social work practice, the ecological perspective was used to assess a person’s positive and negative relationships in all their domains of functioning. From there, we used the positive relationships or connections to build self confidence and courage to either work to improve the negative ones or to sever them.

I no longer see myself as a social worker. I am a most ardent public health educator. In public health we use the ecological perspective as well. In this sense we are looking into the areas of a person’s life where behavior can be influenced. I do want to stress that word, influenced. I have learned my social work lessons well and do not hold any false perception of changing people.

With regard to either field, or any – a person teems with opportunities for impact. A few that you might think of are intrapersonal (our inner thoughts, beliefs, doubts, moods – what we say to ourselves about ourselves and about others), interpersonal (exchanges between one or more people – outside behaviors influenced by our inner selves, the others' inner selves, the context, the place), environments (home, neighborhood, local, national, geographical, etc) our institutions (school, work, church, government) or social or recreational outlays (clubs, groups, gyms, churches/synagogues/temples)… And the list can go on… and cannot leave out our social networks both in person and on line.

It is with this background that I read an article on Health Communication and Marketing found in BMC Public Health 2007, 7:88 – lead author Is Edward Maibach from GWU.

I wanted to mention some interesting concepts/constructs from the article – just the idea of them will give you fodder for contemplation.

The authors propose 5 Fields of Influence which they put into two categories. They are either People-based or Place-based. It is then suggested that health messages be targeted in various ways to these specific fields.

People – individuals, social network, population or community
Place – local level, distal level
Here is the figure as provided in the journal article –

A people and places framework for public health influence.
Maibach et al. BMC Public Health 2007 7:88 doi:10.1186/1471-2458-7-88

If you look at this chart and then think about things that we need to do or not do to be healthy or injury free – you can think of how a health communication could be specifically tailored and used based on a field and ALSO that many times we have to target multiple fields at once to see a positive outcome.

Or as I have become fond of saying, we can’t just make it acceptable on the individual level but also possible on the environmental or place level.