Breadth of the socio-ecological model

Kilanowski, Jill F.

doi:10.1080/1059924x.2017.1358971

Cited by 245 publications

(272 citation statements)

References 19 publications

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“…The social ecological model (SEM) is one such framework. Originally introduced in the 1970s as a framework for understanding human development (Bronfenbrenner , Kilanowski , Zhong et al . ), the SEM is now most commonly used in the development of public health promotion and prevention programs (Baral et al .…”

Section: Discussionmentioning

confidence: 99%

‘Treat them into the grave’: cancer physicians’ attitudes towards the use of high‐cost cancer medicines at the end of life

Wiersma

Ghinea

Kerridge

et al. 2018

Sociology Health & Illness

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The prescribing of high-cost cancer medicines at the end of life has become a focus of criticism, due primarily to concerns about the safety, efficacy and costeffectiveness of these medicines in this clinical context. In response to these concerns, a number of interventions have been proposedfrequently focused on improving physician-patient communication at the end of life. Underpinning these strategies is the assumption that the prescribing of high-cost cancer medicines at the end of life is primarily the result of poor communication on the part of cancer physicians. In this paper, we explore the factors perceived by cancer physicians to be driving the use of high-cost cancer medicines at the end of life. Drawing on semi-structured interviews with 16 Australian oncologists and haematologists, we demonstrate that these physicians believe that the use of high-cost medicines at the end of life is driven by multiple factorsincluding individual, interpersonal, socio-cultural and public policy influences. We conclude that these factors, and their interactions, need to be taken into account in the development of public policy and clinical interventions to address the use of high-cost medicines at the end of life.

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Section: Discussionmentioning

confidence: 99%

‘Treat them into the grave’: cancer physicians’ attitudes towards the use of high‐cost cancer medicines at the end of life

Wiersma

Ghinea

Kerridge

et al. 2018

Sociology Health & Illness

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“…The SEM is considered relevant to health promotion and disease prevention, and it has been adopted by the Centers for Diseases and Prevention in its initiatives. As various factors contribute to effective chronic disease management in the community, the authors also considered SEM in the process of collecting data and formulating recommendations [45].…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Facilitators and barriers of managing patients with multiple chronic conditions in the community: a qualitative study

Foo

Sundram²,

Legido‐Quigley

2020

BMC Public Health

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Background: Approximately one-third of all adults worldwide are diagnosed with multiple chronic conditions (MCCs). The literature has identified several challenges facing providers and patients coping with managing MCCs in the community, yet few studies have considered their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore. Methods: This study involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provide subsidised primary care services. Topic guides were developed with reference to the literature review, Chronic Care Model (CCM) and framework for patient-centred access to healthcare. Results: Despite the perceived affordability and availability of the support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nationwide medical savings scheme to cover outpatient treatment and medications. Half of healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those who did not visit the clinics might not receive timely care. Furthermore, patients reported long consultation waiting time. Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges to delivering safe and quality care with limited consultation duration due to the need to manage high patient load and waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients. Although providers could equip patients with self-management and lifestyle-related guidelines, patients' actions are influenced by multiple factors, including work requirements, beliefs and environment. Conclusions: There were barriers on care access, delivery and self-management. It is crucial to adopt a whole-ofsociety approach involving individuals, community, institutions and policymakers to improve and support MCC management. This study has also highlighted the importance of considering the different viewpoints of healthcare providers and users in policy formulation and community care planning.

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“…In coherence with these models, our findings also demonstrated the need to involve multiple stakeholders to extend efforts to address gaps and scale up positive aspects of respective components such as health systems, delivery systems, self-management, community support and care access. Specifically, this would involve a whole-of-society approach in accordance to socio-ecological model to examine several areas, as shown in Figure 2 (45). and dieticians, involved in managing chronic diseases, this study only interviewed physicians.…”

Section: Key Findings and Recommendationsmentioning

confidence: 99%

Facilitators and Barriers of Managing Patients with Multiple Chronic Conditions in the Community: A Qualitative Study

Foo¹,

Sundram²,

Legido‐Quigley

2020

Preprint

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Background Approximately one-third of all adults worldwide are diagnosed with multiple chronic conditions (MCCs). The literature has identified several challenges facing providers and patients coping with managing MCCs in the community, yet few studies have considered their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore. Methods This study involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provide subsidised primary care services. Topic guides were developed with reference to the literature review, Chronic Care Model (CCM) and framework for patient-centred access to healthcare. Results Despite the perceived affordability and availability of the support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those who did not visit the clinics might not receive timely care. Furthermore, patients reported long consultation waiting time. Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges to delivering safe and quality care with limited consultation duration due to the need to manage high patient load and waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients. Although providers could equip patients with self-management and lifestyle-related guidelines, patients’ actions are influenced by multiple factors, including work requirements, beliefs and environment. Conclusions There were barriers on care access, delivery and self-management. It is crucial to adopt a whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCC management. This study has also highlighted the importance of considering the different viewpoints of healthcare providers and users in policy formulation and community care planning.

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Breadth of the socio-ecological model

Cited by 245 publications

References 19 publications

‘Treat them into the grave’: cancer physicians’ attitudes towards the use of high‐cost cancer medicines at the end of life

‘Treat them into the grave’: cancer physicians’ attitudes towards the use of high‐cost cancer medicines at the end of life

Facilitators and barriers of managing patients with multiple chronic conditions in the community: a qualitative study

Facilitators and Barriers of Managing Patients with Multiple Chronic Conditions in the Community: A Qualitative Study

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