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Ecological models acknowledge the importance of human-environment interactions in understanding and changing behavior. These models incorporate multiple levels of influence on behavior, including policy, community, organizational, social, and individual. Studies applying ecological models to explore health behavior correlates have tended to identify determinants at the individual level, with fewer exploring correlates at the social, physical, and policy levels. While primarily developed to explain human behavior, some ecological models have been further developed to inform interventions to change human behavior, often paired with theories such as social cognitive theory, organizational theory, and behavioral choice theory. Evidence syntheses indicate that ecological models are seldom used to inform intervention design, with the majority focusing on just one or two levels of the model. Most interventions applying ecological models to target child and adolescent health behaviors have reported small effect sizes, while child obesity prevention initiatives targeting factors at multiple levels of influence have shown larger effects. Future research should focus on developing interventions targeting all levels of ecological models, using interventions based on ecological models to change the behavior of whole communities, using ecological models within a systems framework, and exploring how they can assist with the scaling up of interventions to improve population reach.
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