Social Ecological Model

II. Social Ecological Theory In general, ecological models focus on the understanding of the intersection of organisms and the environment surrounding them9. When applied to public health, this type of model attempts to assess how individuals interact with both their physical environment and their social or cultural surroundings9. For this reason, a Social Ecological Model (SEM) is often used to understand these more complex human interactions. This framework is targeted at the environment and individual's behaviors-which enact upon multiple levels of influence9. The social ecological approach also accounts for individual differences, attitudes, and behaviors that might lead to distinct levels of susceptibility or vulnerability to certain

Public health interventions that employ this model, are also said to be most effective when it addresses multiple levels of influence at once9,10. An intersectoral approach is more likely to mimic the reality of how individuals and a societies function, and thus, is more likely to effectively invoke change among the population to which it's being applied. This type of approach is also thought of as being more sustainable and likely to remain functional among the population throughout the passage of time9. The levels of influence studied for behavioral change and environmental enhancement within social ecological theory usually include the individual or personal level, the interpersonal level, the community level, the institutional or organizational level, and the societal, policy, or enabling environment level9,10,11. Infectious disease has often been analyzed through similar host-agent-environment models in which rates of infectious disease within a population are viewed as being influenced by changes in the host, the environment, and the agent itself12. Incorporating additional social and environmental factors-which might lead to changes in host behaviors, population structures, and enabling environments-into a model for studying infectious disease, results in delving further into the inadvertent factors that could be leading to higher rates of disease

This all-encompassing perspective on the factors directly and indirectly influencing the transmission of the virus, should provide with a clearer view of the changes that could be made to reduce the burden of the disease among communities and populations. A retrospective analysis of events and conditions pertaining to previous Ebola outbreaks in history-including the most recent large-scale outbreaks within the African continent-will be used to develop a framework based upon factual information and evidence. This paper aims to provide with a holistic approach to mitigating Ebola virus transmission, provide a better understanding of the health behaviors leading up to increased or sustained transmission, and potentially encourage the development of future interventions for prevention and control of