As we celebrate mothers in all their roles this week, one powerful role especially comes to mind – change agent. When we have social issues that impact all of us, mothers stand up, alert us to the problem and create movements. Candy Lightner lost her 13-year-old daughter, Cari, in 1980 because of the actions of a drunk driver. She channeled her grief into establishing MADD (Mothers Against Drunk Driving), which led to heightened awareness and the passing of legislation to raise the legal drinking age to 21. Because of her and many advocates across the country, drunk driving fatalities have been cut in half from 21,000 in 1980 to 10,000 in 2013, saving more than 300,000 lives. It is one of our proudest public health victories and is being replicated worldwide. MADD is celebrating its 35th anniversary this year. How did we get this change to happen in such a short amount of time?

As we have studied this success, researchers have found and perfected a model that accelerates the pace of social change – the socio-ecologic model. It provides a comprehensive framework for understanding and modifying the range of social and environmental factors that have an effect on individual human behavior. It shows that, while individual behavior change is hard and something we still are trying to understand, humans are shaped most profoundly by their environment. The model showcases overlapping levels of environments – individual, relationship, community and societal.  Each level is critical, and interventions are more effective as they address risk and opportunities at multiple levels. Efforts focused on the outermost levels of the model can help create a social and physical environment that is supportive of individuals impacted.

Social-Ecological Pic

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To illustrate this model, it is helpful to observe the last two decade’s efforts to reduce drunk driving by organizations like MADD. Through coordinated efforts that focused on individual change as well as complementary efforts at the policy level, they created a social and physical environment that became intolerant of drunk driving.  Using the model, here are some efforts that exemplified their strategy:

  • Individual:
    • Through educational programs at schools, they created a new generation of educated and aware drivers.
  • Relationship (also called lnterpersonal):  
    • Through the “Friends Don’t Let Friends Drive Drunk” campaign, they created a social support network that made friends and family feel responsible for the actions of individuals.  Many efforts even encouraged party hosts to take guests’ keys at the door.
  • Community:
    • Through efforts at schools and churches, they succeeded in changing group norms by offering “drug-free” parties and proms.  Schools also started on-campus clubs that encouraged students to sign drug-free pledges.
    • Through efforts at educating bar owners and staff, they developed programs to help identify people who were intoxicated, stop them from drinking and encourage them to use alternate transportation.
  • Societal:
    • Through lobbying efforts, they increased city officials’ awareness of the problem and encouraged them to enhance efforts to apprehend people driving under the influence during holiday weekends.
    • Through PR efforts, they encouraged the media to assist in making more people aware of the problem and discouraging the behavior. The media featured dramatic stories about families who had lost loved ones due to drunk driving.
    • Through lobbying efforts, they were successful in getting the federal government to decrease the accepted level of intoxication to .08 and increase the minimum legal drinking age to 21. They also tied the receipt of federal transportation dollars to each state’s compliance with this standard.

The socio-ecological model has been used in the following areas: violence, obesity and chronic disease, and early childhood development. As illustrated above, interventions that target the outer levels of the model (i.e., community, societal) can improve individual status by modifying underlying factors that influence the individual.  This often yields greater impact than focusing on the individual alone.

We encourage organizations and communities looking at large-scale social change to chart their efforts against this model and look for gaps in their efforts.  As Mother Teresa noted, each level can “create many ripples” and cumulatively those ripples lead to change that matters. We welcome your input on this model as well as others that move your work forward.  Tune in next week as we explore project management.

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