Ecological Model. The Parties agree that regional ecological model may be a useful tool in evaluating and predicting effects of SNWA groundwater development when coupled with a sufficiently resolved hydrologic model. Based upon the success of the ecological modeling effort being conducted by SNWA in Spring Valley, the TWG will evaluate the utility of an ecological model within Snake Valley during the Initial Period. If the TWG recommends and the Management Committee approves proceeding with an ecological modeling effort, the ecological model will be created in years one and two of the Baseline Period. During the remainder of the Baseline Period and throughout the Operational Period SNWA will maintain, update and operate an agreed-upon model in cooperation with the TWG. Notwithstanding anything to the contrary contained in this Agreement, SNWA’s contributed funding of the ecological model during the Baseline Period shall be limited to $500,000. Any funding commitment for ecological modeling during the Operational Period is subject to appropriation approval by SNWA’s Board of Directors.
Ecological Model. The findings from this study identified barriers and facilitators at each level of influence in the Social-Ecological model. The factors affect the behavior of the psychiatrists, which is, in this case, the extent to and the manner in which they provide or connect adult women with SRH services. All of these factors interacted interdependently - one influenced the other. For example, a psychiatrist may believe that it is not their professional responsibility to test for STIs and treat them at the Outpatient Center (the individual level) and so they do not incorporate these services into their practice. The perception of the psychiatrist’s responsibility could be based on experiences with patients that show up late to appointments (intrapersonal level), resulting in time management issues (organizational level). The psychiatrist may also have had a supervisor during residency that did not model the provision of SRH services to their patients and who has not reviewed updated STI testing and STI treatment since medical school (community level). Finally, the psychiatrist may also worry that prescribing treatment for an STI, without adequate training, would make them liable to be sued (policy level). All of these factors would influence the psychiatrists’ final decision not to provide SRH services on site. Multiple interventions targeted at each of the levels of influence could help support psychiatrists in providing and better connecting their patients with SRH services. However, the findings from this study make a strong case for targeting interventions at the community and policy levels in order to positively influence SRH health outcomes. Possible interventions include trainings for attending psychiatrists on incorporating SRH services into their practice and standardizing training for supervision of residents. In addition, there needs to be a clarification of psychiatrists’ responsibility for SRH services by medical associations, health organizations, and health care centers.
