A broad range of factors contribute to individual and community health across the globe. This includes beliefs and behaviors, interpersonal influences, institutional rules and practices, and societal factors (i.e. norms and policies). An examination of each factor independently gives a limited perspective. To enhance understanding of the complex issues, individual influences should not only be considered,but also the interaction of external contributing factors and their combined impact. The current text provides an outline of methodological processes for instrument development using social ecology and mixed methods. A systems approach,such as that present in social ecological models,offer guidance to examine multiple influences on human health/behavior and may provide an effective solution to the problem of limited sustainability. Mixed methods research provides an added advantage of including qualitative and quantitative data for an all-inclusive perspective. Epidemiological data related to HIV/STIs among adolescents and young adults is presented. The reader will find the text very useful for any areas related to Public Health, Health Education, Statistics, and Research Methods.

LASONJA B. KENNEDY, PhD, MA, CHES, began work in the health field over ten years ago while volunteering in the US and internationally. Her experiences provided detailed insight into the complexities of health issues and disparities. That insight combined with lessons shared by others is presented in the text.