The biopsychosocial model has dominated research and theory in health psychology. This article expands the biopsychosocial model by applying systems theories proposed by developmental scholars, including Bronfenbrenner's ecological models and Sameroff's transactional model, as well as contemporary philosophical work on dynamic systems. The proposed dynamic biopsychosocial model construes human health as a product of the reciprocal influences of biological, psychological, interpersonal, and macrosystem contextual dynamics that unfold over personal and historical time. The importance, or centrality, of these influences varies within a person over time. The model is explicated using two hypothetical case studies derived from existing interdisciplinary health research. Implications for health, theory, research, and policy are discussed. | RETHINKING THE BIOPSYCHOSOCIAL MODEL OF HEALTH: UNDERSTANDING HEALTH AS A DYNAMIC SYSTEMDynamic interpersonal, biological, and psychological systems interact with contextual factors to shape health over the life span. This manuscript integrates theoretical perspectives that promote health understanding and considers the implications of these perspectives for research and policy related to health psychology. We first outline the dynamic biopsychosocial model of health, highlighting its conceptual roots and then present two hypothetical research-based examples that clarify the model's utility for understanding health.The model shown in Figure 1 and discussed below is an expanded version of the biopsychosocial model. The model integrates existing conceptualizations of the biopsychosocial model (Engel, 1980) with other systems models, especially those proposed by Urie Bronfenbrenner, Arnold Sameroff, and Evan Thompson. The major goals of this paper are to (a) explain the interactive elements of the dynamic biopsychosocial model and (b) use Bronfenbrenner's work to elaborate interpersonal dynamics in social environments and introduce centrality as a factor that modulates influences on health. | COMPONENTS OF A DYNAMIC BIOPSYCHOSOCIAL MODEL OF HEALTHThis model conceptualizes biological, psychological, interpersonal, and contextual effects on health as dynamics. Each dynamic captures a set of interactive forces or systems that affect health. The term dynamics is used to emphasize that

School-based health centers (SBHCs) positively influence student health. However, the extent to which these benefits are actualized varies across sites. We conducted focus groups with high school students and teachers at an underperforming SBHC to identify facilitators and barriers to student access to SBHC services. Our qualitative analysis revealed four main emergent categories: (1) students' knowledge of SBHC services; (2) teachers' perceptions of, and experiences with, the SBHC; (3) accessing and utilizing SBHC services; and (4) student and teacher suggestions to improve the school–SBHC relationship. Our findings suggest that the relationships between health center staff and teachers are crucial and can be damaged with poor implementation. Additionally, there was a general lack of knowledge about the procedures for accessing services at the SBHC. Participants provided recommendations, including strategies for better outreach and engagement with teachers and students, as well as operational strategies to enhance communication systems and the physical environment.

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