PH Communications & Advocacy
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Chapter17ppt.pptmChapter 17
Advocacy and Public Health Policy
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
“The business of improving population health has always been linked to action. First document, then analyze, then act, then document the effect. Public health takes place in boardrooms, on street corners, in our homes, and in the legislature. So too, does public health advocacy.”
Eyler, Chriqui, Moreland-Russell & Brownson, 2016, p.329
Public health (PH) and advocacy
Preventing disease, prolonging life and promoting health via organized efforts and informed societal, organizational, communities, and individual choices.
PH research builds on knowledge and identifies strategies to achieve health promotion and disease reduction.
Advocacy uses these findings to create new public policies that impact health outcomes
Tobacco
Seat belt
Recycling
Baby-friendly hospital initiatives to encourage breastfeeding
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
What is advocacy?
The act or process of supporting a proposal or cause
Public health advocacy influences legislative or regulatory decision makers that have the power to change policy
Range of tools and strategies are used
Typical tools and strategies:
Explaining the benefits of the desired action (in person, writing, or both), especially in terms of the problem it will solve
Anticipating objections and preparing responses to them
Appealing to emotions of the decision makers or constituents
Forming coalitions
Pointing to other decision makers who have taken the requested action
Negotiating
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
P331 17.1
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
What is advocacy?
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
CDC Public Law News – great resource for recent legislative activity and policy updates
CDC Winnable battles – focus is on the largest ph policy initiatives. Excellent resource for coalition development
Policy
Built environment
Retail encvironment
Work environments
Restaurant environments
Media environment
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
What is advocacy?
Key Elements in Policy
PH policy should create optimal defaults
Should lead to creation of a more healthful default option
Common nature leads us to the default
Example
Restaurant offers french fries as default
Modify the default to garden salad and frendh fries upon request
Idea is that healthy choice is the easy choice, the default choice
Advocates look for policy solution to displace the unhealthful defaults
Let’s read box 17.1 p332
PH policy should be effective
To be effective it needs to have a basis in science
Provide policy makers with data and scientific evidence
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Key Elements in Policy
PH policy should create health equity
Achieved when every person is provided the opportunity to attain full health potential and no one is disadvantaged due to social position or socially determined circumstance
Creating optimal defaults can promote equality but that is often not enough
Leads to health disparities
Unfair health differences linked to social, economic, environmental disadvantages adversly affecting different groups
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Lobbying
Communicating with a legislator to intentionally influence the way he or she will support or vote for a specific legislation
Direct
Includes a communication (visit, call, letter) directly to a legislator that reflects a view on a particular legislation
Write a letter to representative requesting vote in favor of Bill x banning smoking from parks
Grassroots
Process of expressing a view to the public on a specific legislation and including a “call to action”
Involves asking the public to contact their legislators and provide the public with information on who their legislators are and how to contact them (email, petition)
Identifies a legislators position on a specific bill
Read examples on 334 and 335
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Key Elements in Policy
Who can advocate?
Individuals
Organizations
Coalitions
Very effective for public health advocacy
Group of organizations that come together to achieve a goal on a shared interest
For-profit companies
Nonprofit organizations
Grassroots groups
State and local health departments
Academics
Researchers
Faith-based
Health & social justice organizations
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Key Elements in Policy
Steps in the Advocacy Process
Define the problem and possible solutions
Identify the general issue: obesity, Alzheimer's, healthcare, tobacco
What national, state, or local data are available to document the scope of the problem?
Who is affected by the problem? Identify.
What has been written on the issue? Collect.
What is the economic impact of the problem?
What work is presently being done on it by the governmental and nongovernmental (national, state, local) agencies?
What are some possible solutions?
You and your coalition will be working on defining the problem for Week one group discussion as well as forming a coalition
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Form a coalition
Include a variety of members including those that may not be immediately obvious as advocates
Create an asset map
Table 17.2 p 337
Includes skills, knowledge, representation and resources needed to achieve policy change sought
We will review the asset mapping example on pps 337-338
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Begin “Ground Softening”
Raise awareness about the issue among the public and government decision-makers (legislators, agency officials, or both)
Explain why it is a:
public health issue
who is affected
what policy solutions are warranted
Necessary first step before viable legislation can be introduced
An advocacy role in this first phase would be an educator who introduces people to the problem and explains why it should be a priority
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Begin “Ground Softening”
Pouring on the Pounds
2009 New York City DHHS
Relationship between sugary beverages and weight gain
Video, posters, brochures, educational materials to increase awareness
Goal: educate the public (soften the ground) in preparation for proposals designed to help New Yorkers limit the amount of sugary drinks they consume, such as the “portion cap” policy
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Pouring on the Pounds
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Determine Who Has the Power to Make the Change Sought
Public health policy can be accomplished on local, state, and national levels.
A coalition may decide that the best initial approach will be to change policy on a local level, prior to attempting on a state or national level
After jurisdiction determined, then RESEARCH whom has the power to make the change
Director of town council
State speaker of the house
Senate President
Sponsor of future bill
Chair of committee in Congress
Begin to build a relationship via background information. Learn about them to help you frame the issue so it interests them
Do they have personal connections to your issue?
What are their current positions?
What are their future ambitions?
How have they talked about or voted on your issue?
What is their social media presence?
See entire list p.340
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Translate research for Decision-makers and the Public
Work with coalition partners to translate the information
Modify studies, data, and tables into easy- to-understand fact sheets, policy briefs, and one-pagers for policymakers and the public
Graphic representations of compelling research findings can communicate the importance of a policy issue or intervention quickly and clearly.
Sugar and health factsheet for policymakers
Read case study box 17.2 p.341
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Understand the Opposition
Critical to a successful advocacy campaign to know the opposition as
learn what their arguments will be, and prepare counterarguments in response
If the issue is one that has already been through a legislative cycle, public testimony from hearings, news articles, the opposition’s website, or even social media can be used to find out how the opposition frames their arguments.
Review other public health campaigns, even on different health issues, for patterns in how an affected industry will oppose the policy
Box 17.3. p 342
Eyler, Chriqui,
Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Understand Public Opinion
Are most people aware of the problem?
Do people already have strong feelings one way or another about possible solutions?
Do attitudes about the issue tend to be associated with particular demographic characteristics, such as sex, age, socioeconomic status, race, ethnicity, political orientation, or geography?
Eyler, Chriqui,
Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Understand Public Opinion
Create and implement a public opinion survey.
Media outlets, universities, and professional organizations that regularly conduct national public opinion polls can be important partners in designing and administering the survey.
Survey goal is to understand allies and opponents, and identify the biggest obstacles to public acceptance of the policy proposal.
Polling also can be used as an advocacy strategy to raise public aware- ness and gain legislator support.
A poll that shows substantial support for a policy near the date of the hearing or vote can reflecting the desires of the people
Eyler, Chriqui,
Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Outline Possible Solutions
Work with the coalition to identify a range of possible policy solutions
Formative research
Literature search for systematic reviews (i.e., syntheses of research studies on a particular topic) and evaluations of experiments
This process will help weed out solutions that have not been effective
Discuss the pros and cons of each strategy with the coalition
Which solutions achieve maximum impact?
Consider health equity—will the proposed solutions reach the populations most affected?
Are some solutions good but unrealistic?
In order to build momentum toward an ultimate goal, advocates sometimes decide to pursue policies with a higher likelihood of success, even if those policies on their own may have limited impact
Eyler, Chriqui,
Moreland-Russell & Brownson, 2016
Box 17.4 Case Study: School Wellness Policies
In the early 2000s advocates were interested in reducing or eliminating unhealthy snacks and beverages from schools. Many wanted federal regulation to require the complete removal of these products, but there was not enough political will or public support to achieve this goal. An interim policy was proposed instead, requiring school districts to write “wellness policies,” which would include setting nutritional standards for competitive foods. Although the requirement to have a wellness policy did not guarantee that any districts would remove unhealthy competitive foods, it did increase the public’s awareness of the issue and created an opportunity for local school districts to discuss the topic. Eventually, as public support grew, the federal government was able to push forward new regulations for competitive foods through the Healthy, Hunger-Free Kids Act.
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Consider unintended consequences
Talk to all potential stakeholders, importantly those that will be implementing the policy to prevent negative consequences
Eyler, Chriqui,
Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Plan Your Media Advocacy Strategy
Media advocacy harnesses the power of the news to mobilize advocates and apply pressure for policy change... . The public and policymakers do not consider issues seriously unless they are visible, and they are not visible unless the media have brought them to light.
Inform the public about the policy issue
Newspaper and electronic media first choice
Press release or press conference
1-2 page statement coalition can send to media and post on website
A good press release should be brief, clear, and quotable
A media strategy is an important element in every advocacy campaign.
Low-cost methods include writing letters to the editor, opinion editorials for the newspapers that key decision-makers read, and reaching audiences through social media:
Blogs, Facebook, Twitter, Instagram, YouTube, and Snapchat
Eyler, Chriqui,
Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Plan Your Media Advocacy Strategy
Inform the public about the policy issue
Newspaper and electronic media first choice
Press release or press conference
1-2 page statement coalition can send to media and post on website
A good press release should be brief, clear, and quotable
A media strategy is an important element in every advocacy campaign.
Low-cost methods include writing letters to the editor, opinion editorials for the newspapers that key decision-makers read, and reaching audiences through social media:
Blogs, Facebook, Twitter, Instagram, YouTube, and Snapchat
Eyler, Chriqui,
Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Evaluate Your Advocacy Efforts
Important for success; each attempt should be evaluated
Helps document what did and did not work in the advocacy campaign
Share evaluations with other working on similar policy goals
Showing what was done last and comparing what will be the updated policy solution to funders will help to secure funding the next time
Eyler, Chriqui,
Moreland-Russell & Brownson, 2016
Steps in the Advocacy Process
Evaluate Your Advocacy Efforts
Can include examining organizational capacity, alliances, or strength of support
Others include assessment of improved policies resulting from advocacy efforts, and if implemented, the changes in impact
Evaluations of short policy briefs or case studies also can be useful
Interviewing a wide range of people, including representatives of health equity organizations can gain insight into if the effort was inclusive and focused on the communities most affected by the issue
Eyler, Chriqui,
Moreland-Russell & Brownson, 2016
Reference
Eyler, A.A., Chriqui, J.F., Moreland-Russell, S.M., & Brownson, R.C. (Eds.). (2016) Prevention, policy, and public health (1st ed.) New York, NY: Oxford University Press.
Eyler, Chriqui, Moreland-Russell & Brownson, 2016
