communicating health justice

8/8/2019 Communicating Health Justice

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CommuniCatingfor health JustiCea Cc sy Cc ac h i

t P Pjc

Y m Cc

Yot Ma Coc

1611 Tga A. St 510

Oaka, CA 94612

510.444.0640

tt://.yotmacoc.og

Photo courtesy o Community Coalition


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tb C

1 Acknowledgements

2 AboutThisCurriculum

5 IntroductiontoFraming:HowDoesitWork,WhyDoesitMatter?

8 CurriculumOverview:HealthJusticeCommunicationsStrategy

9 TrainingFlow:HealthJusticeCommunicationsStrategy

ToolsandResources

CaseStudy:WomensEconomicAgendaProjectBuildsaBigTentor

HealthJustice

HealthCareEquity:ToolKitorDevelopingaWinningPolicyStrategy


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c o m m u n i c a t i n g f o r h e a l t h j u s t i c e

Thishealthjusticecurriculumwasmade

possible by unding rom the Caliornia

Endowment, and by Makani Themba-

Nixon,whocontributedthelionsshareo

expertise, writing andsynthesisorthis

publication.

Thanksarealsoduetotheparticipantsin

the pilot session or this curriculum that

tookplaceSeptember2006inSanFrancisco.

EthelLong-ScottandtheWomensEconomic

Agenda Project were among the partici-

pantsanddeservea specialshoutoutor

theirsignicantcontributionstotherame-

work.Wearegrateulorthetimeande-

ortWEAPspentlayingouttheirapproach.

Acasestudyontheireortsisincludedin

thistoolkit(see p. 18).

Berkeley Media Studies Group pro-

videdthebulkotheworkinthesec-

tiononmetamessagingaspartoan

earlier published work (coauthored

withThePraxisProjectandavailable

at www.thepraxisproje ct.org). We

are also grate ul to SCOPE-LA and

S yl vi a C as ti ll o or h er a da pt at io n

o SCOPEs Power Analysis Tool to

health justicework includedin the

appendices. SCOPE-LA has helped

hundredsoorganizationsdosharp-

erstrategyasaresultotheirinno-

vation.OurthankstoSylviaorher

d e t a pp li ca ti on o t hi s a nd o th er

analyticaltoolstohealthjusticeor-

ganizing.MoreonSCOPE-LAcanbe

oundatwww.scopela.org.

acw


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Wenowknowthatthehealthiestnations

have social and political structures with

the most equity and access. Small na-

tions with relatively ewerresources like

Cuba have better health

outcomes than large, high

resource nations like the

UnitedStates. Thisisbe-

causehealthycommunities

are more than the sumo

individualchoices.Healthy

communities are the sum

opolicies,structures,sys-

temsor education,resourcedistribution,

politicalenranchisementandmore.

When combined, these elements orge

healthyenvironments,andprovidequal-

ity,accessiblecarethatsupportshealthy

choices.Iequityistheprimaryactorin

healthier outcomes, as research shows,

communicating to advance health jus-

ticeis,atitsmostbasic,buildingpublic

support or more equitable systems o

healthnotsimplypromotingindividual

healthychoices.

Asaresult,healthjusticeadvocatesmustshitromthedominant,portraitrame

(characterizedbyindividualchoiceslike

whatwechoosetoeat),toalandscape

perspective that includes how policies,

institutional behavior, structural and

historical issues undamentally shape

healthoutcomes.

Thiscurriculumisdesignedtohelpad-

vocates make this shit in three impor-

tantways:

1.Byprovidingtoolstohelp

advocatesmaketheshitrom

healthpromotionandindividual

behaviorchangetoahealthsystems

ramework

2.Byprovidingmethodsor

integratingissueidentication,

poweranalysisandoverall

organizingstrategyinto

communicationsplanning

3.Byoeringcurriculum

oracilitatingstrategic

communicationsincludingaudience

identicationandmessagingto

advancehealthjusticeraming

Health can be a complicated issue to

ramesincemuchoourunderstanding

o health is really about sickness and

care.However,healthcareisacriticalis-

sueasmillionsintheU.S.areuninsured

andeventhosewithinsurancehavelim-

itedaccesstoqualitycare.Opponentsto

undamentalchangeinthesystemwantto keep theocuson individualchoices

made by those inthe care system by

bothpatientsandproviders. This xis

relatively easier than systems change

anddoesnotachieveundamental,last-

ingchangesinhealthcareinstitutionsor

communityhealthconditions.

ab Cc

heAlTh juSTiCe

AdvOCATeSMuST ShifT frOM

The dOMinAnT,

pOrTrAiT frAMe

TO A lAndSCApe

perSpeCTive.


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Core related Beliefs

We saY theY saY

i y

Poverty,poorhealthandothersocial

problemsaresystemic,notnatural.

i pp

Poorhealthistheresultolacko

initiativeandindividualailing

W

Allhumanbeingsarebasicallycon-

nectedanddeservethesamethings.

Systemsthathelpusspreadgood

airlydoesnotcreate

lazinessbutbetter,more

productivecommunities.

ey

Andwillonlyhurtwhatyouhave.

Equitableresourcesharing,aircare

systemslikesinglepayerwillmean

lesshealthoryou.

g py

Governmentandthepublic

sectorisaneectiveplaceto

handlesocialissues.

g b c

Governmentisineectiveandine-

cientandshouldberunmorelikea

business.Thebestoptionistoleave

asmuchuptoindividualsand/orthe

marketaspossible.

W p w

Ourwellbeing,saetyand

qualityolieincreasinglydepends

onhowtheU.S.operatesintheworld.

Wecanlearnvaluablethingsrom

othercountriesthatcanmakeliebetterhere.

t u.s. /

W b p

Wehavenothingtolearnromother

nations;theirsystemswontwork

here.


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Movingtowardalandscapeanalysiscan

betricky,especiallybecausetheanalysis

willpresentnewideasormanypeople.

Further, health issues are closely tied

withthepeopleseelingsaboutgovern-

ment. As a result, our opponents are

wearingawayatuswithasteady,engi-

neeredattackagainstpublicsectorsolu-

tionsandtheroleogovernmentinsocial

issuesingeneral.

Most health care is delivered through

private, corporate systems. Although

these systems have been shown to be

ineective,costlyandunairinmostre-

search,most peoplethink corporations

are necessary and more ecient than

government.Pollsshowthatmanypeo-

ple especiallythose undertheage o

50--aremoresupportiveoprivatesec-

torapproachesthanpublicsectorones.

Theurtherwegetawayromacollec-

tive memory o the depression and a

structuralunderstandingopovertyand

theeconomy,theharderitisorpeople

to empathizewith andunderstand the

benetsopublicinterventions.Forar

too many, people are poor because o

theirownault;aringwellintheecono-

myandinourhealthsystemsisamatter

owitandskill,notdependentonsocial

andeconomic systems. Yet, there is a

growingnumberopeoplewhoaread-

versely aected by current conditions.

Theyknowtherecanbesomethingbet-

ter.Movingtheseolktoactionwillre-

quireadvancingourcorebeliesinthe

communicationsworkwedo(see core

values ch art, p. 3)

Together, these core belies orm much

otherameinwhichhealthissuesare

discussed.Framingcannotbeseparated

romotherwaysweworktochangepublic

opinionincludingorganizingpublicsup-

portandgrassrootsadvocacy.Inact,in

thiscurriculumasinourwork,raming

ismoreeectivewhenintegratedintoan

overallstrategyto buildpower,support

andconcretechangeorthebetter.

aBout this CurriCulum, Continued


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i n t r o d u c t i o n t o f r a m i nc o m m u n i c a t i n g f o r h e a l t h j u s t i c e

Framing means many dierent things

topeople.Somethinkoramingasnd-

ingtherightword,othersbelieverames

refectdeepersetsovalues,andstilloth-

ersbelievethatramestap

intocomplexmoralstruc-

turesthattriggerhowpeo-

plereacttoaconstellation

osocialandpublicpolicy

issues.Framingiscomplex

and abstract. To simpliy,

wedescribetwotypesorames:ccp-

l m andw m.Conceptual

rames are important because they ex-

pressthevaluesyouandyourorganiza-

tionholdaswellasthechangeyouseek.

News ramesare importantbecauseul-

timately, most conceptual rames have

tobeheardinanewscontextandnews

shapesramesinitsownparticularash-

ion.Bothtypesoramesleadtopredict-

ableinterpretationsinaudiences.Iyou

understand how therames work youll

have an easier time infuencing those

interpretations.

ConCePtual frames struCturethinking and interPretation

Scholars like George Lako, William

GamsonandculturalstudiesguruStuart

Hallteachusthatramesaretheconcep-

tualbedrockorunderstandinganything.

Peopleareonlyableto interpret words,

images, actions, ortext o anykind be-

cause their brains t those texts intoa

conceptualsystemthatgivesthemorder

andmeaning.Justaewcuesaword,

animagetriggerwholeramesthatde-

terminemeaning.Thats whythe choice

owordsbecomesimportant.

Heres how a small cue can trigger a

wholerame,evokingspeciicpresup-

pos itions and logic al outcome s. In

Caliornia,theChamberoCommerce

regularly issues a list o job killer

legislationittriestodeeat.Theterm

is simple and evocative. Killer im-

pliesthatsomeoneiscomingateryou

the situation is threatening, even

dire. Killers must be stopped. Their

targetsneedimmediateprotectionand

deensivemaneuvers.Therameevokes

theseideasbeorewehaveevenanin-

kling o what the speciic legislation

mightbeabout.Inact,itheChamber

issuccessulwithitsjobkillerrame,

it wont everhaveto debate themer-its o the bill. I the public discus-

sionstaysocusedonwhetherthebill

killsjobs,thentheChamberhaswon

thetermsodebate.

ic f:hw d i W, Wy d i m?

TO SiMplifY, we

deSCribe TwOTYpeS Of frAMeS:

COnCepTuAl frAMeS

And newS frAMeS.

This section on raming is rom MetaMessaging:FramingYourCase,ReinorcingYourAllies

by Berkeley Media Studies Group and The Praxis Project. Reproduced with permission.


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i n t r o d u c t i o n t o f r a m i n g c o m m u n i c at i n g f o r h e a lt h j u s t i c e

Themessageswedevelopwillbebased

on a conceptual rame that refectsour

values and uses metaphors, images, or

otherdevicestocommunicatethoseval-

ues. Most othe time,thosevalues will

beaboutairness,justice,equity,respon-

sibility, opportunity, democracy, or any

o theotherbigreasons thatmotivate

ustomakechangeagainstterricodds.

neWs frames are Portraits

and landsCaPes

Asecondtypeorameimportanttousis

thenewsrame,simplybecausesomuch

oour public conversation about policy

and social change is mediated through

the news. News rames evolved rom a

storytelling structure that emphasizes

peopleandevents.

Mostreporterstrytoputaaceonthe

issue toillustratethe impact ona per-

sonslie,ratherthandescribethepolicy

implications,inpartbecausetheybelieve

thatreadersandviewersaremorelikely

to identiy emotionally with a persons

plight than with a tedious dissection

o policy options. They might be right.

Storiesaboutpeoplearecertainlyeasier

totellthanstoriesaboutideas.Theprob-

lemisthatstoriesthatocusonpeopleor

isolatedepisodesdonothelpaudiences

understandhowtosolvesocialproblems

beyonddemandingthatindividualstake

moreresponsibilityorthemselves.

Asimplewaytodistinguishnewsstory

ramesis to think o thedierencebe-

tween a portrait and a landscape. In a

news story ramed as a portrait, audi-

encesmaylearnagreatdealaboutanin-

dividualoranevent,heavyonthedrama

andemotion.But,itishardtoseewhat

surrounds individuals or what brought

them to that moment in time.

introduCtion to framing, Continued


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i n t r o d u c t i o n t o f r a m i nc o m m u n i c a t i n g f o r h e a l t h j u s t i c e

A landscape story pulls back the lens

to take a broader view. It may include

peopleandevents,butconnectsthemto

largersocialandeconomicorces.News

stories ramed as landscapes are more

likelytoevokesolutionsthatdontocus

exclusivelyon individuals, but alsothe

policiesand institutionsthat shape the

circumstancesaroundthem.

landsCaPes reinforCe

institutional aCCountaBilitY

A key value that is aected byportrait

and landscape rames is responsibility.

Newsstoriesocusedonpeopleorevents

evokeeelingsopersonalresponsibility

in audiences. Landscape stories evoke

sharedresponsibilitybetweenindividu-

als and institutions. The challenge or

advocates is to make stories about the

landscapeascompellingandinteresting

astheportrait.

Thisisnoteasytodo,butcrucial.Inthe

seminal book, Is Anyone Responsible?

How Television Frames Political Issues

(ChicagoUniversityPress,1991),Shanto

Iyengarshowswhathappensiwedont

utilize landscaperames. Iyengaround

thatwhenpeoplewatchnewsstoriesthat

lackcontext,theyocusontheindividu-

als.Withoutanyotherinormationtogo

on,viewerstendtoblamethepeoplepor-

trayedinthestoryortheproblemand

itssolution. Butwhen audiences watch

storieswithcontextlandscapestories

theyassignresponsibilitytoindividu-

alsandinstitutions.

Ratherthanasteadydietonewsramed

as portraits, we need more landscapes

that bring the context into the rame.

Advocatesmusthelpreportersdoabet-

ter job describing the landscape so the

contextbecomesvisibleandinstitutional

solutionsbecomepossible.


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c u r r i c u l u m o v e r v i e w c o m m u n i c at i n g f o r h e a lt h j u s t i c e

Cc ow:h Jc Cc sy

Thiscurriculumisdesignedorhealthjusticeadvocatesandorganizerswhowant

todeveloporsharpentheirramingandmessagingstrategy.Facilitatorswhohave

thecommunicationsexperiencenecessarytoexplaintheramingandmessagingcon-

ceptsthatmakeupthebulkothiscurriculumshouldconductthiscurriculum.

Thiscurriculumismostuseulwhenbeginningcommunicationsworkoradened

campaigntoreneissueidentication,goalsandtargets,mediaaudiences,rames

andmessages.Itcanalsobeusedtoidentiycommongoals,targetsandstrategiesin

anemergingalliance.Iyouareconductingthistrainingwithparticipantsworking

onmultiplecampaigns,eachcampaignmusthaveadenedstrategyincludinggoals

andtargets.


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t r a i n i n g f l oc o m m u n i c a t i n g f o r h e a l t h j u s t i c e

full-daY agenda

(Duration:7Hours)

Introductions,ObjectivesandGroundRules 30min

OverviewoHealthJusticeCommunications 30min

IdentiyingtheTerrain 20min

MappingCampaignandMediaGoals 30min

Break 10min

ConductingaPowerAnalysis 45min

ReportOutandStrategyQuestions 30min

Lunch break 1hr

OverviewonConceptualFraming 20min

CreatingOURConceptualFrame 20min

MappingTargetAudiences 45min

ElementsoEectiveMessage 20min

DevelopinganEectiveMessage 40min

ClosingandEvaluation 20min

materials

twopadsochartpaperontwoeasels

non-toxicmarkers

maskingtape

overheadprojector

screen(orgoodwallsurace)

threekindsocoloredpaper(8.5x11in.)

roomlargeenoughorsmallgroupbreakoutsessions

twopackagesoindexcardseachadierentcolor,

watchortimerwithsecondhand, bell,triangleorsomesortonoisemakinginstrument(oruseyour

voice;nothingtooannoying!)

t fw:h Jc Cc sy

sYmBol keY

Scriptedoverviewona

keyconcept

Facilitatornoteand/or

instructions


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t r a i n i n g f l o w c o m m u n i c at i n g f o r h e a lt h j u s t i c e

introduCtions, Course oBJeCtives, ground rules 30min.

Startbyaskingparticipantstotakenomorethan20secondstogivetheirname,wheretheyarerom,

andanyotherbriecomments.Itishelpuliyouuseabellorsomethingthatmakesasoundtogentlykeep

peopleontrack.Beoreyoubeginlargegroupintroductions,askeveryonetobesilentandlistentowhat20

secondssoundslike.Ringyourinstrument/voiceattheendo20secondssoeveryonewillknowhowto

proceed.Nowbegin.

Settinggroundrules.Aterlargegroupintroductionsarecompleted,introducetheconceptothe

parkinglot(i.e.,aplacetowriteupemergingissuesthatshouldbedealtwithatalatertime).Havethe

groupsetgroundrulesortheremainderothetraining.Ask,Whatkindogroundrulesorcourtesieswould

begoodtoestablishduringourtimetogether?Ineeded,suggestoneoyourown(e.g.,respectordierence

oopinion,noputdowns,etc.).Recordgroundrulesonchartpaperandpostwhereparticipantscansee

them.Takenomorethan10minutes.

overvieW of health JustiCe CommuniCations 30min.

LargeGroupDiscussion.Facilitatorasksquestionsandscribesresponses,synthesizesresponsesto

refectbackcommondenitionohealthjustice.

FacilitatorAsks:

What do we mean by Health Justice?

What are the key issues in health justice?

What is the most important actor in health quality: Resources? Technology?

FacilitatorWrap-Up:

The most important actors in health quality are equality,

equitable access and distribution o resources.

Where there is equity, there are better health outcomes.

What does this mean in light o how we talk about

health issues?

Drawthreecirclesasillustratedbelow.

personalsocial

marketing

media

advocacy


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Facilitator: There are many ways to communicate. Communicating eectively requires that we develop

a strategy that takes into account personal or direct communication, social marketing and

media advocacy.

Explaineachtypeocommunicationmethodindetail.Tomakeitmoreinteractive,rstasktheaudience

whattheythinkeachmethodincludesbeoregivinganswers.

Personalordirectcommunicationsincludedirectmail,phonecalling,wordomonthorthe

useotippersorlocalmavens(tousemarketinglanguage)peoplewhoareinfuentialina

circleoothers;whoserecommendationmeansagreatdealtocommunicateourmessage.

Socialmarketingisapplyingtheconventionsoadvertisingand/ormarketingto

communicateamessage.Themessageinthiscaseisusuallyinormationtoinfuence

individualbehavior.

MediaAdvocacyissimplyusingthenewstoinfuencepublicopinionandaecttheterms

odebateonanyissue.Newsconerslegitimacy,setsthepublicagendaandistheocial

story.Wewillocusmuchoourtimetogetheronmediaadvocacyinordertoprepareyou

orinteractingwithmassmedia.

Facilitator: There are a ew misconceptions that we as advocates oten have about what to

communicate. Lets take a moment to explore them.

UnveilchartpaperMythsinHealthCommunications.

MYTH1:MOSTPEOPLEDONTKNOWNEARLYASMUCHASWEDO.

Facilitator Eective communication begins with a clear understanding o how much the people we

are talking to know and the many non-traditional ways they know it. An eective message

speaks to people in their own idiom, their most amiliar/even intimate way o speaking. It

requires a healthy respect and understanding o the incredible experience our audience

brings to bear.

MYTH2:WEMUSTCOMMUNICATEMOREINFORMATIONONTHEPROBLEM.THEMORETHEYSEE

HOWBADITIS,THEMORELIKELYTHEYARETOACT.

Facilitator People are rarely shocked into action. Most o us are airly jaded by now and have already

assumed the worst. So its no surprise that the media eects research conrms that its

practical inormation on what they can do about an issue versus the severity o a problem

that moves us. Not that we dont need to communicate that our issue is a serious one -- wedo. Weve just got to make sure we dont leave it at that. Besides, otentimes our audience

already knows that the problem is serious beore we begin.

So what constitutes an eective message?

Allowthegrouptobrainstormandseewhatemerges.

Addtheseinecessary(ocourse,synonymscount):

Goodmessagesareaective(theytouchusemotionally),eective(theyconveywhatweneed

to),andconnectwithshareddreamsandbelies.


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Theysurace,whatJamesScottcalledinhisseminalbookDomination and the Arts

o Resistance,thehiddentranscript.Thishiddentranscriptconstitutestheprivate

conversationsmostoushaveabouttheinjustice,theunairnessothoseinpower;about

therightthingweoughttodobuttoodiculttoundertakeonourown;andeventhat

whichweear.Itislikesomeonesayingoutloudwhatyouwerethinkingallalong.

Ocourse,thisrequiresamessagetobegrounded,again,inthelanguageandidiomandeven

thedreamsothosewearetryingtomove.Wellgetdeeperintomessagingtowardstheend

othetraining.

Sohowdowebegin?Withapoweranalysisandsurveyotheterrain.

small grouPs exerCise: identifYing the terrain 20min.

Dividethelargegroupintosmallgroupsoourpeopleeach.Giveeachgroupapieceobutcherpaper.

Theywillhave15minutestodothisexercise.Haveeachgroupappointareportbackperson.

Facilitator: Your task is to brainstorm about what people currently believe about health issues. It

doesnt matter i theyre true or i you agree, just brainstorm and write down what you

know to be current belies that aect your work. Then identiy two belies that help your

work, and two that harm your work, and why.

Ater15minuteshaveeachreportbackpersonreportoutor3minutes.Scribeeachgroupshelpuland

harmulbeliesonabutcherpapertitledRelatedBelies.

Facilitator: Keep these helpul and harmul belies in mind. You will need to appeal to the helpul

belies and counter the harmul belies in order to advance your health justice rames and

messages.

overvieW: maPPing CamPaign and media goals 30min.

Facilitator: Weve landscaped common denitions and belies about health justice, as well as areas o

communications to infuence the conversation about health. Now were going to identiy

current campaign and communications goals.

PassouttheMedia planning Worksheet (see p.16) andwalkthroughtherstpage.Distinguishbetweencampaigngoals,whichdescribewhatyouwant,andcommunicationsgoals,whichdescribehowyou

willusethemediatogetwhatyouwant.

Facilitator: What are your current campaign goals? What communications goals can you set to help

you win your campaign goals?

Scriberesponsesonbutcherpaper


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Break 10min.

small grouPs exerCise: ConduCting a PoWer analYsis 45min.

Thisactivitycanbedoneinsmallgroupsiparticipantsareworkingondierentcampaigns,orinone

largegroupieveryoneisworkingonthesamecampaign.

Facilitator: In order to engage in strategic communications, you must identiy the key players you are

trying to move/organize in your campaign.

Walkthroughthepoweranalysistool (see p.34)andreerparticipantsbacktothecampaignand

communicationsgoalsidentiedinthepreviousactivity.

Facilitator: Using the inormation you identiy in the Communications Planning Kit and in the power

analysis chart rom the health equity tool kit handout, identiy key decisionmakers, allies,

opponents, ence sitters, etc. that are important to winning your campaign. Map target

audiences using color coded post-it notes and power analysis grids provided. Answer the

Initial Strategic Questions on chart paper. Be prepared to present your charts and a verbal

summary o your power analysis. Youll have 3-4 minutes to report-back.

grouPs rePort out PoWer analYsis and strategY questions 30min.

Eachgroupprovidesasummaryotheirstrategydiscussion.Poweranalysismapsandstrategycharts

arepostedinagallerythatparticipantscanvisitduringlunchandaternoonbreak.

Facilitator: Now youve mapped out key players and identied whom you need to infuence to win

your campaign. These are also the audiences you need to communicate with to win.

Ater lunch well look deeper at some o these audiences, and begin crating rames and

messages that will move them to action.

Applaudtheirwork.

lunCh

Facilitatorswilldevelopchartpaperwithkeyaudiencesidentiedthatmostgroupssharewithroomor

participantbrainstormasillustratedbelow.Postenoughsheetsornomorethanourparticipantsateachsheet.

LegisLators

outLets:

who/what they watch, read, listen to

seL interest:

what they care about

VaLues/BeLies

ideas, values they hold that affect

this issue


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re-Convene/overvieW on ConCePtual framing 20min.

Facilitator: What is a rame? Why is it important to rame? Why dont we just tell people the acts?

Framing gives our audiences a conceptual container loaded with preconceived values and

belies. Framing helps audiences understand our stories and messages on their own terms.

Audiences will not go where they havent already been in their minds.

CONCEPTUALFRAME

Unveilconceptualramedenitionondenitionsbutcherpaper.Askavolunteertoreaditoutloud.

Facilitator: A rame denes the boundaries o a story. A rame projects your point o view through

characters, setting, plot and values. A rame should project the social and political

landscape o your issue, and push an immediate ght AND a long-term agenda.

There are lots o dierent ways to look at the acts. We want people to look at the acts rom

a vantage point that advances our goals.

Frames convey belies and values that give people a lens through which to understand

Everything has a rame

That means our issues, our stories are going to be ramed, whether by us, or our opponents.

So whos gonna control the debate?

Creating our frame 20min.

Bringeveryonesattentionbacktothecampaignandcommunicationsgoals,andtothepoweranalysis

conductedearlier.

Facilitator: Take a look at these goals and targets. Given what were trying to do and whom were

trying to pressure, what would you add to the helpul side o this themes chart to rerame

this issue according to our goals?

Scriberesponses.

RefectbackthemesandchangeheadingobutcherpaperromcurrentrametoOurrame

Facilitator: Weve just reramed the issue based on our goals, and ensured that we hold institutional

targets rather than individuals accountable. For health justice, this is key to achieving

undamental systemic change instead o band-aid solutions that put responsibility back onindividuals to make healthy choices.

ConduCt small-grouP maPPing of target audienCes 45min.

Facilitator: Nowthatwehaveourramewerereadytocreatemessagestailoredtoourtargetaudiences.

Onthewallarebutcherpapersthatrepresenttargetaudiencesidentiedbyyourpower

analysis.Youregoingtogetinthesamesmallgroupstoworkononeotheseaudiences,


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andtoidentiythreethings:whatoutletsthisaudiencereads,watchesandlistensto,what

theycareabout,andwhattheircorebeliesarethatmightaectthisissue.Thiswilldirect

theramingandmessagingwedoortherestotheworkshop.

Givethesmallgroups20minutestoworkontheiraudience.Thengiveeachsmallgroup10minutesto

walkaroundandlookatwhattheothergroupshavecomeupwith.Thendoalargegroupdiscussion:what

didyounotice?Anythemes?Recurringvaluesandbelies?Whataretheimplicationsormessaging?

elements of effeCtive messaging 20min.

Facilitator: Now that weve mapped the values and belies o key target audiences, were ready to begin

crating tailored messages that move them to action. Whats a message? What makes up

an eective message?

UnveilbutcherpapertitledComponentsoamessage

1. Whatswrong?

2. Whydoesitmatter?

3. Whatshouldbedoneaboutit?

Facilitator: The rst question orces you to make a clear statement o concern. It fows directly rom

your overall strategy, which should be determined beore you construct the message. This

statement o concern will, by necessity, be a statement o part o the problem, not the whole

problem and its history. Too oten, advocates try to tell journalists everything they know

about the issue, because they eel this may be their only opportunity to convey the enormity

and importance o the problem. Resist that urge. It is impossible to be comprehensive and

strategic at the same time. Instead, ocus on just one aspect o the problem and be able to

describe it succinctly. Once that piece o the problem is being addressed, you will be able to

shit your policy goal and message to ocus on another aspect o the problem.

Takequestions

Facilitator: The second question represents the value dimension. This is the place to say whats at

stake. Berkeley Media Studies Groups studies show that advocates dont do this enough. In

news coverage, the value component is oten absent; policies are named but not justied.

Advocates are not saying why the policy matters. They may state a act X number opeople are homeless, X number o people are hungry but they dont say why that matters

to those who arent hungry or arent homeless. They dont say what it means to our society

at large. Values should be specic, clear, and indicate why you and your target should care

about the matter at hand. Name the value, calling on your targets sense o airness, duty,

or scal responsibility. Remind them o our obligation to the greater good.


18/39


Takequestions

Facilitator: The third question articulates the policy objective. A common pitall is that advocates

expend so much energy communicating about the problem that when the inevitable

question about the solution is asked, they are ill-prepared to answer it. They give vague

responses like, Well, it is a very complex problem with many acets, so the solution is

complicated, or The community needs to come together. Certainly, these responses are

truthul, but they are not strategic; they dont advance the issue toward a specic solution.

More eective by ar is to answer with a specic, easible solution, which will usually be an

incremental step toward the larger goal.

revieW eleMents of successful Message (see p.20)

develoPing an effeCtive message40min.

Remindparticipantsthatgoodmediamessagesareshortandconcise,buttheyarenotslogans.They

shouldsoundnatural.Encourageparticipantstobrainstorm,withoutcensoring,thentorenebasedonthe

elementsoasuccessulmessagehandout.Givethem45minutes.Asummaryotheseinstructionsshould

bewrittenonchartpaper.

Groupsshouldreconveneandreportouttheirgoal,target,messageandpreerredmediaoutlets.

Facilitatorshouldworktominimizecriticalcrosstalk.Commentsandquestionsshouldocusonclarication

andsupportorothers.Thankparticipantswithapplauseandpraise.

Closing and evaluation 20min.

Thankparticipantsandcheckoitemsromagenda.Recapkeypointsandtakequestions/comments.

UnveiltheEvaluationbutcherpaper.Doago-around,askingeachpersonoronethingtheylikedrom

theworkshopandonethingtochange.

EndwithclosingcircleandAssatachant:

It is our duty to ght

It is our duty to win

We must love each other and protect each otherWe have nothing to lose but our chains


19/39

t o o l s a n d r e s o u r cc o m m u n i c a t i n g f o r h e a l t h j u s t i c e

Eectivemediaadvocacyisanintegralpartoyourorganizingcampaign.Theworksheetonthenextthree

pageswillhelpyoutothinkstrategicallyaboutyourmediaplans.Therstandmostimportantruleis:Create

yourmediaplansbeoreyoustartyourcampaign.Identiyingyourtargetaudience(s)andoutletsisjustas

importantasidentiyingyourorganizingtargets.Getreadyormediajustice!

goals & outComes

Writeyourthreemainorganizinggoalshere:

Listthreegoalsoryourworkwiththemedia:

Howwillyouknowyouvereachedyourgoals?

Listthreeoutcomesthatcorrespondtoyourmediagoals:

Worksheet

m P

Created by the Praxis Project and We Interrupt this Message. Reprinted with permission.


20/39

t o o l s a n d r e s o u r c e s c o m m u n i c at i n g f o r h e a lt h j u s t i c e

targets

Whomdoyouwanttoreach?Rememberanytargetsyouidentifed.

oz/

Ccy

Wy w w

?

W w w

?

W y

c b?

(values, vulnerabilities)

W/w

y , wc,

?

outlets

Whatarethebestmediaorconveyingthismessageoreachtarget?

(list targets and choose one or more that fit. try to focus on no more than three)

media Planning Cont.

LargeAcademicPublications Proessionaldevelopmentorjournalarticles

Newsmedia: print radio television

on-line opinion

Entertainmentmedia

Otheronlinemedia Advertising: billboards/public kiosks print

radio television on-line other

Personalnetworks Other(leaflets, etc)



21/39


hooks and oPPortunities

Listupcomingeventsandproducts,datetheyarescheduledtobecompletedandwhethertheyhaveany

piggybackingopportunities:

e/Pc d b nw /

m pp

Listothereventsandnewshooksyouknowabout(annualconerences,anniversaries,etc.)thatprovide

opportunitiestocommunicatewithothersandadvanceyourgoals:

timelining

Organizetheseeventsinchronologicalorderandprioritizewhicharethecommunicationsopportunities

youdliketoollowupon.

tasks

Identiywhattasksneedtobedoneandbywhominordertocompletetheollowup:

media Planning Cont.



22/390


f i rpby

Calloutyourtargetbyhighlightingwhatinstitutionorwhatocial

representinganinstitutionisresponsibleormakingchange.

sp s v

Valuesaremorepowerulthanactsgureoutwhatyouandyouraudience

bothcareabout,andcommunicatebasedonthissharedvalue.

sp rc Jc Exposeinstitutionalracismandocusonsolutionsthatmaketherulesmore

justorpeopleoallraces.

e Pc

Usewordsthatpaintpicturesyouraudiencecanrelateto.

B c

Userhymes,sharpphrases,metaphorsandcomparisonstomakeyourpoint.For

example,comparinganexpensive,ineectivepublictransportationsystemtoa

brokendownbusshowsaudiencesthatthesystemdoesntwork.

fc

Advocatesspendtoomuchtimetalkingaboutproblems,insteadmakesureyour

messageclearlycommunicatessolutionsyouraudiencecantakepartin.

kp p

Useclear,reasonablelanguage,especiallywhencommunicatingorradical

policychange.

Worksheet

e o a scc m

Adapted rom We Interrupt This Message


23/39


We are all in the same boat. The system hurts health

workers. It hurts patients and it hurts low income

communities even more.

SEIU790EducationDirectorKaregaHart

WhentheWomensEconomicAgendaProject(WEAP)

started organizing around health andhuman rights

issues, they began with their considerable base o

low and no income women in NorthernCaliornias

EastBay.Thegrouphasalonghistoryoorganizing

women and progressive ally organizations around

bread and butter issues such as welare rights,

access to childcare and living wage using a human

rights ramework. As part o the Poor Peoples

EconomicHumanRightsCampaign,aninternational

movement to advance economic human rights

(www.economichumanrights.org),WEAPwasalready

groundedinaglobalcontext.

Thehumanrightsrameworkjustmadesensetous,

saysWEAPexecutivedirectorEthelLong-Scott.Itis

ahigherstandard.Itisnotaboutwhatthemarketwill

bear.Itdoesnotendwithwhetheritisprotable.It

simplysays,herearestandardsorhoweveryhuman

beingshouldbetreated.Wewereclearthisshould

bethelaw.

Health issues have long been a challenge or

WEAP members. These issues spanned beyond

health coverage to access to care, linguistic access,environmentalhealthandmore.RefectsLong-Scott,

Therewasnowaytoghtorajusteconomicagenda

withoutaddressinghealthasahumanright.Health

was connected to work, to wages, to education, to

saety,toamilyqualityolie,tocredit,tobenets.The

connectionsareendless.Movingahealthashuman

rightsagendarequiresabigtentsotospeak.

WEAPorganizeddiscussiongroupswithismembers

to better understand how health issues were

aecting their communities as well as to identiy

strategicgoalsoradvancingahealthjusticeagenda.

Itwasimportanttobuildabroadcoalitionothose

aected by these issues soWEAP reached out to

organized labor andhealthcare advocates to help

buildsupportoramorecomprehensiveramingo

healthashumanrights.

Through their work with Service Employees

InternationalUnion(SEIU)790,theCaliorniaNurses

Association (CNA) andthe SanJose Communication

WorkersoAmerica(CWA),WEAPwasabletoexpand

itsreachtomorethan130,000workersinCaliornia

alone. For the unions, the connections were clear.

The health care systemwasbrokenor workers, or

patients, or employers and it would take a broad

basedmovementtoxit.

Cc h Jc

WEAP developed a multi level communications

strategytobuilduniedvisionamongitscoalition,

promote grassroots spokespersons and to elevate

policyapproachesthataddressedhealthinabroad

rame. The frst phase consisted o building a

commonrameworkamongitsbaseandcoalition

members. It was important to get everyone on

thesame page, says Long-Scott. Westudiedthevarious proposals, studies and approaches that

linked the poverty-health connection. We looked

at the proposals or systems change and elt it

wasimportantnottosettleorminorreorm.We

hadto buildunity around theunderstandingthat

healthcaremustbeparto thebroaderstruggleto

eliminatepoverty.

W ecc a PjcB B t h Jc


24/39


The group conducted a serieso two-hourtrainings

that allowedparticipantsto share their experiences

interactingwiththehealthcaresystem.Thesessions

tookplaceatworksites,unionmeetings,churchgroups,

housemeetingsanywhereWEAPcouldgotoengage

coalition constituents on the issue. The trainings

helpeddevelopasharedsenseoagendaandraming

up ront, which made developing communications

strategymucheasierlaterinthecampaign.

Building on the work o the trainings, WEAP

worked with coalition partners to organize a

Truth Commission/Congressional Hearing on

health issues. The hearing was presided over by

local congresswoman Barbara Lee (D-Oakland) who,

alongwithanumberoBayArealuminaries,listened

toaseriesograssrootstestimoniesonthestateo

healthcareinthearea.

Thesehearingsareawayotellingourstoriessothat

those inpowercan hear them.Makingthe invisible

visible,saysCNAsNancyLewis.Itsaboutorging

solutions.

Thehearingswereusedasnewshooks,toengagethe

media in ways that allowed thecoalition to control

therame. When we developed ourown event, we

couldbeproactive.Wecouldstartwherewewanted

thediscussionto go, says Long-Scott. We didnot

havetoreact.

Thegroupstartedwithopinionpiecesandinterviews

to notonly promotethe hearingsbut to elevatethe

stories and ideas that served as a catalyst or the

hearings.Thisearlyworkwasimportantasithelped

create a new set o spokespersons or experts to

be heard on healthcare rom theperspective o low

income,workingclasspeople.Womenocolorwere

highlighted specically and ethnic and community

mediawereimportantcampaignpriorities.

Themessagingwasnetunedtoocusmoreattention

onreraminghealthcareromanindividualproblem

to a social/systemic issue that, with political will,

could be solved. As a result, messages ocused on

threekeypoints:

1. Thehealthcaresystemispartoalargersystem

thatsnotworkingorthevastmajorityous.

2. Theproblemisnotlackoresourcesoreven

goodideas;itsthelackopoliticalwill.

3. Thereisagrowing,broadbasedmovement

workingtoturnitaround

Personal testimonies and aected spokespersons

helpedtoprovideevidenceortherstandlastpoints

while thecoalition reachedout tolocal expertsand

studiestohelpbuttresspoint2.Closing the Gap,a

study by the Northwest Federation o Community

Organizations and the Applied Research Center

provided the group with concrete examples o best

practices to address health disparities by race.

Single payer and similar approaches outside o the

USprovidedinspirationorwhatwaspossiblewith

regardtoreorm.

Although it was sometimes challenging to bring uppolicy examples rom abroad, the group ound that

most people were open and interested in hearing

abouthowothercountriesaddresshealthcareissues.

Katrinaexposedhowdangerousitiswhenwestop

investinginourcommunities,inourpeople;whenwe

ignoretheneedsothepoor,saysLong-Scott.For

Womens eConomiC agenda ProJeCt Continued


25/39


manypeople,itistimetondadierentway.Katrina

putitoutthereasareminderthatthereisnosaety

netnotonlyorthemillionsaectedintheGulbut

orallous,whereeverweare.

Cc d

SEIUs members have experienced many layos in the

last ew years, leaving ormer members struggling to

nd healthcare. The rising cost o healthcare is one

reason employers keep demanding more take-aways

not just rom health coverage, but rom pensions, pay

and job security. In endorsing WEAPs ongoing work

in building a broad movement to eliminate poverty

and win our healthcare rights, SEIU has taken the

initiative in strategically linking up with community

groups to put orward long-term solutions to the

healthcare crisis.

WEAPSpring2006Newsletter

The group piggybacked on Katrina and other

currentnewstohelpexpandtheiraudiencereach.

WiththesupportotheYouthMediaCouncil(YMC)

andThePraxisProject,WEAPheldaspokesperson

training to help prepare coalition leadership or

interviewsandthehearings.Theeveningsession

p rov ided p art ici pa nt s w ith o ppo rt uni ti es t o

practice their soundbites, respond to potentially

hostile questions and practice staying on

message.

Amediaworkgroupwasormedwithrepresentatives

romeachotheunionscommunicationsdepartment,

YMC, Praxis and WEAP leadership. The group

discussedandrenedstrategy,developedaplanor

dissemination anda division o labor to help move

the communications work orward. Unions helped

topromotethehearingsandtherameworkintheir

member publications, the group divided up outlets

to pitch orinterviews. WEAP generated pieces or

opinionpagesandoritsmembershiptobuildpublic

awarenessothehearingssetorMarch2006.

The all day hearings drew a diversegroup omore

than 200 including several key policymakers at the

localstateandederallevels.WEAPcontinuestobuild

on the success o these eorts through continued

trainings, member surveys, articles and interviews

thatampliythehealthashumanrightsrame.

ThealliancesbuiltwithunionsremainstrongasWEAP

workstotaketheireortsstatewide.SaysLong-Scott,

Weareconstantlysayingthatweareghtingora

systemwitheverybodyin,nobodyout.Weknowthat

partothisisacommunicationstaskbutthebulko

theworkwemustdocomesdowntoorganizing. O

course,havinganeectivecommunicationsstrategy

alwaysmakesthingsthatmucheasier.

FormoreinormationonWEAPandtheirhealthcare

rightscampaign,gotowww.weap.org.

Womens eConomiC agenda ProJeCt Continued


26/39


25 Introduction

26 WhyPolicyChange?

TheBigPicture

TheProblemHealthInequity

WheretoBegin?

30 SampleIssueDevelopmentProcess

32 SamplePowerAnalysisProcess

34 SamplePowerAnalysisChart 35 SampleStrategyChart

36 SummaryoPowerAnalysisStepsandStrategyProcess

37 GlossaryoTerms

h C ey:t k dp W Pcy sy

Sylvia Castillo / Castillo Consulting Services. For The Praxis Project www.thepraxisproject.org


27/39


This publication provides an analytical

ramework and tools to support policy

advocacyorhealthjustice.Itassembles

techniques developed and tested by

SCOPE, Community Coalition, and The

Environmental & Economic Justice

Project.

ThePraxisprojectworksromtwobasic

assumptions about the root causes o

healthproblems:

1. There is something wrong with the

currentsystems o powerrelations.

Theyareunjust,unairandmakeit

challenging to impossible or most

peopleinthisworldtothrive.This

is a problem thats systemic and

institutional or which individual

actionandbeliesplayapart.

2.Much o what maniests as social

problems(disease,poverty,etc.)are

symptoms o these larger issues

o injustice.I weare to eectively

addresssocialproblemswehaveto

develop ways o addressing their

rootcauses.

Ourapproachisshapedbyaramework

that makes community organizing

and capacity building central. We

are committed to building power in

communitiesthatareotenmarginalizedin

policymaking.Projectswiththepotential

orbuildinglongterminrastructureor

changearea priorityasaddressing root

causesisalongtermproject.

Praxis mission is to support and

partner with communities to achieve

health justice by leveraging resources

and capacity or policy development,

advocacy and leadership. Praxis uses

innovativeparticipatoryapproachesthat

bridgetheory,researchandaction.

Wy pcy c?

Policies determine ourqualityo lie.A

policyisadenitecourseoactionsuch

asagreements,thecodesthatshapeevery

aspectolie.Theyguideanddetermine

presentand uture decisions about our

lives.

Great brochures and good advice may

helpchangeindividualbehaviorbutare

notenoughtoachievehealthjustice.It

will take organizing rom the ground

up: social change that transorms the

current systems o neglect, bias, and

privilegeintosystempolicies,practices,institutionsthat truly support health

orall.

WHOCARRIESOUTPOLICYCHANGE?

Social change agentspeople like us.

Change agents come rom a wide

tool kit

ic


28/39


variety o backgrounds, they have

widelyvaryinginterests,andtheyapply

their talents to an equallybroad seto

challenges.Butthosewhoaresuccessul

in winning a policy issue share one

thingincommon:Theyhaveaneective

strategy that is based on a power

analysis.

the Big PiCture

HowdoIgetstarted?Strategicthinking

beginswithlookingatthebigpicture.

First, amiliarize yoursel with the

health ca re system in its current

context.Groundyourselinhowhealth

c are is adminis te re d, nance d and

legislated in your state and county.

This is process will provide you and

your constituents a window onto the

eldwheretheplayerse.g.legislators,

unions, consumers interest groups,corporatelobbyistsandothersbattleit

outtoshapehealthcarenancingand

provision. Remember to summarize

yourndingsinabriengpapersothat

can share with your constituents and

allies.

t u by rc

PeopleWithoutHealthInsuranceortheEntireyearbyRaceandEthnicity(3yearAverage):1998to2000.(Numbersinthousands)

Total Uninsured

Number Percent

Total 274,123 39,558 14.4

White 224,834 29,831 13.3

White,Non-Hispanic 193,634 19,531 10.1

Black 35,499 6,916 19.5

AmericanIndianor

AlaskaNative

2,739 733 26.8

AsianandPacifc

Islander

11,051 2,074 18.8

Hispanic 32,785 10,737 32.7

Source: U.S. Bureau o the Census, Current Population Surveys, March 1999, 2000, 2001


29/39


sp: h C usa

Inbrie, thenational health care modelis structured on prot motives. Health

care is a commodity not a right, and

themarket is themost ecientarbiter

o health care provision and nancing.

As a primarily private model, the

governmentshastworoles:careprovider

through public health acilities, and

insurer through Medicaid and MediCal

program.Theelderly,childrenandsome

low-income residents have access to

these government-supported programs.

Otherwise,themajorityoresidentsare

expected to purchase health insurance

ontheirownorreceivehealthinsurance

benetsthroughtheiremployer.

This model is ineective because all

employersdonotoerhealthinsurance

and insurance costs have become too

expensive or many peopleto purchase,

resulting in a signicant portion o

the public becoming uninsured or

underinsured (i.e. limited access to

healthcare).2

Since the late 1990s,or-prot insurers

and providers, recognizing the prot

potential o health care, entered the

managedcareindustry.Asthesystems

privatesector,thewayitworksmanaged

careinsurersnegotiateeesandservices

withaselectedgroupoproviders.Mostsubscribers enrolled in managed care

receive health care rom this selected

groupoprovidersorpayadditionalcosts

toseeprovidersoutsideothesystem.

3

Today,thenationacesahealthcarecrisis

o monumental proportions. With 44

millionpeoplewithouthealthinsurance

andewerpublichealthacilities,health

care or people o color and working

class is bleak. Simply,the Republican

Revolution health care design has

prevailed. The ederal government has

pusheditsresponsibilitiesorhealthcare

provision and nancing to cash

strappedstateandcountygovernments.

Meanwhile, managed care is driven by

prot-making as opposed to providing

accessible quality care. This trend

has increased the denial o care, and

contributedgreatlytothedemiseothe

publichealthcaresaetynet.

the ProBlem: health inequitY

The United States with a $1.3 trillion

healthcaresystemisthemostexpensive

andthemostinequitableamongWestern

industrialnations.4Whatdoesthismean

or communities o color? Their health

statusislower,theirdeathrateshigher,

and lie spans shorter than the white

majority.5

Considerthesestatistics:

The inant mortality rate or

2 Community Institute or Policy Heuristics Education & Research (CIPHER), CaliorniaHealthCareCrisisBriengBook, 2002.

3 Ibid.4 Ibid.5 National Academy o Sciences Institute o Medicine, Cause Communications and the

Caliornia Endowment, UnequalTreatment,UnequalHealth:WhatDataTellUsAboutHealthGapsinCaliornia, 2002.


30/39


Arican Americans is more than

twiceashighthatowhites.6

Asian American/Pacic Islanders

havethehighestrateolivercancer

among all populations ve times

that o their white counter parts.

Cambodian,HmongandLaotianmen

areespeciallyatrisk.

Arican American, Hispanics and

NativeAmericanhaveamuchhigher

rate o death and illness rom

diabetes.

Someresearcherssuggestthatracialand

ethnic disparities in health are linked

tohealthinsurance status. Itis a act,

people o color are more likely to be

uninsured,andalackoadequatehealth

insurancemeanspatientsarelesslikely

toreceiveadequate,timelycare.Yet, how

do we account or the data that shows

lower health status indicators persist or

people color even among those who have

health insurance.

So why is it that or most causes o

deathanddisability,AricanAmericans,

Latinos, and American Indians suer

poorerhealthoutcomesrelativetowhites

with statistically equivalent levels o

socioeconomicposition?

Oneansweris racism. Racismunctions

as a power relationship that designates

access to resources and opportunities,

environmental conditions, and

Daily exposure to institutional racism and internalized racism contribute to

healthdisparities.Thisrace-relatedstressanditsnegativehealthconsequences

cutacrosssocioeconomicstatus.Forexample,middleclass-blackwomenwithhealthinsuranceinPrinceGeorgesCounty,MD,hadpoorerbirthoutcomesthan

whitewomenwiththesameincomeandproessionalstatus.

Examples o the negative impacts o institutional racism include: a lack o

providersocolorinhospitalsandclinics;alackomultilingualsta,alacko

culturallycompetentcaregiversincommunities;patternsounequaldiagnosis

and treatment, anda lacko responsiveness bymedical training institutions.

Similarly racial and ethnic bias within healthcare institutions and among

practitionerscontributestodisparities.

Internalized racism, associated witha sense o hopelessness and inability to

envisionapositiveuture,contributestomentalhealthproblemsamongpeople

ocolor,inparticulardepressionamongwomen,violenceandsuicideinmen,and

substanceabuse.

Reducing Health Disparities through a Focus on Communities, Policy Link Report, 2002.

6 Ibid.


31/39


psychosocial actors. As a power

relationship; the white category receives

privilegesattheexpenseotheBlack/non-

whitegroup.Thereore,racismissystematic

versusanindividualprerogative.

Where to Begin?

The crisis in health care access or

people o color is a broad concern.

The rst step is to analyze the

problem and decide what kind o

solutiontoworktoward.Werecommend

beore the group starts to choose an

issue, the members or constituents

be asked to participate in an issue

development process. Think o it as

doing social justice detective work,

sleuthingortheanswerstoanunsolved

crime.


32/39


33/39


steP 4:i e

Doesitdirectlyaddressproblem(structuralchange),orsetupawayoraddressingproblem

(procedurechange)?

Isitdeeplyelt?Why?ByWhom?Testoutyourissueatacommunityorumorsurveytheconstituency.

Viewthisstepasanopportunitytoengageyourmembers,constituentsintostrategyplanningand

variousactions.

Isthereaclearhandle(s)?(Legal,moral,orpoliticalleveragepoint)Ahandleisalegal,moral,political,

oreconomicactthatstandsincontradictiontothepositiontakenbythetarget/opposition.Usually

inormationthatexposesaweaknessotheopposition,dataordocumentationthatcanembarrassthe

targetorshowsthatyourpositionisair,just,andlegal.

Isthereacleartarget?Whoholdspowertogiveyouwhatyouwant?(BOD,stockholders,statebureauo

insurance,CEO)

Isitwinnable?(Doapoweranalysistoanswerthis)Whattypes/amountopowerdoweneedtomove

them?

Analysis/prolesonprimaryconstituencyandallies

Analysis/Prolesonopposition

Isthereacleartimeline?

hw y yz pb w y w pb

Somepoliticians,corporations,

peoplebelieve:

Whilesocialjusticedetectives

believe:

Theproblemsare: Theresultogenetic

predisposition,weakness,poor

habits,irresponsibility

Somepeoplearejustundeserving

Theresultoracism,community

disorganization,poverty,

unemployment,social,economic

andpsychologicalactors.

Thesolutionsare: Donotextendbenetstothesepeopleuntiltheydemonstrate:

betterpersonalresponsibility

lowertheirrisksthroughproper

healthpractices

Improvetheaccesstohealthcare,andchangethebasicliving

conditionsopeopleby

Bringingallsectorsothe

communitythatismostaected

tothetabletochangethe

inequitablepolicy

Form courtesy o SCOPE


34/39


InthehypotheticalcaseoBlack&BlueInsurancethegroupwillinvestigatethecompanysinternaldecision-

making/powerstructureandthegovernmentregulationbodywhocanholdthetargetsaccountable.

tool kit

sp Pw ay Pc

what is your proposal to change this inequity?

The Black/Blue Insurance Co. agrees to a written policy that commits to uphold the law and extend coverage

to all.

what system has the power to adopt your proposal?

Analyze the target system the various orces exercising infuence over the decision-maker, and ways in

which the campaign can build the power to win. The target system is dened by the power holders, i.e.,

anyone with authority to make decisions. The issue determines the target. An individual target helps to

structure decision making by identiying who must be infuenced, who must be held accountable, and

who the organization is up against. It is oten easier to apply direct pressure to an individual than an

institution.


35/39


. what power does the decision-maker have to meet your goal/demands? by what authority?

. what is the decision-makers background and history?

dp p t/dc-

. what is the decision-makers position on your issue/goal? why?

. what is the decision-makers self-interest?

. what is the decision-makers history on the issue?

. who is the decision-makers boss?

. what/who is the decision-makers base and support?

. who are the decision-makers allies?

. who are the decision-makers opponents/enemies?

0. what other social forces influences the decision-maker?

Courtesy o SCOPE


36/39


tool kit

sp Pw ay C

PowerAnalysisisanorganizingtoolthathelpsbuildastrategyplantowin.

Imagineaootballgame--thecoachaidstheteamtodeterminetheopposingteamspowerasdenedbyits

strengthsandweaknesses.Whatkindopowerandwhichplayerswillittaketomovetheballacrosstheeld

tothegoallineandvictory?Thecoachisconductingapoweranalysisthatwillinormhisdesignoawinning

strategy.

Thepoweranalysisisaprocesstodeterminewhatkindopower(quality)andhowmuchpower(quantity)is

neededtomoveatarget,theindividualwhocangiveyouwhatyouwant,toaccepttheorganizationspolicyor

proposalorresolvinganissue.

Theprocessincludesasystematicseriesoquestions,investigativesteps,inormationcollectionandrened

knowledgeotheplayerswithpowertodeliveryouclosertoyourgoal.Allwiththepurposeomovingthe

peoplewithpowertogiveyouwhatyouwantorwinyourproposal.

(PowerAnalysischartseeAttachment1)

op g: W w c?

1.Meetingswithmediarepresentatives

2.Presenceoractiononyourtargetstur

m g: W w b j c?

1.Theinequitydebatebecomesaactorinthehealthcaredebate

2.Thedecision-makersareaskingoryourinputandrespondingtoyourissues

e g: W w c cy?

1.Thetargetandhisorganizationagreetoproposalinwriting

2.Thetargetorganizationvotestoexpanditsprocessandgivesatimelineorimplementation


37/39


Derived romgametheorya strategy isthe most eective courseo action oreachplayerdepends upon

theactionsootherplayersandtheplayersanticipationandassessmentothosemoves.Assuchtheterm

emphasizestheinterdependenceoalliesandadversariesdecisionsandtheirvariousexpectationsabouteach

othersbehavior.

Reviewed side bysidethe strategy chartand poweranalysisshouldbe updatedrequentlyassessingyour

actions,andtheirimpactandyouradversarysreactions.Youareconcernedwithmovingorwardtowinyour

proposalsoalongthewayyoumayneedtotakeastepbacktotaketwostepsorward.Rememberitislike

ootballorchess,youvegotyourmovesbuttheydotoo.

Goals Inonesentencewhatarewetryingtoaccomplish?Whatspecifcandconcrete

changedowewanttoseetake?

Strategicft Howthisissuewillhavesignicanceandactuallymakeadierencewhythisissueis

evenimportant

DecisionMaker Whohasthepowertomakethedecisionconcerningthecampaigngoalwhoisthe

person/decisionmakingbodythatcangiveuswhatwewant?

Campaign

Strategy

Whatistheprimaryplanormethodtobeusedtowinthecampaignandaccomplishthe

goal?

Constituency Whoisthetargetpopulationweneedtoorganizetomovethedecisionmaker?

Specifc

Objectives

1.Objectivesectionshouldbeconnectedtopoweranalysisothedecisionmakerwhat

numericallymeasurablestepsdoweneedtotaketoinfuenceororcethepersonin

powertogiveuswhatwewant.

2.Whatarethespecicstepsweneedtotaketomovethestrategyorwardandmoveus

towardaccomplishingourgoal?

3.Thenumericalmeasuresaresowecanexamineandthenknowiwearemoving

orward.

Activities

Tactics

1.Activitiesandtacticsshouldbedirectlyconnectedtoapoweranalysisthatdissects

thedecisionandidentieswhatweneedtodotomakethemdowhatwewant.

2.Intheobjectivessectionwelistednumberstheactivities/tacticsshouldbe

connectedanddirectlyaecteachobjective.

3.Inmostinstancestherewillneedtobemorethanoneactivityortacticthatwillbe

neededinordertoaccomplishtheobjective.

tool kit

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DevelopunderstandingotheBigPicture

Identiyanddevelopanissue

Researchanddevelopproleontarget

Researchanddeveloppowerprolesokeyopponents

ResearchanddeveloppowerprolesoOurSide

Chartpowerrelationships

Explorewaystochangepowerequation

UpdateCampaignPlan

sometimesprocesswillleadtoachangeinTarget

explorationandupdateshouldleadtochangesinthepowerrelationshipin

ouravor

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Cmp: asetocollectiveactivitiesplannedandexecutedoveradenedperiodotimewhosepurposeis

tomobilizethesupportandresourcesnecessarytowinavictoryortheorganization.

Cmp gl:thedecisionand/oractionwhichwillresultinthedesiredchange.

tcc: istrategyisthegameplan,thentacticsaretheactionsoreventsthatexecutetheplan.

ac: aspecicactivity,usuallyamongasetoactivities,whichmovestheorganizationtowardsthe

directionoitsstrategy.

Ccy: agroupingopeoplewhosesel-interestwouldbeserveditheysupportedyourorganization

orcampaign.

Hdl: alegal,moral,political,oreconomicactthatstandsincontradictiontothepositiontakenbythe

target/opposition.Itshowsthatyourpositionisair,just,andlegal.

i: descriptionoaproblemwhichsuggestsitssolution.

Pblm: somethingthatpeoplewanttoseechanged.

Pw aly:aprocesstodeterminewhatkindopower(quality)andhowmuchpower(quantity)is

neededtomoveatarget--theindividualwhocangiveyouwhatyouwant,toaccepttheorganizations

policyorproposalorresolvinganissue.

sy: anoverallplantodestabilizethepositionothetargetthatgivesdirectionandocustoother

elementsothecampaign.

t/Dc-Mk: Anindividualwiththepowertogranttheorganizationitsdemands.Theperson

and/orbodywhohavethepowertomakethedecisionand/ortaketheactionyourorganizationhas

determinedasthepolicyoutcome.

spcfc objcv Dmd:Specicmeasurableincrementalvictories/stepsleadingtowinningthe

campaign.

tmm: Thetimeperiodromthebeginningothecampaigntotheend.

allc: ashort-termrelationshipotwoormoreorganizationsaroundasingleissueorsinglecommoninterest.

Cl: along-termrelationshipotwoormoreorganizationsbuiltuponasharedvision,politics,and

actionaroundacommonsetoissues.

tool kit

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communicating health justice

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