PROMOTING CHANGE/ PREVENTING DISEASE Tracy Garland Washington Dental Service Foundation May 20, 2004 Grantmakers In Health Washington, DC CITIZENS’ WATCH FOR ORAL HEALTH THROUGH POLICY

POLICY CAMPAIGNS: Focus shifts: From Problem defined at individual level Short term focus on programs Treating people as consumers Using mass media to change health habits To Blend of individual and societal responsibility Long term focus on policy Treating people as citizens Using mass media to influence policy

POLICY CAMPAIGNS You can’t have a media strategy without an overall strategy

POLICY CAMPAIGNS: Strategy Development  What is the problem?  What is the solution or policy?  Who has the power to make the necessary change?  Who must be mobilized to apply the necessary pressure?  What do the targets need to hear?

POLICY CAMPAIGNS: Problem ID “A public problem doesn’t exist until enough people with enough clout in the society say it does.”

POLICY CAMPAIGNS: Theory of Change  Public officials look to media as a proxy for public opinion  Media set the public agenda  Use media to frame our issue  Public officials –Feel it is safe to move the issue –Believe that people will understand why he/she is doing this

POLICY CAMPAIGNS: Communications Research  Media creates a framework of expectation about an issue (dominant frame)  Must understand how ordinary people think –Frame trumps facts  To change opinion, must shift the frame –Search for metaphors, messengers, images to support new frame

Oral Health in America: A Report of the Surgeon General EXECUTIVE SUMMARY Department of Health and Human Services June 2000

Q. How to give legs and longevity to the Surgeon Generals report on oral health? A. Citizens’ Watch for Kids Oral Health

ORAL HEALTH POLICY CAMPAIGN  Issue is unknown; no salience  Issue is undervalued; connects to toothbrushes, junk food, smiles, self-esteem  Issue is framed solely as personal responsibility (habits, discipline)  For children, likely frame is parent responsibility  No consequences, no connection to overall health  No opportunity for public/private partnerships  Dental visits an expendable luxury  Dentists seen as self-interested, not credible Research Findings

The Good News in the Research Findings  When prompted, adults believe that oral health is part of overall health and well- being.  When prompted, adults can understand that children’s oral health is a community responsibility. ORAL HEALTH POLICY CAMPAIGN

How Do We Shift the Frame?  Emphasize prevalence of problem  Explain severity of problem  Identify consequences of problem  Underscore the efficacy of prevention in solving the problem  Mainstream the issue ORAL HEALTH POLICY CAMPAIGN

“Tooth decay is the most common chronic childhood disease in America. It affects half of all first graders and 80% of seventeen-year-olds. In Washington State, one in seven low-income children has unmet dental needs, and many more families struggle to pay for dental care. Oral disease keeps kids out of school and later out of work…” ORAL HEALTH CAMPAIGN: Message

ORAL HEALTH CAMPAIGN: Solution “It doesn’t have to be this way. When communities make prevention and early treatment a priority, kids can get regular check-ups, sealants, and fluoride. So let’s watch our mouths and use them to speak up for the children of Washington State. Because if our mouths aren’t healthy, neither are our bodies.”

ORAL HEALTH CAMPAIGN: Tools  COALITION  MEDIA –PAID –EARNED  POLICY –Phase IPolitical advance work –Phase IIawareness solutions

ORAL HEALTH CAMPAIGN: Coalition Citizens’ Watch for Kids Oral Health BusinessBusiness LaborLabor MedicalMedical The Ask -Embed this in your policy agenda -Open your communication channel -Sign Op-Eds -Testify Dental Education Public Health

ORAL HEALTH CAMPAIGN: Results  Issue reframed, with new identity  Success broadening constituency  Policy “wins” –Defeat anti fluoridation attack –Oral health references in model nutrition legislation –WSMA policy: responsibility of md’s to identify, treat and refer oral disease  WDS Foundation seen as “moral authority” in state capital

ORAL HEALTH CAMPAIGN: Summary Improved health status will come about as a result of Individuals getting more knowledge about personal health behaviorsIndividuals getting more knowledge about personal health behaviors Groups getting more power to change social and economic conditionsGroups getting more power to change social and economic conditions