1. Module 1a: Intro to 2d Half Day
November 5, 2017
Preventive Services ToolKit
Introduction to PSTK
Rapid Protocol
ATV Exercise
Joel L. Nitzkin, MD
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar

2. Module 1a: Intro to 2d Half Day
November 5, 2017
History of PSTK
Funded by CDC in 2004 as curriculum to enable public health professionals to be more effective in preventing budget cuts and developing new programming
Based on
Epidemiology as a policy tool
Principles of public administration
Experience of PSTK faculty in securing outcomes not considered possible before they were achieved
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar

3. Module 1a: Intro to 2d Half Day
November 5, 2017
Goals of Seminar
-- to enable participants to get the bureaucracy and legislature to do what you want them to do –
- - to open the hearts and minds of participants to “out of the box” thinking
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar

4. Module 1a: Intro to 2d Half Day
November 5, 2017
-- the problem
Tradition!!!
“in the box” thinking
Researcher
Clinician
Administrator
Legislator
Patient/Community Client
Organizational culture hostile to new approaches
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar

5. Module 1a: Intro to 2d Half Day
November 5, 2017
PSTK Response
A ladder to climb out of the box
Policy Analysis skill set
Epidemiology
Public administration
Political Science
Real life experience
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar

6. Module 1a: Intro to 2d Half Day
November 5, 2017
Root of Most Problems
Mark Twain – “it’s not what people don’t know that worries me – it’s what they know for sure that just aint so”
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar

7. AAPHP PSTK Advocacy Strategy Seminar
MLK on Thinking
“Rarely do we find men who willingly engage in hard, solid thinking. There is an almost universal quest for easy answers and half-baked solutions. Nothing pains some people more than having to think."
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar

8. AAPHP PSTK Advocacy Strategy Seminar
How to Think
PSTK teaches how to think these bureaucratic and legislative things through
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar

9. Lesson 1: Framing and Mindsets
Technical/Scientific
Administrative
Policy/Political
Deeply held belief/Org. culture
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar

10. Lesson 3: Stakeholder Analysis
Power
Leverage
Character types
Games People play
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar

11. AAPHP PSTK Advocacy Strategy Seminar
Lesson 4: Partnering
-- a bird may love a fish – but where can they make a home together?
(ref: Fidler on the Roof)
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar

12. ATV Initial Narrative (all terrain vehicle)
Prominent local legislator
Teenage daughter killed when thrown from ATV
Wants them banned county-wide
Health director asked to write the bill and provide the justification
?? How should you, as health director, proceed??
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar

13. Rapid Protocol – Step 1 Define and Set Up
November 4, 2017
Rapid Protocol – Step 1 Define and Set Up
Specify problem and proposal
Anticipated
What intervention?
Who pays?
Who gets the benefit?
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar

14. Step 2: ATV Policy Options
November 4, 2017
Step 2: ATV Policy Options
Ban all terrain vehicles (ATVs)
Require warning placards on ATVs
Impose control on ATV events
Prohibit use under age 18
Safety training and licensure or certification
Posting of hazardous properties
Research and surveillance
Health education
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar

15. AAPHP PSTK Advocacy Strategy Seminar
Step 3: some numbers
Local ATVs
Injuries and deaths
Number and percent that might be prevented by various options
(start with best guestimate – save research for later)
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar

16. Step 4: Stakeholder Analysis
November 4, 2017
Step 4: Stakeholder Analysis
Brainstorm obvious stakeholders
Identify key stakeholders who otherwise would have been missed
Select the 1-5 stakeholders that appear most critically important
10-20 minutes (the heart of the brainstorming session)
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar

17. Preliminary list of ATV Stakeholders
November 4, 2017
Preliminary list of ATV Stakeholders
Local vendors
Manufacturers (none local)
Current owners of ATVs
Members of ATV clubs
Families of kids injured by ATVs
Emergency room doctors
County legislators
State legislators
Local police
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar

18. Step 5: Brainstorm Partnering
November 4, 2017
Step 5: Brainstorm Partnering
Decide who to partner with
For leverage and for advocacy
For implementation
ATV potential partners
Vendors
Doctors
Parents
Police
DMV
3-5 minutes
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar

19. Step 6: Identify Research Needs
November 4, 2017
Step 6: Identify Research Needs
(research to be done before initiating advocacy)
Stakeholder research
(per stakeholder analysis)
Evidence and guidelines
(literature review)
Baselines and benchmarks
(project likely benefits)
3-5 minutes
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar

20. Step 7: Initial and Final Decisions
November 4, 2017
Step 7: Initial and Final Decisions
Options:
“Go”
“No Go”
“Hold until . . .”
ATV:
“go” on health education and training
“Hold” on ban and legal restrictions
5-10 minutes
5/21/2018 Module 1 Intro
AAPHP PSTK Advocacy Strategy Seminar
AAPHP PSTK Advocacy Strategy Seminar