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TABLE OF CONTENTS

Contents

Acknowledgement _____________________________________________________________________________________1

AbouttheChapter’sGuidetoPromotingHealthEquity__________________________________________2

Introduction_____________________________________________________________________________________________5

UnderstandingtheIssues_____________________________________________________________________________6

GettingOrganizedattheChapterLevel____________________________________________________________13

EngagingMembers____________________________________________________________________________________20

EducatingKeyStakeholders_________________________________________________________________________22

EstablishingPartnerships____________________________________________________________________________26

GettingOutThere_____________________________________________________________________________________28

ExamplesofHealthEquityPromotionActivities_________________________________________________31

AppendixA_____________________________________________________________________________________________32

AppendixB_____________________________________________________________________________________________34

AppendixC _____________________________________________________________________________________________35

ContactInformation __________________________________________________________________________________36

SOPHE CHAPTER’S GUIDE TO PROMOTING HEALTH EQUITY

Page1

Acknowledgement

ThispublicationwasdevelopedtoserveasaguidetoassisttheSocietyforPublicHealthEducation(SOPHE)Chaptersandtheirpartnersineducatingkeystakeholdersonhealthequitypromotion.ThedevelopmentofthisguidewasheadedbySOPHEHealthEquityDirectorNicoletteWarren,MA,MCHESwiththeassistanceofSOPHEinternRheaP.Olegario,MPH,CHES,SRAS.

ThisguidewassupportedbytheCooperativeAgreementNumber5U58DP002328‐04fromtheCentersforDiseaseControlandPrevention.ItscontentsaresolelytheresponsibilityoftheauthorsanddonotnecessarilyrepresenttheofficialviewsoftheCentersforDiseaseControlandPrevention.

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Page4

2. IllustratetheorganizationneededwithintheChapter,Chapter’srespectivecommittee(s),andChaptermemberstocarryoutsuccessfulhealthequitypromotionpriorities,initiatives,andactivities

3. DemonstratewaystoengageChaptermembersinhealthequitypromotionactivitiesandinitiatives

4. Understandtherolethatkeystakeholdersplayinpromotinghealthequityintheirstateorregion

5. Identifywaystoeffectivelyeducate,collaborate,andworkwithkeystakeholdersandothersinpromotinghealthequity

6. Identifyanumberofmediumstocommunicateandeducatehealthequitypromotionissues,activities,andinitiativestothecommunityatlargebyutilizingthemediaandothereventstoincreaseawarenessandvisibility


Page5

Introduction

ABOUT THE SOCIETY FOR PUBLIC HEALTH EDUCATION

TheSocietyforPublicHealthEducation(SOPHE)isa501(c)(3)professionalorganizationfoundedin1950toprovideglobal leadershiptotheprofessionofhealtheducationandhealthpromotion.SOPHEcontributes to thehealthofallpeopleand theeliminationofhealthdisparitiesthroughadvancesinhealtheducationtheoryandresearch,excellenceinprofessionalpreparationandpractice, andadvocacy forpublic policies conducive tohealth.

SOPHE is theonly independentprofessionalorganizationdevotedexclusively tohealtheducation and health promotion (SOPHE Board of Trustees Mission, 2010). Membersinclude diverse behavioral scientists, faculty, practitioners, and students engaged indisease prevention and health promotion in both the public and private sectors.Collectively, SOPHE’s 4000 National and Chapter members work in universities,medical/health care settings, businesses, voluntary health agencies, internationalorganizations,andallbranchesoffederal/state/localgovernment.

ABOUT SOPHE CHAPTERS

SOPHE’s20Chaptersspanmore than30states,westernCanada,andnorthernMexico,and provide “boots on the ground” linkages for continuing education, partnerships,networking,andadvocacyat thestate/local levels (SOPHEBoardofTrusteesChapters,2010).SOPHE’sHouseofDelegatesprovidestechnicalassistanceandcapacitybuildingtostrengthen Chapters’ impact. Chapters must meet National SOPHE requirements,althoughtheyareautonomousingovernanceandfinancialstructure.MostChaptersaresustainable501(c)(3)organizations,butallarestateincorporatedtooperatewithintheirstate or region. On average, Chapters have 80 members, offer continuing educationprograms for state/local health professionals, and convene 2 membership meetingsannually. Furthermore, Chapters must be re‐designated every 5 years and provide anactionplaninconformancewithNationalSOPHE’sstrategicplan.ThisChapteroutreachis complemented by SOPHE’s connections to some 250 professional preparationprogramsinhealtheducationandpublichealtharoundthecountry.


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UnderstandingtheIssues

THE NEED TO ADDRESS HEALTH DISPARITIES

TheUSDepartmentofHealthandHumanServices,OfficeofMinorityHealthhasstatedthat“changinghealthoutcomesformanyoftheUnitedStates’racialandethnicminorities,thepoor,andotherunderservedpopulationsisacriticalneed”(USDHHS,OMH,2012).TheexistenceofhealthandhealthcaredisparitiesintheUnitedStatesisindisputable(USDHHS,OMH,2012).Consideringthatthelikelihoodofadversehealthoutcomesforanyofthesevariouspopulationsisoftengreaterwhentheindividualsarefromracialorethnicminoritypopulations,thegoaltoachievehealthequity,ortheattainmentofthehighestlevelofhealthforallpeople,shouldbethemainpriorityfornotjustpublichealth,butthenation(USDHHS,OMH,2012).

SOPHEhasbeencommittedtoeliminatinghealthdisparitiesandachievinghealthequity.TheevidenceofSOPHE’scommitmentcanbefoundinitshistory,mission,resolutions,andtrackrecordofhighly‐regardedprogramsandproductsimpactingthenation,state,andcommunitylevels.SOPHEhashadrich,lengthypartnershipswithgovernmentalandnon‐governmentalorganizationstopromotehealthequityandtoadvancetheapplicationofevidence‐basedpracticestoimprovecommunityhealth,particularlywiththeREACH(RacialandEthnicApproachestoCommunityHealth)andHealthCommunitiesprogramsaswellasSOPHE’snewSustainableSolutionsforHealthEquityProjectcooperativeagreement.

SOPHEChaptersalsosharethiscommitmenttoeliminatehealthdisparities.Infact,SOPHEChaptersarevitaltothesuccessfulexecutionofNationalSOPHE’sactivitiesandinitiativesinhealthequitypromotion.With20Chapterseachservingdiversecommunitiesandpopulations,itisimportantthatChaptersnotonlyprioritizehealthequitypromotion,butalso,establishacleardirectionsintheimplementationoftheactivitiesandinitiativesrelatedtohealthequitypromotion.Thispublicationservesasa


GettingOrganizedattheChapter

Level

EngagingChapterMembers

EducatingKey

Stakeholders

EstablishingPartnerships

GettingOutThere


Page7

guideonhealthequitypromotiontosupplementandenhanceallthelaudableworkdonebySOPHEChaptersandtheirpartners.

NATIONAL STAKEHOLDER STRATEGY

Inordertohaveeffectivehealthequitypromotionactivitiesandinitiativesthatimprovethehealthoftheirrespectivecommunities,organizationsmustfirststrategicallyplanonhowtoeducatethosekeystakeholders.Keystakeholdersareindividuals,groups,orinstitutionslikelytobeaffectedbyaproposedactivityorinitiative(eithernegativelyorpositively),orthosewhocanaffecttheoutcomeofanactivityorinitiative(ParticipationandSocialAssessment:ToolsandTechniques:CompiledbyJenniferRietbergen‐McCrackenandDeepaNarayan,WorldBank,April1998).Keystakeholderscanalsobethoseindividualswhoultimatelyholdthedecisionstoaffectpolicy.Inthisguide,policyreferstoalaw,regulation,procedure,administrationaction,incentive,orvoluntarypracticeoforganizationsinallsectors—governmental,corporate,andnon‐profit(AppendixA).

Chaptersandtheirpartnerscanworktopromotehealthequitybyeducatingkeystakeholdersonpolicythatpromoteshealthequity.Healthdisparitiesareinfluencedbypolicies,systems,andenvironmentsthatcaneitherbefavorableordisruptivetothepublic’shealth.Whenkeystakeholders,especiallydecisionmakers,establishpolicies,systems,andenvironmentsthatsupporthealthequity,thegreatestimpactinendinghealthdisparitiescanbeachieved.

Thegoalofeveryhealthequitypromotionplanmustbebasedonidentifiedhealthissues,objectives,andgoalsestablishedbythelocalcommunitiesintheirstateorregion.Theactivitiesofthisplansettheframeworkforprioritizingstrategiestoaddressthesocialdeterminantsofhealth,whicharemajorfactorsofhealthdisparities.TheNationalStakeholderStrategysupportsthetheoreticalcontextforchangemodelfocusedonthesocialdeterminantsofhealth.Thesocialdeterminantsofhealtharesignificantfactorsthatcaninfluencechangemodel,and,therefore,shouldbestrategicallyincorporatedintoanorganization’sorcoalition’splanonpromotinghealthequity.Themodelprovidesageneralroadmaptoensurethatindividuals,organizations,andcoalitionsstayfocusedwhileimplementingincrementalstepsthatleadtotheendofhealthdisparities(U.S.DepartmentofHealthandHumanServices,2011).Theimplementationofthese


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strategiesbyorganizationsandcoalitionscanimpactthehealthinequitiesinthecommunitiesoftheirstateorregion.

Throughcollaborativepartnerships,organizationssuchasSOPHEChapterscanformulateahealthequitypromotionplanthatincorporatestheNationalStakeholderStrategygoals:

NationalStakeholderStrategyGoalsGoal1:Awareness Increaseawarenessofthesignificanceof

healthdisparities,theirimpactonthestate/localregion,andtheactionsnecessarytoimprovehealthoutcomesforracial,ethnic,andunderservedpopulations

Goal2:Leadership Strengthenandbroadenleadershipforaddressinghealthdisparitiesatalllevels

Goal3:HealthSystemandLifeExperience

Improvehealthandhealthcareoutcomesforracial,ethnic,andunderservedpopulations

Goal4:CulturalandLinguisticCompetency

Improveculturalandlinguisticcompetencyandthediversityofthehealth‐relatedworkforce

Goal5:Data,Research,andEvaluation Improvedataavailabilityandcoordination,utilization,anddiffusionofresearchandevaluationoutcomes

Source:USDHHS,OMH(2011)

Overall,SOPHEChapters’objectivesineducatingkeystakeholdersonhealthequitypromotionshouldbeto(1)develop,implement,andevaluateahealthequitypromotionplantoincreaseChapteractivitiesthataddresshealthdisparities;(2)expandcollaborativepartnershipstoincreaseawarenessandknowledgeamongkeystakeholders;and(3)trainkeystakeholdersandhealtheducatorsaboutpolicy,systems,andenvironmentalchangetoaddresshealthdisparities(e.g.,diabeteseducation).

CHAPTERS’ ROLE IN ADDRESSING HEALTH DISPARITIES

SOPHE’s20Chaptersofferanetworkofopportunitiesforprofessionaldevelopment,collaborativepartnerships,andhealthequitypromotioninitiativesandactivities.Chaptersplayavitalroleineffectivelycommunicatingthepolicies(governmental,corporate,andnon‐profit)thatsupportpopulationhealth.Chapters’


Page9

abilitytobuildcapacitytopromotetheimplementationofevidence‐basedactivitiesforaddressinghealthdisparitiesiscriticaltounderstandingthesocialdeterminantsofhealth.Strengtheningthefieldofhealtheducationandeducatingkeystakeholdersonevidence‐basedandcost‐effectivepoliciesthatpromotehealtharemeasuresthatChapterscantaketoreducehealthinequitiesandimprovehealthoutcomeslocallyattheirstateorregion.

Ineffectivelyeducatingkeystakeholderstopromotehealthequity,Chapterswillneedto(GuidetoEffectivelyEducatingStateandLocalPolicymakers,2012):

Identify,define,andanticipatepublichealthproblemsoropportunities Applythescienceandevidencebasetoinformpolicydecisions Informandeducatekeystakeholders Trainothersineffectivehealthequity/healthdisparitiespromotion

communications Developandimplementmediacommunicationsstrategiestargetedto

variousaudiencesabouthealthpolicies Assesscurrentpublichealthlawagainstevidenced‐based

recommendations Buildcoalitionsofkeystakeholders Evaluatethereturnoninvestmentofcurrentproposedpolicies

RECOMMENDED CHAPTER ACTIVITIES

Chaptersshouldaddressracialandethnicpopulation’shealthdisparitiesbyfocusingondiseaseorotherhealthconcernpreventionandmanagement.Forexample,diabetesisthesixthleadingcausesofdeathintheUnitedStates(CentersforDiseaseControlandPrevention,2011).About10percentofthenation’sadultsages20andolderhavediabetes,and37percentofthosewithdiabetesareaged65andolder(CentersforDiseaseControlandPrevention,2011).Infocusingonincreasingpublicawarenessofracialandethnichealthdisparities,Chapterscanestablishcollaborativepartnershipstoengagekeystakeholdersondiabetesdisparitiesandotherrelatedhealthconcerns.SOPHEChaptersareencouragedtoconveneeducationalforumsandworkshopsonthelatestevidence‐baseddiseaseandriskbehaviortrends,andpolicies.Byconducting

SOPHE C

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toeducatekeystakeholdersinhealthequitypromotionbyintroducing,co‐sponsoring,andadoptingproposedpolicy.Indoingso,Chapterscanaddresshealthdisparitiesrelatedtochronicdiseases,andincreasefinancialandotherprogramresourcesatthestate/locallevelforchronicdiseasepreventionandwellnesspromotion.Chaptersshouldencouragememberstoparticipateintheannualhealtheducationsummit.Lastly,Chaptersshouldworkondevelopingeffective,educationalhealthequitypromotionalmaterialsforhealtheducators.

ExampleChapterActivitiesActivityArea Example BenefitsTraining Trainhealtheducatorson

conductingHIAs(CommunityCommons,RobertWoodJohnson),whichareusedtoevaluatetheeffectsofaplan,project,orpolicybeforeitisbuiltorimplemented(CDC,2012)

‐Increasepositivehealthoutcomesandminimizeadversehealthoutcomesbybringingpotentialpublichealthimpactsandconsiderationstothedecision‐makingprocessforplans,projects,andpoliciesthatfalloutsidethetraditionalpublichealtharena,suchastransportationandlanduse(CDC,2012)

CollaborativePartnerships

EstablishcollaborativepartnershipswithOfficeofMinorityHealth,10RegionalHealthEquityCouncils(RHEC)(Figure2)toengagekeystakeholderstoreducehealthdisparitiesbasedontheNationalStakeholderStrategy

‐Reduceduplicationefforts‐ImproveOutcomes‐Distributeresourcestoaddresshealthdisparities(USDHHS,2011)

TechnicalAssistance

Providehealtheducatorsandorganizationswithevidence‐basedchronicdiseaseself‐managementprograms,resources,andtoolstoreducetheburdenofhealthdisparitiessuchasdiabetes

‐Self‐managementprogramsprovideagreatopportunityforhealtheducation.‐Healtheducationoffersanaffordableandeffectiveapproachtoprimarypreventionandmanagement‐HealthEducatorsprovidecost‐effectivepreventionandmanagementinhealthcare


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Figure 2

RegionalHealthEquityCouncils(RHEC)Map


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GettingOrganizedattheChapterLevel

(AdaptedfromtheNAEYCAdvocacyToolkit)

ASSESS RESOURCES

Aspartofanationalorganization,SOPHEChaptersareencouragedtoworkonhealthequitypromotioninitiativesandcommunications.Chaptershavedesignatedresourcesfortheirhealthequitypromotionactivitiesandinitiativesandcommunicationsworkinordertobeintentional,strategic,andreadytoactorreact.TherangeofresourceswillvaryamongChapters.Butwithoutplanningforbasiccostsofeducatingkeystakeholdersinhealthequitypromotion,itisdifficulttobebothintentionalandstrategic.

Thingstoconsider:

1. Volunteertimeandlevelofinvolvement2. Costofcommunicationsactivities(e.g.,mailing,email,andwebmanagement)3. Meetings:travel,copiesofmaterials,incidentals4. Conferencecalls5. Printing6. Requiredregistrations,filingsandotherforms7. Seekingconsultantservices8. Specialevents,suchasaconferenceorcommunityevent

DESIGNATED COMMITTEE(S)

ItiscriticalthatnosinglepersonmakesallofthedecisionsandhastheentireburdenoftheChapter’shealthequitypromotionactivityandinitiativeefforts.HavingadesignatedcommitteeorcommitteestoworkontheissueofeducatingkeystakeholdersonhealthequitypromotionimprovestheChapter’scredibility,andensuresdiversityand



Level


EducatingKeyStakeholders


GettingOutThere


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inclusivityofopinion,expertise,andexperience.Bymakingthiscommittee(s)anintegralpartoftheChapter’swork,andnotaseparate,unalignedpart,Chapterscanremaincommitmenttotheirworktoeliminatehealthdisparities.

ResponsibilitiesoftheDesignatedCommittee(s):

Plansandorganizesthedistributionofinformationandtheactivitiesrelatingtohealthequitypromotionactivitiesandinitiatives

Scheduleregularmeetingsandcommunication Establish and review priorities for health equity promotion Establish and review an annual health equity promotion agenda—the current

health disparities issues that the Committee(s) will focus on each year Create communication systems to keep their members, other Chapters, and the

public aware of health disparities issues Create communications systems to alert members to contact key stakeholders

at appropriate times Provide training and information at conferences and other venues sponsored

by the Chapter Work collaboratively with person(s) responsible for public representation in

speaking at functions, press, etc. on messages regarding health disparities

issues

ResponsibilitiesoftheDesignatedCommittee(s)Chair(s):

Delegatestasksandresponsibilitiestomembersofthecommitteethatmatchtheirinterests,abilities,andskills

Coordinatescommunicationsystems LiaisontoNationalSOPHECommittee(s) LiaisontootherdesignatedcommitteesinotherChapters Facilitatescommitteeinsettingprioritiesandreviewingcurrentprograms

oneducatingkeystakeholdersinhealthequitypromotioneachyear MemberofNationalSOPHECommittee(s)andparticipatesinanynational

healthequitypromotionactivities


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HEALTH EQUITY PROMOTION PROGRAMS

SOPHEanditsChapters’workofeducatingkeystakeholdersinhealthequitypromotionisissue‐driven,notpoliticallydriven.Itisbasedonevidence‐basedresearchonwhatworkstoreducehealthdisparities.Beingabletopromoteandrespondtoproposalswithcredibilityiscritical.Asanissue‐drivenorganization,SOPHEhasevidence‐based,peerreviewedpositionstatementsthatformtheframeworkforSOPHE’spositionsinhealthdisparitiesandhealthequityissues.

KEEPING MEMBERS INFORMED

HavingunitedmembersiskeytoaChapter’ssuccessinallitshealthequitypromotionactivitiesandinitiatives.Messagesandinformationmustbeconsistent,accessible,anddistributedwidely,internallyandexternallyintheChapteramongtheChaptermembersandpublic.

Internally,itisimportantthattheChapter’scommittee(s)onhealthequityactivitiesandinitiativeskeepstheChapterBoardandmembersinformedofitsmeetingsanditsdecisions.LiaisonwiththeBoardandmembersshouldbeaformalizedprocessandclearlyunderstood.Likewise,localchaptersshouldkeepNationalSOPHEabreastofkeyactivitiesandinitiativesregardinghealthequitypromotion.

Internalcommunications–thosewithmembers–shouldbeformalizedaswell.Adesignatedpersonshouldhavetheresponsibilityofsendingoutinformationabouthealthequityrelatedissues.Thecentralizationofthisinformationdisseminationiskeysothatmixedmessagesdonotgetsenttothemembers,whoarevitallyimportanttoimplementinggrassrootsactivitiesoneducatingkeystakeholdersinhealthequitypromotion.

Increasingly,mostcommunicationisdonethroughemailandlistservs.SOPHEatthenationallevelusestwoformsofcommunicatingupdatesfornationalhealthequitypromotionactivitiesandinitiatives:(1)anemaildistributionthatisopentoallofitsmembers;and(2)alistservthatservesmorespecificissuesandtopicsundertheCommunitiesofPracticeandvariousCommittees.ThesecommunicationsmechanismsareestablishedbymostChaptersandhavebeenthemostefficientandspeedywaytodisseminateimportantinformation.


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TYPES OF MEMBERS

UnderstandingthedynamicsofmembershipcanhelpSOPHEChaptersmaximizetheefficiencywithintheirorganization.

MemberType DescriptionLeader Apersonwhoprovidesvisionandkeepsactivitiesoneducatingkey

stakeholdersonthehealthequitypromotioneffortontrackAdvisor Apersonwhoiswillingtosharetheirspecialexpertisewithfellow

colleaguesandtargetedkeystakeholdersResearcher Apersonwhocancollectdataandsynthesizeresearchreportsinto

issuebriefsandbackgroundpapersContributor Apersonwhoiswillingtorolluphis/hersleevesandparticipatein

thenuts‐and‐boltsworkofhealthequitypromotion,frommakingphonecallstostuffingletters

Friend Apersonwhodoesnothavetimeorresourcestoparticipateineveryaspectoftheplanningandimplementationofhealthequitypromotion,yetwhocaresandcanalwaysbecountedontohelpwhenapushisneeded

ACTIONS THAT MEMBERS CAN TAKE

Share research that supports effective and appropriate evidence‐based healthequitypromotionactivitiesandinitiatives

JoinChapter’sdesignatedcommittee(s)onhealthequitypromotion Writetotheeditorofanewspaperormagazine Meetwithastakeholdertoprovideawarenessonhealthdisparitiesandhealth

equitypromotion Volunteer to assist Chapter in planning activities to bring awareness to the

communityonhealthdisparities Collectdata and researchandworkwithothervolunteers todevelopaposition

statementonacriticalhealthequityissue Speakatanykeystakeholdermeeting Conductlocal,state,orregionalsurveysonhealthdisparitiesandhealthequity

CHAPTER’S INTENTIONAL, STRATEGIC STEPS TO HEALTH EQUITY PROMOTION

MakeittheChapter’sprioritytoeducatekeystakeholdersinhealthequitypromotion—organizediscussiongroups,visiting,e‐mailing,writinglettersorcallingkeystakeholders,helpingtopromoteevidence‐basedpoliciesonhealthequitypromotion,etc.


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Keepinformed:SignupforcommunicationonNationalSOPHE’sandotherChapter’swebsites;ReadthenewspaperandNationalSOPHEpublications.Talktoothersinthefieldandasksupportivekeystakeholderstokeepyouinformedabouthealthdisparitiesandhealthequityissues.

Knowtheprocess:Understandcertainhealthpromotionactivitiesandinitiativesareintroducedandenactedatthekeystakeholder’srespectivenon‐profit,corporate,orgovernmentalsector

ExpressChapter’sviews:Asanorganizationrepresentinghealtheducationprofessionals,theChaptershouldhaveaclearunderstandingoftheneedsofunderservedpopulationsintheirstateorregion,andshouldlearntoeffectivelyexpresstheChapter’sviewsandopinionstothepublicandtokeystakeholders

Letothersknow:Contactkeystakeholders,newspapers,joingroupsandnetworks,andbecomeactiveinhealthequitypromotioninyourstateorregion

Bevisible:Attendmeetings,hearingsandvisitkeystakeholdersateventstheyarehosting

Showappreciation:Besuretosendathankyoumessagewhenkeystakeholdershavesupportedorrespondedtoyourrequests.Considerwaystohonorthosewhosupportimportantissuesinhealthequity

Watchtheimplementation:Afterthehealthequityinitiativehasbeensupportedandestablished,Chapter’smustcontinuetomonitoritsimplementation,evaluatinghowitworks,possibleflaws,andifcorrectionisneededorconsidered.

Buildrapportandtrust:Beareliablesourceofinformationforkeystakeholders.Becomefamiliarwiththembyresearchingtheirrecordsandstances,professionalbackgroundandinterests.Keepchannelsofcommunicationopen.

Educateyourkeystakeholders:Keepingkeystakeholdersinformedonneedsofhealthequitypromotion,sendarticles,newsletters,andresearchaboutprogramsthatpromotehealthequity.Invitethemtoattendorspeakatmeetings,forums,conferences,workshops,andsymposiums.ExtendinvitationstovisityourChapter’sevents.

GETTING WHAT YOU WANT FROM KEY STAKEHOLDERS

1. Bestrongandorganized


Page18

Themostcriticalthingyoucandotogaininfluenceistobuildalarge,well‐organizedmembership.Ifwell‐organized,Chapterswillhaveenoughclouttobeheardandtogetsupportfromkeystakeholders.

2. BeknowledgeableabouttheissuesSharingfirsthandtestimonyabouttheconcernstheChapterisworkingonbuildsyourcredibility,asdoeshavingsoundresearchandbringingaccurateinformationaboutpotentialsolutions(whattheycost,whatoutcomeswillresult,andhowthesolutionwillwork).

3. BedirectandrespectfulIfaChapterdoesn’taskdirectlyforthespecificsupportonhealthequitypromotion,itbecomesdifficulttoreceivethatspecificcommitmentfromakeystakeholder.Thegoalisaccountability—youwantthekeystakeholdertopubliclysupportthathealthequitypromotioninitiative.Ifyouaredisrespectful,youalienatethekeystakeholder,thepublic,andChaptermembers.

4. BeknowledgeableabouttherulesofthegameItisalearningprocess,soitisfinetoaskkeystakeholdersquestionsabouttheprocess,butthemoretheChapterknowsaheadoftimeaboutwhenandhowdecisionsaremade,thebetterimpressiontheChapterwillmakeonkeystakeholders.

5. FollowadisciplinedprotocolIfpossible,gowithateam.Becausewhenyoubringagroup:

Membersfeelmoreconfident Apublicstatementisharderforkeystakeholderstoretract Ithelpstohavelessconfusionaboutwhathappenedandwhatwas

reallysaid

IthelpsdeveloptheleadershipandcommitmentofmoreChaptermembers

6. MaintainformalityOnetacticthatkeystakeholdersusetopreventindividualsororganizationsfromholdingthemaccountableistoencouragetheindividualororganizationtorelatetotheminapersonalway.

7. Planyourmeetingstomakesuretherearecleargoals,aclearagenda,andclearroles.


Page19

Whenmeetingwithakeystakeholdertodeterminewhethertheproposedhealthequityinitiativeiswinnable,dosoinastructured,organizedway.

Knowexactlywhatyouwanttoaccomplishinthemeeting. Haveaclearagenda.

Assigndifferentmemberstorolesbasedontheirstrengths. Practiceandpreparebyroleplaying. Haveabriefingbeforethemeetingtogooverthegoals,agenda,and

roles. Evaluateafterwardtoarriveatacommoninterpretationofwhat

happened,learnlessons,andfigureoutnextsteps.8. Dressprofessionally


Page20

EngagingMembers


Promotinghealthequityisabouteducatingkeystakeholdersonhealthdisparitiesandonactivitiesandinitiativesthatpromotehealthequitysothatkeystakeholderscanbemoreresponsivetoissuesaffectingalargenumberofthoseaffectedbyhealthinequity.Thismeansbringingtoattentiontheproblemsofhealthdisparitiesinkeystakeholders’respectivecommunitiesandeducatingthemonevidence‐basedsolutions.Healthequitypromotionwouldrequireengagingmemberstoseeksupportfromkeystakeholdersbyeducatingthemontheissuesofhealthdisparitiesandhealthequityintheirrespectivecommunities.

Role of Health Educators

Chaptermembersconsistofavarietyofhealtheducatorsingovernmental,non‐profit,andcorporatesectors.HealtheducatorswhoparticipateinSOPHEChapters’“train‐the‐trainer”educationalforumsandworkshopscanbeequippedwiththetoolsandresourcestoconductlocaltrainingamongsub‐communities.Healtheducatorsareencouragedtoimplementatleastthreestrategiesandutilizeevidence‐basedresourcestoeducatekeystakeholdersaboutdiabetesdisparities.Localhealtheducatorsshouldworktoestablishlong‐termrelationshipswithkeystakeholders,especiallypolicymakers.Localhealtheducatorswhoworkwithhealthjournalistsandeditorialscanimprovemediacoverageofhealthequityissuessuchasdiabetesdisparities.

ByapplyingforSOPHEchapters’mini‐grantsandparticipatingintrainingsessions,healtheducatorscanparticipateinplanningcommittees/workgroups,andidentifyspeakersforlocalevents.Additionally,healtheducatorsshouldattendannualhealtheducationtrainingsessionssponsoredbytheCoalitionofNationalHealthEducationOrganization.Andthroughparticipationinmeetingsonkeypolicyissuesandthe



Level


EducatingKey

Stakeholders


GettingOutThere


Page21

utilizationofevidence‐basedhealthequitypromotioninformationfromNationalSOPHE(i.e.SOPHE’sadvocacyplan),localhealtheducatorscanworktopromotehealthequityinitiativesandactivitiestohighlighthealtheducationandhealthpromotionprogramsandresearch.


Page22

EducatingKeyStakeholders


WHO ARE KEY STAKEHOLDERS

Keystakeholdersareindividuals,groups,orinstitutionslikelytobeaffectedbyaproposedproject(eithernegativelyorpositively),orthosewhocanaffecttheoutcomeoftheproject(ParticipationandSocialAssessment:ToolsandTechniques:CompiledbyJenniferRietbergen‐McCrackenandDeepaNarayan,WorldBank,April1998).Theyarepersonswhomightbeinvolvedorbeimpactedbytheproject.Thestakeholderpopulationcanbebroad,sonarrowingthefieldtokeystakeholdersisamainobjectiveofconductingastakeholderanalysis.Theidentificationstagecouldstartwiththedesignatedperson,especiallyifheorsheisfamiliarwithcurrentorpotentialstakeholders.Remember,themoreinvolvedstakeholdersareintheproject,themorelikelyaprojectwillbesuccessful.

EXAMPLES OF KEY STAKEHOLDERS BY SECTOR

SECTOR KEY STAKEHOLDERS

Nonprofit ExecutivesBoardofdirectorsFaith‐basedleadersAgencydirectorsCollegedeansLeadersinPTAsandotherformallyorganizedvoluntarygroups

Corporate Executivesuite:CEO,COO,CFOBoardofdirectorsHumanresourcedirectorsMedicaldirectorsforahospital,nursinghome,healthplan



Level


EducatingKey

Stakeholders


GettingOutThere


Page23

EditorialboardsPropertyownersormanagers

Governmental Elected:governors,legislators,citycouncil,schoolboardAppointed:cabinetsecretaries,advisorycommittees,judgesCareer:agencysectionheads,legislativestaff,schooladministrators

Source:SOPHE(2012).GuidetoEffectivelyEducatingKeyStateandLocalPolicymakers

ESTABLISH PRIORITIES

TherearesomeperiodsoftimeinhistorywhenitiseasierormoredifficulttomakeprogressinacertainpriorityofaChapter.Healthequityactivitiesandinitiativesdevelopmentandadvancementisoftendependentinthecontextofthepolitical,social,andeconomicclimateofthestate,communityandnation.DeterminingspecificprioritiesinaChapter’shealthequitypromotionagendaasitrelatestothecurrentclimatetoimplementtheactivitiesandinitiativesisoftendifficultwithoutplanningstrategicallybeforehand.ThechartbelowistoassistChaptersindevelopingspecificpriorities.

Determining Health Equity Promotion Priorities – Short Term and Long Term Issue Need

(Date, Scope, Scale,

Importance)

Political Environment (Government,

Agency, Board, etc.)

Economic Environment

(Source of Financing)

Social Environment (Awareness,

Ease/difficulty, generating

interest/support)

Capacity (Partners, resources,

etc.)


Page24

DEFINITIONS: CONCERNS, SOLUTIONS, AND ASKS

(AdaptedfromtheChapterHandbookbyStandforChildren)Theseconceptsareimportanttokeepinmindwhenchoosinganissuetoaddress,figuringouthowtoaddressissues,andarticulatingwhatyouwantfromkeystakeholdersKeystakeholderscanbethoseindividualswhocanaffecthealthequitypromotionactivitiesandinitiativesand/ordeterminehowfundscanbespent.

Concerns/Issues:SpecificproblemwithHealthEducatorTrainingExample:HealtheducatorshaveaskedtheirSOPHEChaptersforassistanceandtrainingtoconducthealthimpactassessments(HIAs)amongtheethnicandracialminorityandunderservedpopulationsintheirrespectivecommunities.Solution:AwaytoaddressaconcernorissueExample:ProvideaHIAtrainingworkshopsforhealtheducatorsinthelocalareaAsk:AspecificstatementofsomethinganorganizationwantsdonefromakeystakeholdersabyasettimeframeExample:SOPHEChapterwouldseekspartnershipwiththekeystakeholder’sorganizationtoconductHealthImpactAssessmenttrainingworkshopsfor30healtheducatorsinthecommunityandtohelpcontributeafinancialfundofabout$forthisworkshop.Usethefollowingquestionswhenfiguringoutwhetherasolutiontoaparticularconcernorissueiswinnable.PotentialAlliesandOpponents

Isthereanallywithdecisionmakingpowerwhowillchampionyoursolution?

Canthatallywinthesupportofotherkeystakeholders? Isthereakeyindividualorgroupwhoisadamantlyopposedtoyour

solution? Aretherestrongalliesinthecommunityyoumightenlist?

PoliticalDynamics

Canyouidentifyapotentiallyfavorablemajorityonthedecisionmakingbody?HowmanykeystakeholdersareyoufairlysurewouldvoteinsupportyourChapter?Inopposition?Howmanyareyouunsureabout?


Page25

Isitfeasible,giventhesizeofyourmembershipandtheeffectivenessofyourpartners,topersuadethekeystakeholderyou’reunsureabouttosupportyoursolution?

Arethereanyofthekeydecisionmakers,particularlytheonesonthefence,upforre‐electionsoon?

Didthosekeydecisionmakerswinbyalargeorsmallmarginlasttime? Doyouhaveenoughmemberstobeconsideredafactor? Isthedecisionmakeranappointedallywhosebossisorcouldbe

encouragedtobesupportive?

INFLUENCING EACH STEP OF THE PROCESS

Step1

FindaChampiontointroducethehealthequitypromotionactivityor

initiativetoakeystakeholder

Step2

Introducethehealthequitypromotionactivityor

initiativeandgetkeysponsors

Step3

Getthewordoutonthemeeting

fortheintroductionofthehealthequity

promotionactivityor

initiativetothekeystakeholder

Step4

Negotiatechangesonthehealthequitypromotionactivityor

initiativewiththekey

stakeholder

Step5

Callonthekeystakeholdertotakeactiononthehealthequity

promotionactivityorinitiative

Step6

Havemeetingnegotiations

Step7

Keystakeholderwithadopttheproposedhealthequitypromotion

activityorinitiative


Page26


Thereispowerinnumbers,andmoreresourcestoo.SOPHEdoesnotexpectitsChapterstoworkonhealthequitypromotionactivitiesandinitiativesalone.Everystateandlocalcommunityhasothergroupsworkingonhealthequityissues.ThetaskforChaptersistoseekouttheseothergroups,findoutabouttheirparticularfocus,andforgestrategicrelationshipswhenpossible.

BUILDING PARTNERSHIPS

Healthequitypromotionactivitiesandinitiativescanbemosteffectivewhengroupsworktogetherinpartnerships.Themostpowerfulcoalitionsareoftenthosethatcombinegroupsthataretraditionallynotseenasdirectstakeholdersinthehealthequitypromotioneffort.

Whenlookingforgroupstoworkwithonaparticularissue,committeeshandlingtheChapter’shealthequitypromotionactivitiesandinitiativescandiscussthesequestions:

• Whoisalreadyengagedinthisissue?• Whocanbringadditionalresources(notjustfinancial),clout,orexpertise,

totheeffort?• Hasthecommitteereachedouttogroupsbeyondpublichealth?Which

individualsororganizationscontactedwilldependonthenatureoftheissue?

Effectivecoalitionsarestableandformal.Regularmeetingsshouldbeheld,toshareinformation,andkeepeveryoneconnectedtoeachotherandtotheagenda.Everyorganizationinthepartnershipshoulddesignateoneormorerepresentativeswhowillcommittoattendingthesecoalitionmeetingsonaregularbasis.




EducatingKey

Stakeholders


GettingOutThere


Page27

Choosingcoalitionpartnersisanimportantpartofastrategicplan.Amethodofformingacoalitionistoidentifyothergroupsthathavesomeorallofthesameinterests.Aslongasthereissomecommonobjectivesharedbyallthegroups,thepotentialexiststoformacoalition.

• Oneapproachistojointlydevelopandagreeuponamissionstatementandsetofguidingprinciplesforthecoalition.Allpotentialmembersmustagreetotheseprinciples,eveniftherearedifferingopinionsonspecificissues.

NONTRADITIONALS PARTNERS TO CONSIDER

• Leadersoftargetpopulation• Healthcarepractitioners,lawenforcementofficials,andother

professionals• Community‐basedandfaith‐basedorganizations• Business• Laborunions

CHECKLIST FOR CHAPTERS FORMING PARTNERSHIPS

Ensure participation reflects Chapter priorities and policy program Ensure partnership reflects health equity needs/concerns Know what the Chapter’s role in the partnership will be: lead, partner in

message and strategy decisions, information dissemination Consider the resource allocation: Is every partnership equal in the amount of

time, staffing, and materials development? Have designated persons represent the Chapter at partnership meetings and

events so there is a visible, recognizable Chapter presence and voice


Page28

GettingOutThere

MEDIA

Whencallingtoattentionahealthequitypromotionactivityorinitiative,Chaptersneedtoknowhowtoworkwiththeirlocalmediatohavetheiropinionstransmittedwidely.Beingeffectiveatthislevelinvolvesstrategyandaclearideaofwhatmessageyouwanttorelay.Membersofthemediaoftenhavelittletimetolearnasubject—SOPHEChaptersmustserveaswell‐preparedexpertsontheissuesyouknowbest.

TIPS ON COMMUNICATING WITH THE MEDIA

Thefirststepinworkingwiththemediaisrecognizingthoseorganizations,communities,andindividualswhodonotknowaboutSOPHEortheexistenceofhealthdisparities,andaren’tawareofthebenefitsofpromotinghealthequity.Whenpeopledon’tknowaboutSOPHE,yourChapter’seffortsaremadeevenmoredifficult.Thebestwaytobuildawarenessof–andsupportfor–yourChapterandissuesofhealthdisparitiesisthroughthemedia.

Whencommunicatingwiththemedia,makesureyou:

KnowwhatyouwanttosayYouwon’tgetyourmessageacrossifit’snotclearinyourownmind.Writedownthetwoorthreemostimportantpointsyouwanttomake.Keepthemshortandtothepoint.

SayitwellReportersdon’tlikeboringquotes.Useabriefbutpowerfulmetaphororanecdote.Backyourmessagewithdatafromcrediblesources.

Sayitclearly




EducatingKey

Stakeholders


GettingOutThere


Page29

Jargonisabarriertocommunicatingwithreporters–andthepublic.Don’tuseshorthandtermsoracronyms.Describeissuesineverydaylanguage.

SayitagainWhenyoufindaclearandeffectivewaytomakeyourpoint,stickwithit.Avoidgettinginextendeddiscussionsaboutotherdetailsofearlychildhoodeducation.Tomakesureareportergetsyourmainmessage,stayonthatmessage.

BecomearesourceRespectdeadlinesandprovidegoodinformation(andifyoucan’t,suggestotherswhocan.)Reporterswilllearntheycanrelyonyouinthefuture.

ReachoutReachouttoreporters.Buildrelationships.It’simportanttorespondwhenreporterscall,butyoualsoneedtocontactthemproactively,suggestingissuesandideastheyshouldconsiderforfuturereports.

WAYS TO REACH OUT WITH MEDIA

PrepareaPitchStory WriteaMediaAdvisory WriteaPressRelease WriteaBackgrounder. WriteanOpinion‐Editorial(Op‐Ed) WriteaLettertotheEditor WriteaRadioPSA UseSocialMedia

SOPHE’S MEDIA TOOLKIT

Formorein‐depthdetailsonworkingwiththemedia,visitSOPHE’sMediaGuideforSOPHEChaptershttp://www.sophe.org/Sophe/PDF/Media_Guide_for_SOPHE_Chapters.pdf

PUBLIC EVENTS

There are some days in the year that present natural opportunities for public awareness and public events such as community/state fairs, town hall meetings, chapter meetings,

SOPHE C

Page30

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Page31

ExamplesofHealthEquityPromotionActivities

InSeptember2009,theCentersforDiseaseControlandPreventionawardedSOPHEafive‐yearcooperativeagreementasoneoffivenationalorganizationstoutilizeitsnationaloutreachtoexpandandsupporttheRacialandEthnicApproachforCommunityHealth(REACH)program(Warren,2010).Inthisproject,SOPHEisworkingwithREACHCentersofExcellenceforEliminationofHealthDisparitiesandActionCommunitiesbyempoweringitsChapters,nationalpartnersandcommunitymemberstoreducediabetesandrelatedriskfactorsamongAfricanAmericanandNativeAmerican/Indianpopulations(Warren,2010).TwoSOPHEChaptersaresub‐recipientsof$250,000overfiveyearstoreducehealthdisparities.ThetwofundedSOPHEChaptersarefocusedon:1)Enhancingtheirleadershipandpartnershipcapacitytofacilitatecommunityactiontowardspolicyandenvironmentalsystemschangetoreducehealthdisparities,and2)ImprovingthelivesofAmericanIndian/AlaskaNativesandAfricanAmericanstodeveloptools,policies,andstrategiesthatwillimprovethesocialconditionsthataretherootcauseofhealthinequities,particularlyrelatedtodiabetes(Warren,2010).

GeorgiaSOPHEChapterisexpandingthecapacityforpolicy,systemandenvironmentalchangethroughcontinuedcoalitionbuildinginruralJenkinsCounty,Georgia(Warren,2012).TheNorthernCaliforniaSOPHEChapterisaddressingdiabetesinAmericanIndian/AlaskaNativepopulationsintheurbanBayAreaofCaliforniabypartneringwiththeIntertribalFriendshipHouse(Warren,2012).NationalSOPHEstaffprovidestechnicalassistancetothefundedChaptersandcommunitiesthroughmonthlyconferencecalls,sitevisits,materialsdevelopment,andwebinars(Warren,2012).

Inconclusion,SOPHEChaptershavethepotentialtobeleadersinthecommunitiesbysharingresources,programs,andtoolstoaddresshealthdisparities.Healtheducatorsoffertheexpertisetoplan,implementandevaluateeffortstoimprovehealthoutcomes.Itisimportantforcollaborativepartnershipstodevelophealthequitypromotionplanstoaddresshealthinequities.


Page32

AppendixA

KeyTerms

ADVOCACY

Anyactivitydesignedtoinfluencepolicyandlegislationaffectinghealtheducationandhealthpromotionbyprovidingaviewwithregardtoaparticularpieceofpendinglegislationatthefederal,state,orlocallevel,executivebranchpolicies,oraskingothergroupsorpersonstolobby

POLICY

Alaw,regulation,procedure,administrativeaction,incentive,orvoluntarypracticeoforganizationsinthegovernmental,corporate,ornon‐profitsectors.

EDUCATION

Anyactivitydesignedtodeliverfactualinformationwithoutexpressingavaluejudgmentandwithoutreferencetoaspecificpolicyorlegislativeaction.Examplesincludeprovidingdataaboutprogramparticipants,briefinglawmakersabouttheevidencebaseforpolicyoptions,ororganizinganonpartisandiscussionaboutasocialissue.

HEALTH EDUCATION

Asocialsciencethatdrawsfromthebiological,environmental,psychological,physical,andmedicalsciences(SpotlightingDiabetesPrevention,2012).Itaimstopromotehealthandpreventdisease,disability,andprematuredeaththroughtheory‐basedvoluntarybehaviorchangeactivities,programs,campaigns,andresearch(SpotlightingDiabetesPrevention,2012).Healtheducationisanessentialpublichealthservicethatrequiresthepracticeofthreecorefunctionsofpublichealth:assessment,policydevelopment,andqualityassurance(SpotlightDiabetesPrevention,2012).

HEALTH DISPARITY

Aparticulartypeofhealthdifferencethatiscloselylinkedwithsocial,economic,and/orenvironmentaldisadvantage.Healthdisparitiesadverselyaffectgroupsofpeoplewhohavesystematicallyexperiencedgreaterobstaclestohealthbasedontheirracialand/or


Page33

ethnicgroup;religion;socioeconomicstatus;gender;age;mentalhealth;cognitive,sensor,orphysicaldisability;sexualorientationorgenderidentity;geographiclocation;orothercharacteristicshistoricallylinkedtodiscriminationorexclusion.

HEALTH EQUITY

Theattainmentofthehighestlevelofhealthforallpeople.Achievinghealthequityrequiresvaluingeveryoneequallywithfocusedandongoingsocietaleffortstoaddressavoidableinequalities,historicalandcontemporaryinjustices,andtheeliminationofhealthandhealthcaredisparities.

KEY STAKEHOLDERS

Individuals,groups,orinstitutionslikelytobeaffectedbyaproposedactivityorinitiative(eithernegativelyorpositively),orthosewhocanaffecttheoutcomeofanactivityorinitiative.Keystakeholderscanalsobethoseindividualswhoultimatelyholdthedecisionstoaffectpolicy.

SOCIAL DETERMINANTS OF HEALTH

Examplesincludegender,socioeconomicstatus,employmentstatus,educationalattainment,foodsecuritystatus,availabilityofhousingandtransportation,racism,andhealthsystemaccessandquality


Page34

AppendixB

RESOURCES

Writteninformationthatisconcise,briefandtakesuponlyoneissueatatimecanbehelpfulinaChapter’shealthequitypromotionactivitiesandinitiatives.Givinginformationshouldnotbetheactivityorinitiativeinitself—itisthetoolforpromotinghealthequity.HerearesomedataresourcesthatChapterscanrefertowheneducatingkeystakeholderstopromotehealthequity.

Issue Briefs

NationalSOPHEhaspublishednumerouspositionstatementsandissuebriefsthatChaptersandotherorganizationscanutilize.

HealthDisparitieshttp://www.sophe.org/healthdisparities.cfm

HealthEquityhttp://www.sophe.org/healthequityproject.cfm

State Fact Sheets

KaiserFamilyFoundationStateFactSheetshttp://kff.org/statedata/

National and State Data Sources

NHANEShttp://www.cdc.gov/nchs/nhanes.htm

BehavioralRiskFactorSurveillanceSystemhttp://www.cdc.gov/brfss/

YouthRiskBehaviorSurveillanceSurveyhttp://www.cdc.gov/HealthyYouth/yrbs/index.htm

CensusBureauhttp://www.census.gov/

CentersforDiseaseControlandPreventionwww.cdc.gov


Page35

AppendixC

References

1. CDC,OfficeforState,Tribal,Local,andTerritorialSupport.(2011).atCDC.Availablefrom:http://www.cdc.gov/stltpublichealth/policy/index.html

2. CentersforDiseaseControlandPrevention.(2012,August22).HealthyPlaces,HealthImpactAssessment.RetrievedMay6,2013,from:http://www.cdc.gov/healthyplaces/hia.htm

3. CentersforDiseaseControlandPrevention.(DATE).Diabetes:FastStats.http://www.cdc.gov/faststats/diabetes.htmAccessedonFebruary2,2011.

4. CentersforDiseaseControlandPrevention.(DATE).Number(inMillions)ofCivilian/NoninstitutionalizedPersonswithDiagnosedDiabetes,UnitedStates,1990‐2007.DiabetesDataandTrend.http://www.cdc.gov/diabetes/statiistics/prev/national/figpersons.htmAccessedFebruary2,2011.

5. Mathis,J.(2012,October).ChronicDiseasePolicySOPHEResourceTool.RetrievedMay6,2013,http://sophe.org/cdp/resources.cfm

6. SOPHEBoardofTrustees.(2010,February).SOPHEOurMission.RetrievedMay6,2013,http://www.sophe.org/mission.cfm

7. SOPHEBoardofTrustees.(2010,February).SOPHEChapters.RetrievedMay6,2013,http://sophe.sophe.org/chapters_sophe_list.asp

8. SpotlightingDiabetesPrevention:EmpoweringCommunitiestoTakeControl.(2012,October).RetrievedMay6,2013,from:http://sophe.org/Sophe/PDF/Diabetes_toolkitrevised.pdf

9. U.S.DepartmentofHealthandHumanServices,OfficeofMinorityHealth.(DATE).NationalStakeholderStrategyforAchievingHealthEquity,2011.OfficeofPublicHealthandScience/OfficeoftheSecretary.

10. Warren,N.(2010,March).SOPHEHealthEquityProject.RetrievedMay6,2013,http://www.sophe.org/healthequityproject.cfm

11. Warren,N.(2012).SOPHEHealthEquityProjectTrackingProgress:EvaluationPlan.PapersubmittedtotheCentersforDiseaseControlandPrevention,Atlanta,GA.

SOPHE C

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