Transcript Working with Community Coalitions J. Gary Wheeler, MD, MPS Little Rock, Arkansas.

Working with Community Coalitions
J. Gary Wheeler, MD, MPS
Little Rock, Arkansas
Goals and Objectives
• Goal:
– Appreciate the complex structure of
community behavioral change and the role of
community advocacy
• Objective:
– Describe how physicians can collaborate with
community coalitions to influence tobacco
prevention and control policy
How things happen
• By choice
• By fiat/force
• By incentives
• Uncontrolled events
Choice
Washing clothes
Fiat/force
Speed
Limits
Incentives
Tax Code
Social Change: Ecologic Model
MD
RN
Models of policy change
• Outside initiative model
– NGOs (policy entrepreneurs)
– Bring pressure on policy makers
• Mobilization model
– Government leaders who define terms
– Seek broad support
• Inside Access Model
– Those with easy access to policy makers
– Slip in specific laws under the radar
Advantages/Disadvantages
• Inside Access Model
– Efficient for technical issues; undemocratic,
unsustainable
• Outside Access Model
– Populist; cost and effort are huge
• Mobilization Model
– Model of government; popularity/leadership of
the governmental leader
The overlooked factor:
community
So, polls really are important
Benefits and Challenges of
Coalitions
• Benefits
– Strength in numbers
– … relationships
– ….diversity
– ….resources
• Challenges
– Autonomy
– Different Goals
– Efficiency
Steps to Coalition Success
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1.Clarify/reaffirm vision & mission
2.Create ownership of coalition
3.Solidify coalition infrastructure & processes
4.Recruit & retain active, diverse membership
5.Develop transformational leaders
6.Market your coalition
7.Focus on action & advocacy
8.Evaluate your coalition
Why do coalitions need
physicians?
• Most people trust their health care professionals
• Established, credible members of communities
with significant influence
• We represent strong political allies (AMA, AAP,
etc)
• We are the final word on the health science of a
public debate
• We have personal contact with patients and can
tell their stories
Why physicians?
• We are often the only advocates for
patients
• We may have more freedom to speak
compared to others
Effective interactions
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Attendance
Contribute (resources)
Help connect
Schmooze
Accept role as an equal partner
Eye on the prize
Engage other physicians
• Professionals
• Create a “deeper story” by consolidating data
from the clinical/patient perspective and
community perspective
• Have a defined role for their participation. Have
a realistic “ask” of them that builds off of their
skills and talents.
• Be respectful of time constraints. Health care
professionals are often juggling clinical care,
academic work, after-hours call, administrative
responsibilities, and family time.
Most important lessons
• Remember to say thanks