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The Science behind Healthy Change in Communities
How far along is a particular healthy change in a community?
Where might you make a contribution?
The answers can be found in the Salud America! Policy Contribution Spectrum, a science-based way to identify and describe the stages of policy development.
The Spectrum helps pinpoint important activities that contribute to the process of policy development, from noticing there is a problem, to the passing of a policy, to monitoring a policy to make sure it does what it was created to do.
The Spectrum has four main stages and three typical steps in each stage.
Description of Stages
An individual or group believes there is a public health issue and decides to educate himself/herself or itself about the issue.
Step 1: Awareness—An individual notices something in their environment that they feel is a problem or issue. Most of the time, the problem or issue is described by simply summarizing what they know, feel or have seen in their surroundings, on TV or the Internet, or by reading about it.
Step 2: Learn—An individual starts looking for solutions to the problem described. This type of information can be determined by talking with friends, colleagues or other people about the issue, as well as searching the Internet (Google, Yahoo!, CDC website, etc.).
Step 3: Frame Issue—Once an individual understands the problem/issue, what causes it and how it can be improved, he/she can describe the issue and its impact. All information gathered can be used to “make a case” to explain why to address the issue.
An individual or group begins outlining a solution/change to the problem/issue described. People are brought together to brainstorm on a solution and capture the attention and support of communities and community leaders.
Step 1: Education—The information gathered is brought to the public, community leaders, decision-makers, and community organizations affected.
Step 2: Mobilization—A network of supporters is created. Support from community, local, city, state and federal leaders (when appropriate) can help change take place.
Step 3: Debate—Interested community members, leaders, etc. are brought together to discuss the change. Feedback is given and recommendations are made to refine the solution to make it more focused and/or encompass factors that affect the problem.
Continue building the network of supporters and prepare for change.
Step 1: Activation—Supporters are equipped with more information and usually become more involved in ensuring the proposed change is better understood by all affected.
Step 2: Reframe Policy—Interested community members, leaders, etc. are brought together to discuss the change/solution. Further recommendations are made based on better understanding of the problem, increased attention from the community and more involvement from organizations.
Step 3: Change—A policy is presented to decision-making officials. The proposed change is generally adopted, refined, or declined.
4. Post-policy & Implementation
The proposed change begins the process of implementation, ensuring proper access and sustainability.
Step 1: Implementation—The change begins to be implemented by affected parties. Documentation is developed to ensure all parties understand and implement policy as intended.
Step 2: Equity—Procedures are in place to ensure equity for those impacted by the policy change. This usually occurs through monitoring and evaluation of change impact.
Step 3: Sustainability—Sustainability plans are in place to ensure the policy is implemented as designed, and changes are made based on feedback received.
Each of the Salud America! case studies uses the Policy Contribution Spectra to illustrate the development of healthy changes in communities.
To read in-depth about the Spectra, go here.
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