Improving population health requires targeted policy, system and environmental (PSE) change interventions. As respected members of their communities, healthcare providers are uniquely positioned to advance PSE interventions by leveraging their clinical experiences and patient stories to provide context and scope to the public health issue. During this workshop we will: --Discuss the impact of social determinants of health on chronic disease and student health outcomes. --Provide an overview of evidenced-based PSE interventions aimed at increasing access to healthy food and beverages and/or physical activity within the school setting. --Highlight case studies of practicing healthcare providers who have been able to successfully advance PSE change within the school setting, particularly as it relates to obesity prevention efforts. --Practice effective communication strategies to hone one’s voice and message as a means to successfully engage elected officials and key decision makers on important health policy issues. Material for this training will be adapted from the successful Champion Provider Fellowship program- a program aimed at increasing healthcare providers’ capacity to engage in community change efforts within a broad range of settings. The primary audience for this workshop is practicing healthcare providers, however, all individuals with an interest in learning more about these topics are welcome to attend. All workshop attendees will receive a copy of the Champion Provider Fellowship’s PSE Playbook: Implementing Policy, System and Environmental Change in Our Communities. Get the handouts: http://faturl.com/~wftWl6

1. Wagahta Semere, MD, MHS
Assistant Professor, UCSF School of
Medicine

2. BROWN•MILLER COMMUNICATIONS
Championing Change: Tools and Strategies
to Create Healthier School Environments

3. BROWN•MILLER COMMUNICATIONS
Organizational
Disclosure Statement
I have no relationships to disclose

4. BROWN•MILLER COMMUNICATIONS
Objectives
• Discuss the impact of social determinants of health on chronic
disease and student health outcomes.
• Provide an overview of evidenced-based PSE interventions aimed at
increasing access to healthy food and beverages and/or physical
activity within the school setting.
• Highlight case studies of practicing healthcare providers who have
been able to successfully advance PSE change within the school
setting, particularly as it relates to obesity prevention efforts.
• Practice effective communication strategies to hone one’s voice and
message as a means to successfully engage elected officials and key
decision makers on important health policy issues.

5. Who’s in the room?

6. Organizational
Obesity: An Epidemic

7. Organizational
Complex, Multi-Factorial Issue

8. BROWN•MILLER COMMUNICATIONS
CHAMPION PROVIDER
FELLOWSHIP MODEL

9. BROWN•MILLER COMMUNICATIONS
A Call to Action
Organizational
“… advocating for institutional, community, and
state-level strategies that can improve physical
activity and nutrition resources for their patients and
their communities.”
Accelerating Progress in Obesity Prevention:
Solving the Weight of the Nation (IOM, 2012)

11. BROWN•MILLER COMMUNICATIONS
Fellowship Model
HEALTH
CARE
PROVIDERS
LHD
NEOPB,
UCSF,
BMC

13. • Two-year fellowship
• Facilitated linkages
with local health
departments
• Policy, systems and
environmental
change related to
obesity and chronic
disease prevention
Spring Mini College 2018 (San Diego, CA)

14. Social Ecological Model
Where we
are
Where we
want to be

15. Old Model • Patient Care
• Medical Knowledge
• Interpersonal and
Communication Skills
• Professionalism
• Practice-Based
Learning and
Improvement
• Systems-Based
Practice

16. New Model = Old Model Plus

17. New Roles, New (ish) Skills
• Working in partnerships
• Public writing, speaking
• Legislative advocacy
• Leading broad based groups
• Creating a policy strategic plan
• Persuasion across interest groups
• Resilience to setbacks, delays, attacks

18. BROWN•MILLER COMMUNICATIONS
RESOURCES

19. PSE Playbook Version 2.0

20. PSE Playbook Version 2.0
• School Wellness
Case Studies

21. BROWN•MILLER COMMUNICATIONS
RECRUITMENT: COHORT #3

22. Cohort #3
• Applications open December 2018
– Online application
– Letter of support from employer
– 20-minute call with local health department
• Two-day mandatory onboarding May 2019
championprovider.ucsf.edu

23. BROWN•MILLER COMMUNICATIONS
RECAP & EVALUATION

24. BROWN•MILLER COMMUNICATIONS
THANK YOU!

25. Imperial County Champion Provider
Fellowship Program-School Wellness
Dr. Luz Elva Tristan M.D.
Jorge Torres, MBA

27. BROWN•MILLER COMMUNICATIONS
Introduction
• Practicing pediatrician. Solo Practitioner.
Affiliate of El Centro Regional Medical Center
and Pioneers Memorial Brawley Hospital
• Director of Wellness 4 Kids
• Imperial County Champion Provider Fellow
through the Local SNAP-Ed Program

31. Background
• 86.1% of the school age children receive free
or reduced price meals
• 31.3% of children are living in low income
working families
• 65.9% are English learners
• 44% childhood obesity rate
• School wellness policies in Imperial County
can be improved

32. BROWN•MILLER COMMUNICATIONS
PSE GOAL

33. BROWN•MILLER COMMUNICATIONS
PSE GOAL
POLICY
Assist in the
formation of the
Calexico Unified
School District
Wellness Committee
Update the CUSD
School Wellness Policy
to include more
healthy eating and
active living practices

34. BROWN•MILLER COMMUNICATIONS
PRIMARY FOCUS

35. BROWN•MILLER COMMUNICATIONS
PRIMARY FOCUS
• Enhance healthy fundraising
• Remove unhealthy celebrations
• Implement Smarter Lunchrooms Movement
(SLM) strategies
• Close campus for lunch (CALEXICO HIGH
SCHOOL)
• Increase water fountains/stations

36. BROWN•MILLER COMMUNICATIONS
Current Interventions
• Advocate for policy change at the Calexico Unified
School District (CUSD) Board Meeting.
• Assisted in forming the CUSD School Wellness
Committee.
• Participate in the CUSD School Wellness Committee
meeting by providing feedback and recommendations
on nutrition and physical activity.
• Conducting and analyzing Smarter Lunchrooms
Movement Assessments.

37. Partners…and possible
partners

38. BROWN•MILLER COMMUNICATIONS
Partners
• Imperial County Public Health Department
• Calexico Unified School District (CUSD)
• UC Cooperative Extension- CalFresh Program

39. Possible partnerships
• After school programs
• Parent Teacher Boards
• Family Resource Center
• City of Calexico
• Calexico Parks and Recreations

40. Timeline
• Recruited Champion Provider in May 2017
• Meetings on a monthly basis or more often
• Many ideas discussed narrowed down to
school wellness and school meals
• Strategizing how to work with CUSD
• August 2017 School Board meeting
intervention, invited to be part of a school
wellness committee soon to be formed

41. BROWN•MILLER COMMUNICATIONS
Timeline
• October 2017 first School Wellness Committee meeting
• NEOP reviewed WellSAT score given with Wellness
Committee
• January 2018, CUSD started making revisions to the
school wellness policy (work in progress)
• Local SNAP-Ed Program is working with the food
director to conduct SLM assessments
• Changes are starting to happen

42. BROWN•MILLER COMMUNICATIONS
Challenges and Successes
Challenges
• Lack of a school wellness
committee for CUSD
• Time/coordinating meeting
time
• Limited funding to make
changes
Successes
• Creation of a school
wellness committee at
CUSD
• Changes to the cafeteria
layout and more food
options
• Started making changes to
the CUSD School Wellness
Policy

52. NEXT STEPS
• Visit school cafeterias and observe changes
• Teacher – Parent Board approach
• Board meeting presentation to show progress
of wellness committee and areas of
improvement

53. Lessons Learned
1. Partnerships and networking can help
mobilize change
2. The power of the white coat influences
decision makers to take action
3. Education plays a big role in sustaining and
implementing policy, systems and
environmental changes

54. BROWN•MILLER COMMUNICATIONS
ACKNOWLEDGEMENTS
• Imperial County Public Health Department
• Champion Provider Fellowship Program

55. BROWN•MILLER COMMUNICATIONS
“When schools have effective policies and
practices that support the health of their
students and staff; absenteeism decreases,
concentration improves and behavioral
problems are reduced.”
National School Boards Association

56. Questions?

57. championprovider.ucsf.edu
Luz Elva Tristan, M.D.
Jorge Torres, MBA

58. Communications Training For School-
Based Health Centers
May 17, 2018
Presented by Michael Miller and Paula Hamilton

59. BROWN•MILLER COMMUNICATIONS
THE IMPORTANCE OF
IDENTIFYING AUDIENCES AND
MESSAGING

60. Communicating in a Confusing World
We are bombarded by messages
Most information is ignored
Vital to cut through the clutter

61. BROWN•MILLER COMMUNICATIONS
Elements of Communications
 Know your audience
 Know your issue
 Know what you want to
achieve
 Message appropriately

62. BROWN•MILLER COMMUNICATIONS
ID and Segment Your Audience
Success is reliant on knowing your audience...
 What matters to them?
 What are the benefits
and risks?
 Who influences their
thoughts and behavior?

63. BROWN•MILLER COMMUNICATIONS
WHAT Do They Need to Know?
 Key piece of information
 Avoid overreaching
 Specific and focused
 Less is truly more

64. BROWN•MILLER COMMUNICATIONS
WHY Should They Care?
 The “WHY” filter
 How issue impacts them
 Benefits
 Opportunities
 Risks
 Use personal/professional
experiences

65. ACTION
 Be measured
 Don’t overreach
 Suggest a first step:
–Actionable
immediately
–No approval needed
 Build on initial step

66. BROWN•MILLER COMMUNICATIONS
Messaging Considerations
WHAT: What key piece of information does
your audience need to know?
WHY: Why should they care? Emotional,
Fiscal, Personal price?
ACTION: What should they do with the
information? What ONE action do
you want them to take?

67. BROWN•MILLER COMMUNICATIONS
Be Prepared With a Story
• Supports message
• Humanizes issue
• Brings data to life
• Memorable
• Repeatable
• Inspires change

69. BROWN•MILLER COMMUNICATIONS
A Sample Message
WHAT: The ABC Student Health Center has seen enormous growth, with
student participation doubling in the last year alone. Because of the
increased demand for services we’ve outgrown our present space. The
good news is that the soon-to-be abandoned shop building would be
an ideal space to expand our center, requiring only limited
modifications.
WHY: The Student Health Center serves as a well-being hub for the entire
campus, helping children stay healthy, stay in class and learn more. If
we want our students to continue to achieve, we need to pay attention
to their physical and emotional needs as much as their academics
because they all go hand-in-hand.
ACTION: An ad-hoc committee has researched what it would take to
transform the old shop building into a health center. We’d like to meet
with you to discuss our findings.
Audience: School Principal

70. BROWN•MILLER COMMUNICATIONS
Message Practice & Feedback

71. BROWN•MILLER COMMUNICATIONS
Evaluation Slide
• Message
• Credibility
• Control
• Relationship

72. BROWN•MILLER COMMUNICATIONS
For More Information
Contact:
– Michael Miller, President
Brown·Miller Communications, Inc.
mike@brownmillerpr.com
(925) 370-9777
– Paula Hamilton, Director
Brown·Miller Communications, Inc.
paula@brownmillerpr.com
(925) 370-9777

73. Building Healthier Schools:
PSE & Advocacy 101
Alexis Etow, JD
Senior Staff Attorney
California School-Based Health
Conference, Sacramento, CA
May 17, 2018

74. Our mission:
Healthy communities for all
through better laws & policies

75. The information provided in this discussion is for informational
purposes only, and does not constitute legal advice. ChangeLab
Solutions does not enter into attorney-client relationships.
ChangeLab Solutions is a non-partisan, nonprofit organization that
educates and informs the public through objective, non-partisan
analysis, study, and/or research. The primary purpose of this
discussion is to address legal and/or policy options to improve
public health. There is no intent to reflect a view on specific
legislation.
© 2018 ChangeLab Solutions
Disclaimer

76. 1. What Is PSE?
2. What Role Can Providers Play?
3. Tips for Putting Ideas Into Action
4. Q&A
Agenda

77. Warm-Up:
Who’s in the room?
I C E B R E A K E R

78. What Is PSE?

79. Policy
Change
PSE 101
System
Change
Environmental
Change

80. Let’s say you wanted to remove unhealthy foods and beverages
from the vending machine in the teachers’ lounge…

81. Environmental change:
Escorting the unhealthy items to
the recycling bin

82. System change:
Asking the distributor to only stock
healthy snacks and beverages

83. Policy change:
Re-writing your vending machine contract
OR school wellness policy to require only
healthy snacks and beverages

84. Policy
change
Creation or alteration of a formal written
statement of a government, business, or
nonprofit that results in a new organizational
position, decision, action, rule, or regulation.
System
change
Informal and ongoing change in organizational
practices and procedures that results in a new,
voluntary way of doing business.
Environmental
change
Directly alters the physical, economic, social, or
messaging environment, resulting in a new level
of access or opportunity for the target
population.
Definitions

85. Opportunities
for PSE
change in
schools . . .

86. T e s t Y o u r
K n o w l e d g e
PSE Quiz Game:
Kahoot.it

87. What role can
providers play?

89. Example:
Sacramento
Local School
Wellness Policy
Sacramento City Unified School
District (SCUSD) strengthened its
school wellness policy.

91. Putting ideas into
practice …

92. 1Define the problem
and your goals
What is the health problem
you hope to address
through your PSE
intervention? What do you
want to achieve?

93. 2Understand the PSE
Landscape
What existing policies or
environmental conditions
support or present barriers
to PSE change?

94. 3Outline a clear
strategy for change
What strategy should be
implemented to change
the policy, system, or
environmental conditions?
What resources are
needed?

95. 4Mobilize Partners
What partnerships support
the PSE intervention? How
should key stakeholders be
engaged?

96. 5Educate the public
and key decision
makers
How can key stakeholders
and the public be
educated about the issue
at hand?

97. 6Determine whether
success has been
achieved
How will you know when
you’ve achieved your
objective? What are your
metrics for success?

98. 7Take stock and
level up
What is the next step to
broaden the initiative, gain
support, and build on
momentum gained?
Creative Commons Flickr: Michigan Municipal League

99. A C T I V I T Y
Strategizing Action

100. A C T I V I T Y
Answer the following
questions in your handout:
1. What problem are you trying
to solve?
2. What are your goals?
3. What is a PSE intervention
that will address the
problem?
4. Which key element(s) will be
particularly important to
accomplish your goals?

101. Resources

102. Resources
www.changelabsolutions.org

103. Questions?

104. Thank
You!
Alexis Etow, JD
aetow@changelabsolutions.org
Follow us on Twitter!
@ChangeLabWorks