The story matters more than the words

Howdy,

Did that "howdy" make you double take? Hi, hello, hey, yoo-hoo, yo, howdy - so many possible one-word greetings. Don't they each make you feel a little bit different?

I love words. As an avid reader, a writer, and just a human in this world, I love words.

And I do think they matter. As our little greeting exercise shows, words do evoke feelings, and they communicate all kinds of things (the mood you're in, how well you know the person you're talking to, how formal the context is, and so on and so forth).

BUT I don’t think words matter as much as policy or practice. It goes back to the old saying, actions speak louder than words.

If you’ve seen the conversation around whether to use the term unhoused or homeless or persons experiencing homelessness - I always come out of it thinking: 1) ask the people themselves (Folks have. The vast majority of them continue to prefer the term homeless.) and 2) WHO CARES if you aren’t DOING something about it?

As usual, McSweeney’s sarcasm captures it better than I can - “Our City’s New Initiative Will End Homelessness by Calling It Something Else”. Changing our words doesn’t mean we’re changing our actions - in fact, changing words often distracts from the fact that we’re not changing our actions. Much of the time, changing our words is a whole lot of virtue signaling and not much else.

When it comes to community health and well-being, changing actions - changing policy and practice - is what matters. That requires changing minds. And that, in turn, requires a compelling story.

This is where public health - and movements to advance public health - have fallen very, very short.

We should be FAR more obsessed with shaping the narrative than with word choice. As I’ve said before, we need to tell more stories (it's why PoP Health hosts a "Story Space" at the annual community health event we co-organize, sharing stories with kids about our minds, emotions, and connections to others).

But it's not just our kids who need stories. Our communities do too.

How do we tell compelling stories that place the blame on the system and not the individual? How do we tell powerful stories that make the case for prevention instead of after-the-fact treatment? How do we tell stories that build community and bring more people under our tent, instead of further alienating those we need to persuade?

THIS is what we should be obsessing about.

Words can evoke emotions, but stories are what change minds.

I find the work of organizations like Frameworks Institute and Hollywood, Health, and Society to be quite compelling on this front.

In my little corner of the world, I’ve tried to shape a story around our approach to health and am currently working on shaping a story around the impact of corporate power on our health and environment and what we can do about it.

How are you shaping stories in your work and in your communities? Or, if you aren’t yet, how might you want to moving forward? Drop me a line and let me know!

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Why people forget facts but remember stories - an intro to Effective Storytelling

Is your summer off to as hot and joyful a start as mine, Reader?

Our family spent the last week at an all-family violin camp in the Blue Ridge mountains, and it was a joy on so many levels (our girls did not want to come home!).

Being surrounded by music all week had me forgetting the heat (despite the lack of AC at camp) and remembering just how powerful art is and how every piece of art tells a story.

Have you heard the quote about how people forget facts but remember stories? That's definitely true but misses a key piece of the puzzle. People remember stories because they make them FEEL.

Which brings me to another quote, this from Maya Angelou: “People will forget what you said. People will forget what you did. But people will never forget how you made them feel.”

I have always been moved by stories in all their forms - as an avid reader of novels, as a dancer, as a journalist through middle/high school and college, as a mom (and chief bedtime book reader).

I’ve written about the power of narrative and why we need to tell more stories before, so today I’m especially excited today to dive into the final phase of PoP Health’s CAPE process - Effective storytelling.

What do you mean by effective storytelling?

Coalitions and collaboratives working to transform health in their communities need to tell their stories - stories of their communities, their work, their process, their successes, their impact, and also their struggles and the barriers that prevent them from having more impact.

They need to tell their stories with and to community members; they need to recount their stories to policymakers and funders; they need to share their stories with partner organizations and agencies.

Effectively sharing what we know, do, and learn is essential to community health improvement. Elevating the voices of community and coalition members through these stories and synthesizing your experiences and learnings in ways that resonate with community members, policymakers, funders, and other key audiences are not easy tasks - but they are vital.

What are some ways to think about effective storytelling?

There are many storytelling frameworks to choose from, from the Hero’s Journey to the Freytag Pyramid to the Pixar Story Framework.

They all have helpful components and are worth exploring. What might be even more helpful as a starting point, though, are these two highly simplified models of storytelling:

Hook / Story / Close: This is pretty much just what it sounds like. You start with a powerful hook that captures your audience’s attention, tell a compelling story, and close with a call to action or an offer. Each component might be quite different based on your audience (what hooks a policymaker won’t hook a community member and what you want a funder to do is likely quite different than what you want a partner organization to do).

The Golden Circle: Simon Sinek’s idea of a Golden Circle, popularized via his 2009 TED Talk, captures how inspiring organizations and individuals think, act, and communicate: They start with explaining why (what’s the purpose, cause, or belief?), then how (how is the why brought to life?), and only then the what.

While we’ve been focusing on storytelling, it’s not just about the story! Who’s telling it, who’s hearing it, the channel through which they’re hearing it, how they respond, the broader context, misinformation - all of these things matter, and they can matter quite a lot. In a current project focused on strengthening cancer prevention communications, we’ve been using this communications framework to organize our findings, and I find it quite helpful:

Eight Essential Components of Communication:

1. Source: Who’s creating and sharing the message?

2. Message: What are they saying?

3. Channel: How is the message traveling between source and receiver?

4. Receiver: Who’s receiving the message from the source?

5. Feedback: What messages does the receiver send back to the source?

6. Environment: What’s the surrounding physical and psychological context where messages are being sent and received?

7. Context: What’s the broader setting and scene, and what supports/barriers does the receiver face in acting on the message?

8. Interference: What blocks or changes the source’s intended meaning of messages, including misinformation and disinformation?

What are some questions I should be asking myself about effective storytelling?

• How can we elevate and center the voices of community and coalition members in our stories, and who among them will our audiences most deeply connect with?

• How can we transport our audiences through story (given that narrative transportation reduces psychological barriers, serving as a powerful tool for persuasion) and tap into their self-concept/self-identity - their sense of who they are as a person (given that people engage with communications that deepen their sense of self and reject communications that counter their sense of self)?

• Where and how can we best reach our audiences?

• What supports or hinders our audience from acting on what we tell them, and how can we address these factors?

Sometimes, we’re so tired doing the work that we don’t take the time to tell our story - much less tell it well. But it’s a vital part of the process of transforming health in our communities.

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Get to ACTION to transform health in your community with PoP Health's action planning framework

I have an extra hop in my step and a desperate desire to GET. THINGS. DONE. (Currently at the top of my home list is tackling a round of Spring cleaning, beginning with our completely out-of-control basement…but I digress).

How about you?

In our work with community coalitions, getting to ACTION is often a major pain point. So let’s dive right in.

What do you mean by action planning?

Sometimes it’s easier to start with what I don’t mean, and this is one of those times.

Action planning is not information sharing. It’s not learning. It’s not defining your strategy. It’s not writing a plan or a report.

These can all be important components of action planning, but only as a means to an end. And that end is intentional, purposeful action. What are you doing and what tangible change in your community is it associated with?

We’ll get more into specific strategies for action planning in our next newsletter, but for now, let’s wrap our minds around what action planning is.

What are some ways to think about action planning?

There are a bazillion action planning frameworks and templates out there (and so many acronyms! SWOT, PDSA, SMART, the list goes on).

How I feel about them is best captured by the quote “All models are wrong, but some are useful.”

Here at PoP Health, we’ve waded through the action planning acronym soup on many an occasion, and where we’ve landed is here: our own action planning framework (hot off the presses!) - uniquely tailored to collaboratives and coalitions seeking to transform health in their communities through policy and systems change. As with any other model, there are ways in which it will be “wrong” - but we also believe (and can vouch for from experience!) that it is useful.

And while I always hesitate to throw yet another framework out into the world, this one has arisen naturally from our work over the years, and represents our best effort to synthesize many hard-learned lessons as we’ve navigated this space side-by-side with community coalitions and collaboratives.

Introducing PoP Health’s Action Planning Framework

• Grounding Phase: First and foremost, root your action planning in a deep and shared understanding of: the community and key actors; your collaborative’s unique value add and mission; and the nature of the problem(s) and root causes(s) on one end and desired outcomes and vision on the other end.

• Brainstorming Phase: Once you are grounded, brainstorm with abandon. Get the most outlandish, impractical ideas out there. Get the most exciting, transformational ideas out there. Get the most narrow, incremental ideas out there. Get the most bizarre, eyebrow-raising ideas out there. And everything in between.

• Prioritizing Phase: After you have brainstormed with abandon, niche down. You simply cannot be everything to everyone or do everything. Be ruthless in prioritizing - you must make hard choices to do some things and not do others. Make those hard choices based on all that you’ve grounded yourself in in the grounding phase, plus other key criteria your collaborative defines collectively.

• Planning Phase: Only once you have prioritized can you truly plan. This is where you define the exact what/when/how/where/who of it all. Get specific. Where you are exploring, start small - consider pilots and minimum value products. Where you are confident in what works, focus on scaling up.

• Acting + Iterating Phase: Now you are ready: Just do it. Then iterate. Don’t get stuck in the prior phases or spend too long in them. Ultimately, we won’t learn nearly enough until we take action. So just do it - but know that you will need to iterate. Be prepared with the structures/systems needed for continuous quality improvement/responsive feedback, and know the basis on which you’ll decide whether something is working or not (more on evaluation and learning to come in future newsletters!).

What questions should I be asking myself about how we action plan?

• Is your action planning grounded in your collaborative’s UNIQUE value add? What can you do that others are not doing and cannot do? What gap can you fill?

• Who are the targets and agents of change who hold the power/authority/influence to make the changes you are seeking? Are they around your collaborative table during the action planning process? If not, should they be? If not, how will you influence them?

• Have you created a safe space for action planning to occur? Have you unearthed and addressed power dynamics, political constraints, and other conditions that might impact the level of honesty and engagement collaborative members and community members bring to the action planning table?

• Is your action planning process taking into account the realities on-the-ground? When the rubber meets the road, all kinds of roadblocks arise - have you anticipated them and do you have a plan for addressing them? Are there some roadblocks that are - at least for now - insurmountable, and thus require rethinking what actions make sense to undertake?
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These are tough questions, and getting to action is no easy task. But if your collaborative can move through these phases in a thoughtful way, you can chart a path to inspiring and mobilizing concrete, meaningful action and transforming health in your community. Here’s to taking the first steps down that path - remember, just do it, then iterate. More on HOW to move through these phases in our next newsletter!

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A fish, an elephant, and an iceberg: Orienting community towards root causes and systems

When a community is trying to address a public health problem, the immediate causes are often the most apparent.

Too many youth aren't physically active. Why? They don't understand the value of physical activity or the consequences of not being active. What should we do? An education and mass communication campaign to help them understand this value and these consequences, so that they are motivated to be more active.

Not only are immediate causes often the most apparent, the solutions required to address them are often (relatively) non-controversial and don't require the upheaval of established systems.

But to truly transform health in communities, we need to move beyond the immediate. We need to 1) drill down to root causes and 2) fly up for a systems wide view.

On the first point -

WHY are too many youth not physically active? Do they have safe spaces to run and play in their neighborhood, and do their schedules allow them to do so? Are the costs of joining recreational sports leagues prohibitive? Are the apps on their phones designed to be addictive, so they have less time for everything else?

To get community members thinking about root causes, one exercise I have found quite helpful is a fishbone diagram (where you start with the problem, which is the "head" of the fish, and then brainstorm multiple causes, as well as causes of causes). This diagramming is often paired with the "5 whys" facilitation strategy (where you keep asking "why" five times to drill down to deeper root causes). The idea here is that this process can help identify countermeasures (things that prevent root causes) instead of merely solutions (things that might just put a bandaid on the problem by treating a symptom instead of a root cause).

On the second point -

HOW might systems be transformed to encourage more physical activity among youth?

First, we need to be able to take a step back and see the system as a whole. I find the elephant analogy an incredibly helpful way to remind ourselves and our communities to do this. It’s an ancient parable you may have heard before about blind/blindfolded individuals encountering an elephant for the first time. Each person feels only one part of the elephant and comes to a conclusion about what they are encountering based on that. It leads to a lot of misconceptions and no single person who has the full and accurate picture.

To take community thinking a step further, from recognizing there is a broader system to understanding how we can improve that system, I love using the iceberg model of systems thinking. It's a great way to reminder ourselves that what we can see of a problem is usually only the tip of the iceberg. "We know that an iceberg has only 10 percent of its total mass above the water while 90 percent is underwater. But that 90 percent is what the ocean currents act on, and what creates the iceberg’s behavior at its tip." Most public health issues are like this as well! I especially appreciate the way this model helps community members walk through the process of identifying trends, underlying structures, and ultimately mental models.

I've often had clients point to a fairly surface-level approach or solution and say, "This is what our community said they want to see." This may be true, and I'm 100% on board with community-driven approaches. However, we also need to ask ourselves if we've walked ourselves and our communities through the kind of tools above to make sure that the solutions we're brainstorming are oriented towards root causes and systems.

Have you had success with setting the stage to approach problems in a way that is focused on root causes or systems? Or have you tried using any of the tools mentioned above? Please share your experience with me!

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