Simplify your messaging with the "Kindergartener test"

Have you ever struggled to explain what you do or what public health is?

One of my colleagues has a "grandma test" for anything he communicates to a general audience - if his grandma will understand, then he can share the message. Today, I want to share another twist on that, the "Kindergartener test". Will a Kindergartener understand and stay interested and engaged in what you're saying? This requires a simple, relatable, creative, and - where possible - interactive messaging approach.

Let me share an example.

A couple weeks ago, I participated in my daughter's elementary school career fair.
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Public health is pretty abstract (preventing something before it happens means there's nothing to show!) and I needed to explain it to Kindergarteners-3rd graders. Yikes.
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I was momentarily stumped and walking around the house looking for a good prop to illustrate the upstream/downstream story when I came across my daughter's marble maze.
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It was fun and colorful enough to draw in the kids AND - with the addition of a small round paint sponge I found - had all the elements I needed to illustrate the story.

I had the kids drop a marble in at the top and tell them to pretend it's a person going along for a walk when all of a sudden, they fall into a river. Without anything to protect them, they'd fall all the way down the river and (as the marble drops down the last ramp and off the maze) might get hurt or even drown.
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BUT if there was something to protect them (enter round sponge), where might they put it to protect the person?
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Some kids suggested putting the sponge on the first ramp to prevent the person from going downstream, or at the entrance to the maze to prevent the person from falling in at all. These are the ideas I originally had as well - and when kids said this, we got to do it, see how the marble stopped at the sponge, and talk about how "that protects the person BEFORE they get hurt or sick, which is exactly what we do in public health!".
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But the best part were the other ideas kids came up with that hadn't occurred to me at all.

• Some kids suggested putting the sponge on the floor below where the last ramp ended to cushion the person's fall. So I said, "That's such an interesting idea, and you're absolutely right, that would cushion the person's fall, but they might not land right on it or they might get hurt anyway. But where else could we put the sponge if we didn't want them to fall at all?" This would prompt them to suggest putting the sponge somewhere further upstream.

• Others suggested putting an extra marble on the opposite side of the green entrance to the maze, which meant even if the marble person in question began the maze, they would never get tilted down into the blue "stream", because the extra marble acted as a counterweight - a true systems solution!

• A few kids got so excited about the marble maze, they dropped several marbles in at once - the sponge stopped all of them, and I explained how that's how public health solutions work too, once you put them in place, they protect MANY people at once.

None of these ideas had occurred to me beforehand and they all allowed me to have a meaningful conversation with these smart and thoughtful young kids about public health. I loved every minute of it.

The thing is, simple, relatable, creative, and interactive messaging isn't just helpful for Kindergarteners and grandmothers, it's helpful for everyone.

When you're trying to get an entire community on board with pursuing prevention and public health, you're communicating to a wide range of people with a wide range of existing experiences and understanding - this kind of messaging can help you reach more of them.

Also important to consider is that policy changes that support public health are rarely possible without widespread community support - and community support for public health requires an understanding of what public health is and why it works. This was the motiviation behind my talk on the topic a couple years ago, and I hope we see a true understanding of public health spread more widely in the years to come.

Have you had success with simple, relatable, creative, interactive messaging in your work to transform health in communities? Or is there a message you're struggling to communicate in this way? Tell me all about it!

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Too many partners, too little time, one nifty tool

Public health problems live at the intersection of many different sectors and issues.

You can’t help kids in schools do and feel better without also making sure their teachers are well, that school policies don’t kick them out of class, that their communities are safe, and so on.

So any community health improvement effort worth its salt is going to involve multiple components led by multiple partners.

But it can be really hard for those involved in a joint effort to truly understand the work of other partners. Heck, as anyone who has worked at a large corporation or agency can attest to, it's really hard to understand the work of different departments and teams within the same organization, let alone partner organizations!

Yes, we have logic models and summary descriptions and annual reports, but we often don't have the time to read those things and even when we do, they often fail to give us a true understanding of how the work looks, sounds, and feels on the ground where it's happening.
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We were grappling with just this problem as part of a multi-partner effort to help kids in DC schools thrive. We were bringing various partners together for an in-person convening and many of them had expressed a desire to know more about the activities others were leading. How could we create the space for this without taking up the entire day and while keeping things engaging and interesting?
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One of my colleagues on the project suggested using the Ignite Talks format - “20 slides, 15 seconds a slide, 5 minutes on stage, just you and the audience”. The emphasis in this format is on highly visual slides with interesting imagery. It’s similar to the PechaKucha format, which originated in Japan, and involves 20 slides, each for 20 seconds.

We were a little worried about asking our partners to put together a new presentation just for this convening, but decided it was worth the risk.

And it definitely was! We used these talks to open our convening and it was lively, engaging, interesting, and everyone learned a lot about the different elements of this joint effort we were engaging in.

• By emphasizing visuals, we got to see what the work looked like in action.

• By forcing everyone into a new presentation format, we escaped the boilerplate slides and explanations we otherwise would have gotten.

• Perhaps most surprisingly, by providing a tiny bit of extra structure (“20 slides, 15 seconds each” - instead of just saying “no more than 5 minutes, please”), we actually had everyone stay within the time limit - every single person. (Who else has tried the “no more than X minutes, please” route before, only to find that no one listened to you? Turns out, a little extra structure is the answer!)

All in all, it was a wonderful experience, and one I’ll be looking for opportunities to replicate in other settings and with other groups! I think it’s a great tool for community coalitions and collaboratives to have in their pocket - if you use it, please share how it goes, and if you have questions about how we used it, please reach out.

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Hearing vs. Listening to community

You want to transform health in your community. And you recognize that can’t be done without communities in the center and in the lead.

But how do we actually DO that?

We’ve talked about meeting community where they literally, physically are and these strategies are great to hear what they have to say, but today, I want to push us a little further. Because there is a HUGE difference between hearing and truly listening.

Merriam-Webster defines hearing as “the process, function, or power of perceiving sound, specifically: the special sense by which noises and tones are received as stimuli”.

On the other hand, the definition of listening reads, “to pay attention to sound; to hear something with thoughtful attention: give consideration”.

There’s a lot of lip service being paid to community voice these days, as well as genuine efforts to elevate community voice. But either way, community voice isn’t enough if we merely hear it, but don’t listen to and act on it.

The “act on it” piece is vital - I’d take the definition of “listening” and argue for us to take it one step further than paying thoughtful attention and giving consideration to actually internalizing and acting on what community has to say.

I’ve had the pleasure of working with the Allegheny County infant health equity coalition over the last couple years, and we’ve been incredibly intentional about trying to do this. What does this look like in practice?

• The coalition is composed of moms, doulas and other birth workers, nutrition advocates, community leaders, as well as nonprofit, healthcare, and government leaders;

• We used strategies like focus groups in a box that put community members and leaders in the driver’s seat of leading discussions with community members;

• As we continue to gather community input (as we just did a couple months ago during a community kick off event for implementation of the action plan), we reflect back what we’re hearing to community in ways that are easily digestible (you can see our summary of input from the kick off here);

• We directly link the input we receive through these strategies to our action, implementation, and learning/evaluation plans and we make these connections explicit (for example, you’ll see we quoted community members directly throughout our action plan to demonstrate the connections between what we heard from community and what ended up in the action plan);

• We’ll be capturing community feedback in learning and evaluation activities that directly ask them whether they felt listened to and their input acted upon - and we’ll modify our approach to reflect what we learn.

How are you and your coalitions/organizations working to go beyond hearing from community members to actually listening to them? Drop me a line and let me know!

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How to meet community where they (literally) are

One of my favorite parts of my work with community coalitions and collaboratives is working with them to meet the community where they are.

As a recovering academic, let me tell you why communities don’t trust academics and researchers - even when academics are trying to get community input, the typical model is that they bring folks together in a new space where the researcher has all the power and then ask community members to answer a bunch of questions to serve their own research needs and then the community never hears from them again.

Harsh, right?

I’m not trying to throw academics under the bus, I used to be right there with them, and their hearts are often in the right place. But we’re generally not trained in academia to share power with community members and meet them where they are.

You know who does that well? Community coalitions and collaboratives!

Working hand in hand with these groups over the last several years, here are some of my favorite strategies we’ve employed to meet community members where they are:

• Listen where community is already gathering. I’m part of a coalition where I live in Fairfax, Virginia, and last year, we launched our very first community-wide event called Healthy Together Fairfax. We knew we wanted this to be an event by the community, for the community, so we started by…listening. Just listening. Sounds simple, but it’s a step many skip! We knew there were dozens of community groups already gathering regularly to talk about health, so we simply reached out to them, attended meetings, and listened. We took notes, drew out key themes from what we were hearing, and let those themes drive the planning process.

• Focus the conversation through Focus Groups in a Box. In the first phase of my work with the Allegheny County Infant Health Equity Coalition, our top priority was crafting a community-driven action plan. The Coalition awarded small research grants to community partners that were already gathering places for community members, so that they could lead their own focus groups. I helped develop a standard focus group guide and reporting template that was then shared with these partners, and they shared back insights gathered through the conversations they led to inform the development of the plan. This is an approach that checked a bunch of boxes: we put the power in the hands of community members (they led the groups and were compensated for their time), we met community members where they already were, we heard from dozens of additional marginalized community members that we wouldn’t have reached otherwise, and we got meaningful feedback that could be incorporated directly into the plan. So many wins.

• Widen your reach with Street Stalls. There’s a problem with the two approaches I just shared - there’s a certain type of community member that’s already part of existing groups and community organizations. There’s another type - actually many types - of community members that aren’t part of those groups. And sometimes - scratch that, most of the time - those are the folks we most need to hear from. Knocking door to door isn’t typically an option, but what we can do is gather community input on-site at community locations and events (think community centers, recreation centers, festivals, farmer’s markets). We used this approach last year to gather input to inform the Children’s Behavioral Health Blueprint led by Healthy Minds Fairfax. I designed and set up a tri-fold poster board (don’t underestimate the low-tech options!) with various categories of resources and had teens/children use green dots and caregivers/parents use pink dots to vote on the community resources they find most helpful. Another section the board had an open-ended question about what they’d most like to add/change in their community to support children’s mental health, with blank post-it-notes and markers available for passers-by to add their responses. End result: we got helpful input from a wider range of community members and not just those that would self-select into completing a survey or participating in a focus group.

These strategies are great to meet community where they literally, physically are and hear what they have to say. But there is a difference between hearing and truly listening - find that in our next post!

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