Alcohol: Regulating the 'Product' What does the evidence say?

Alcohol: Regulating the 'Product' What does the evidence say?

Alcohol Policy and Adolescent Drinking: Using Science in the Public Interest Module 3 Key Elements of an Advocacy Campaign Alcohol Policy and Adolescent Drinking How do we translate research into action? Alcohol Policy and Adolescent Drinking 2 What it takes: Research Traditional (evidence-based) Public opinion (polling, focus groups) Non-traditional

Relationship building Listening Opposition research Alcohol Policy and Adolescent Drinking 3 What it takes: Advocacy! Articulation of a socially (as well as scientifically) credible threat Ability to mobilize a diverse organizational constituency Convergence of political opportunities with larger vulnerabilities Alcohol Policy and Adolescent Drinking

4 LUCK = PREPARATION + OPPORTUNITY ADVOCACY IS ALL ABOUT PREPARATION Alcohol Policy and Adolescent Drinking Campaign steps 1. 2. 3. 4. 5. 6. 7. 8. 9.

Frame your issue and develop a policy action statement Engage enforcement Collect data Make your case Draft your policy Use media advocacy Mobilize support and provide community education Present the policy to decision makers Evaluate the campaign and its outcomes Alcohol Policy and Adolescent Drinking 6 Where do you start? Most campaigns start with a core group of committed advocates Building a broad-based coalition is often the

next step Along the way, advocates must decide: Vehicles formal or informal coalition? Grassroots or grasstops? National or local? Decision-making process Communications Alcohol Policy and Adolescent Drinking 7 Possible coalition members?

BRAINSTORM Regional, national, state and local public health departments Community substance abuse prevention coalitions Faith-based community Educational community Parent groups Small Business Organizations Employers Trade unions Law Enforcement Civil Society Organizations Medical community

Childrens advocacy groups Alcohol Policy and Adolescent Drinking 8 Key coalition tasks Analyzing and reporting public health data on excessive alcohol consumption and related harms; Providing maps that highlight alcohol-related problems associated with excessive drinking; Assisting community coalitions in developing media campaigns to support the policy; Determining how to best gain access to decision makers and briefing them prior to hearings on the policy; Responding to requests for written information on proposed policy; Responding to questions from decision makers during testimony in parliamentary enquiries or public hearings on general impacts of proposed policy; When permitted, providing testimony on the health and social impacts of the proposed policy during enquiries or hearings; and

Evaluating the impact of the policy, including identifying and tracking outcome measures. Alcohol Policy and Adolescent Drinking 9 Step 1: Frame your issue and develop a policy statement The difference between a problem and an issue Issues are: actionable,

specific, immediate, winnable, and worthwhile. Alcohol Policy and Adolescent Drinking 10 Framing the issue Framing = how different policy issues are described determines the policy solutions that are selected to deal with the problem essential to being able to build support Example: the problem is young people are irresponsible Example: the problem is alcohol marketing encourages youth risk-taking

Alcohol Policy and Adolescent Drinking 11 Framing the issue (cont.) Frames: labels the mind uses to find what it knows (Gilliam 2003) Framing: 3 levels Level 1: overarching values and symbols Level 2: general issue being addressed (housing, schools, environment, health, etc.) Level 3: details about Level 2 policies, strategies, facts, etc. Frames trump facts. Always best to set Level 1 frames ourselves not react to oppositions frames. Alcohol Policy and Adolescent Drinking

12 Public health framings Alcohol: Too many liquor stores detract from the quality of life. It is not fair that certain families are subjected to such degraded conditions. Every family should have the opportunity to raise their children in a healthy environment. The city should make a rule to limit the number of liquor stores allowed within a certain radius. Tobacco: While we have achieved great progress in reducing smoking, there are still large populations, primarily in low income communities of color, that are regularly exposed to toxic secondhand smoke. It is not fair that some of our cities workers are protected and others are not. We should enact uniform clean indoor

ordinances to protect workers in all workplaces, including restaurants and bars. Alcohol Policy and Adolescent Drinking 13 Industry framings Whats needed is more personal responsibility, not government regulation As a precursor to taking personal initiative, education can solve the problem If the issue involves children or youth, it is the parents responsibility. Alcohol Policy and Adolescent Drinking 14

Constructing frames (re-framing) Elements of a frame: Values these guide reasoning and are paramount Metaphors simplifying models these guide understanding One a day is good for vitamins but not for alcohol ads Fish in a polluted stream Context where does this fit in peoples lives Messengers Tone Reasonable (empowering) vs. argumentative (skepticism-breeding) Visuals Solutions Solutions ahead of problem statement? Alcohol Policy and Adolescent Drinking 15

The importance of symbols What symbols or values will touch and mobilize existing and/or potential bases of support because the cultural resonances of those symbols speak to their lives? What are the shared symbols and values of for your country in 2014? Alcohol Policy and Adolescent Drinking 16 Shared values? DISCUSS AND MAKE LISTS Alcohol Policy and Adolescent Drinking Example: Shared values in the USA

Individualism Opportunity Free enterprise Freedom Competition Education Patriotism

Motherhood/family Responsibility Empowerment Leadership Fairness Equity Protection of children and underdogs Generosity Human rights Self-determination Independence Self-reliance Trust Sportsmanship Alcohol Policy and Adolescent Drinking 18

Two dominant frames Market Justice (industry) Self-determination and selfdiscipline Rugged individualism and self-interest Benefits based solely on personal effort Limited obligation to collective good Limited government intervention Voluntary and moral nature of behavior Social Justice (public health) Shared responsibility Interconnection and cooperation

Basic benefits should be assured Strong obligation to the collective good Government involvement is necessary Community well-being supersedes individual wellbeing Alcohol Policy and Adolescent Drinking 19 Alcohol policy: two frames Industry frame Public health frame Alcohol consumption is normal,

fun and healthy. Alcohol consumption is linked to more than 60 diseases and health conditions. The majority of people drink responsibly. Most of the alcohol is consumed irresponsibly (i.e. by binge and underage drinkers). So many people drink The small minority of irresponsibly occasionally that irresponsible drinkers causes all population-level solutions are the problems.

needed. Effective solutions are education, industry selfregulation, and public-private partnerships. Evidence suggests that effective solutions are those that affect availability, price and marketing of alcohol. Alcohol Policy and Adolescent Drinking 20 Step 1: Develop a Policy Action Statement Write a Policy Action Statement based on the local condition and policy solution previously identified (25 words or less):

State the problem State a policy solution What will the policy do? Who will benefit from the policy? Who are the decision makers (who can make it happen)? Alcohol Policy and Adolescent Drinking 21 Step 1: Develop a Policy Action Statement The [national][state][local] government will pass an increase in alcohol taxes to reduce underage drinking, the number one drug problem among youth, and to raise funds to support alcohol and other drug prevention and treatment, mental health services, and increased access to health care.

Alcohol Policy and Adolescent Drinking 22 Step 2: Include enforcement organizations early in the campaign Enforcing policies is central to its effectiveness Including enforcement organizations early increases the likelihood that the policies, once adopted, will actually be enforced They need to understand the benefits of the policy for them Better use of scarce resources Financial resources for enforcement Additional benefits: Collection of local data Selection of policy responses

Crafting policy language Alcohol Policy and Adolescent Drinking 23 Step 3: Collect data 1. Identify whom you want to persuade (your target) 2. Know your facts Key pieces of information that help you make the strongest case possible 3. Begin to communicate What is your ask? (embodied in your policy statement) 4. Advocate 5. Follow-up (it is all about relationships) Alcohol Policy and Adolescent Drinking

24 Making your argument What are your facts? Mortality Morbidity Costs Salient comparisons/social math Anecdotes/authentic voices PICTURES

Alcohol Policy and Adolescent Drinking 25 Social math: Example Alcohol Policy and Adolescent Drinking 26 Social math techniques Break down numbers by time 4500 children under 16 start drinking every day Break down numbers by place This is the equivalent of 160 classrooms a day of new underage drinkers Provide comparisons with familiar things

Gun dealers vs. McDonalds If Arizona's highway system were in the same condition as its health care system, every five miles that you drove along the highway, you would come to a pothole a mile long Provide ironic comparisons Childcare workers earn $10 an hour, prison guards earn $18 an hour Personalize the number 6 tons of pollutants a day from a local gasoline refinery the equivalent of 25 balloons full of toxic pollution for every school child in town Alcohol Policy and Adolescent Drinking 27 More social math examples A child born today is more likely to be diagnosed with Type II diabetes than to graduate from college. In Baltimore, more than 1 out of 3 students drink a highcalorie soda at least once a day. These extra calories

add up: just one can of soda for a year can make you gain an extra 14 pounds. Every minute in the U.S. two women are injured in a domestic violence incident. In Ward 8 in Washington, DC, there are 27 liquor stores for every library. Alcohol Policy and Adolescent Drinking 28 Alcohol Policy and Adolescent Drinking Data about the policy itself What are the policy options? Evidence of effectiveness (scientific credibility) Evidence of public support (social credibility)

Polling data Editorials News coverage Coalition members Celebrities Evidence of feasibility Other comparable jurisdictions that have done this Alcohol Policy and Adolescent Drinking 30 Step 4: Make your case

Message components Whats wrong? Why does it matter? (Level 1 statements) What should be done about it? Alcohol Policy and Adolescent Drinking 31 Five sentence exercise Construct a five sentence pitch for your issue and solution, as follows: 1 sentence on need 2 sentences on values 2 sentences on solutions Alcohol Policy and Adolescent Drinking 32

Arguing and counter-arguing There will be two sides (at least) What are the oppositions arguments? How do you respond to those arguments, and set your own frames? Attack Avoid and restate Absorb Who is symbolic of the oppositions frames vs. your frames? Alcohol Policy and Adolescent Drinking 33 Develop an Issue Brief Create an Issue Brief that: Describes the problem and its impact on the

community Identify costs to community if problem is not resolved Explain how the proposed policy addresses community concerns Identifies ways for community members to get involved Alcohol Policy and Adolescent Drinking 34 Checklist for Issue Briefs Understand that there are two competing frames of the alcohol problem Critically assess how alcohol issues are being framed in your jurisdiction Identify your key advocacy goal and the outcome that you are seeking Identify your key target audiences and potential

messengers and choose the messages likely to resonate most with each audience Ensure that your messaging links with your key advocacy goals Alcohol Policy and Adolescent Drinking 35 Step 5: Draft your policy Draft policy language Research similar policy examples from other jurisdictions Tie to local conditions Clarify legal basis Compile supporting documents (case law, etc..) Control the language Work with the legal gatekeeper (City Attorney/County Counsel/City Solicitor, etc.)

Alcohol Policy and Adolescent Drinking 36 Step 5: Draft your policy (cont.) Policy Language Alcohol Alcohol: Policy No Ordinary and Adolescent Commodity Drinking | An advocates 37 user guide 37

Step 6: Use media advocacy Media Media advocacy advocacy is is the the strategic strategic use use of of the the mass mass media media to to support support organizing

organizing campaigns campaigns to to advance advance social social Alcohol Policy and Adolescent Drinking 38 Media advocacy: The challenges Framing for access: Getting on the news Surmounting the who cares barrier Winning the framing battle (framing for content) Getting the story told the way you want it told

Moving from individual to environment Pointing towards a policy solution Alcohol Policy and Adolescent Drinking 39 Framing challenges Translate Translateindividual individualproblem problem to tosocial socialissue issue Assign Assignprimary primaryresponsibility responsibility

Present Present solution solution Make Make practical/policy practical/policyappeal appeal For news media, develop story elements For news media, develop story elements

use usecompelling compellingvisuals visualsand andsymbols symbols develop social math develop social math identify identifyauthentic

authenticvoices voices seize symbols seize symbols brainstorm brainstormmedia mediabites bites Tailor Tailor to to audience audience Alcohol Policy and Adolescent Drinking 40 Media bite examples

Im tired of Cadillac prisons and jalopy schools. It is easy to think of smoking as an adult problem. But nicotine addition begins when most smokers are in their teens, so lets call this what it is: a pediatric disease. Too many kids are born into zip codes of shame. They live in a city glutted with guns, drugs, and alcohol. They plan more for their funerals than their futures. Toys are subjected to strict safety measures, but in the gun industry, there is absolutely no regulation or standards of manufacture. Saying that unwed mothers cause poverty is like saying that hungry people cause famine or sick people cause disease. In my neighborhood, it is as easy for children to buy guns as school supplies.

The Golden Gate bridge is the worlds leading suicide landmarkputting up a suicide barrier would provide many, many people with a second chance. Employment-based health care is like an electricity grid run on individual generators, or a water system based on scattered wells whats missing is a health care infrastructure. Alcohol Policy and Adolescent Drinking 41 Alcohol policy stages of change and implications for messaging Legislators currently have no interest in alcohol control measures Message to increase recognition of alcohol as

a problem Legislators are beginning to be interested Messaging to encourage populationlevel policy interventions Legislation is being proposed Messaging to support the specific legislation Legislation is being implemented Legislation is being enforced Messaging to inform the public that there are new rules, options for intervention, or a new sheriff in town

Messaging to emphasize positive outcomes from the policy change Alcohol Policy and Adolescent Drinking 42 Preparation Be ready for the hard questions What question do you most fear you will be asked? Exercise Alcohol Policy and Adolescent Drinking 43 Step 7: Mobilize support and provide community education

1. Building a grass-roots base for the policy campaign to establish bottom up support 2. Influencing key decision makers to support the policy to establish top down support Alcohol Policy and Adolescent Drinking 44 Points of influence on decisionmakers Policy change Electoral / political context Decision maker Public health /

public interest coalitions Corporate lobbyists/ relationships Media definitions of problem and support Community voices / support / relationships Research Alcohol Policy and Adolescent Drinking

Alcohol Policy and Adolescent Drinking Who are Grassroots and Grasstops supporters? Go back to lists of possible coalition members which have top down and which have bottom up potential? Alcohol Policy and Adolescent Drinking 47 Assess the individuals who can give you what you want Who has the power to adopt your policy? Who are the most

important individuals? Who must you talk with before you approach him/her? ________________ How do you influence the them if they are elected officials? What is the selfinterest of each? Who will approach this person?

Alcohol Policy and Adolescent Drinking Step 8: Present the policy to decision-makers PREPARE! Consider the voices in the presentation, and choose them to speak to decision makers Speak from the frame in the issue brief, and anticipate and counter opposition arguments Know which decision makers support the policy, and if numbers are not sufficient for adoption, delay Know how many supporters need to be in the room and be sure to turn out at least that many and make them identifiable to decision makers Try to control who speaks in support if there is an open comment period, and to have the last word Alcohol Policy and Adolescent Drinking 49

Step 9: Evaluate the campaign and its outcomes Engage the relevant agencies in a discussion about what is needed for effective administration and enforcement Integrate implementation and enforcement steps into the policy itself Identify necessary data from health departments, law enforcement, and other organizations Set up a mechanism for ongoing communication between the relevant local and EU, national or state organizations and the coalition to promote cooperation and to establish a monitoring procedure Use coalition media contacts to publicize regularly enforcement and administrative efforts Alcohol Policy and Adolescent Drinking 50

Getting started Considerations for moving forward Next steps Alcohol Policy and Adolescent Drinking 51 Parting thoughts I've been absolutely terrified every moment of my life and I've never let it keep me from doing a single thing I wanted to do. -- Georgia OKeeffe Hope is like a road in the country; there was never a road, but when many people walk on it, the road comes into existence. -- Lin Yu Tang Alcohol Policy and Adolescent Drinking

52 Never doubt that a small group of thoughtful, committed citizens can change the world. -- Margaret Mead Alcohol Policy and Adolescent Drinking

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