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From
Product Design
to
Policy Change


   Environmental strategies in plain language

Julie Swanson   Wisconsin Clearinghouse for Prevention Resources
Meet Harriet


                         Eat
                       healthy!



Flickr: grantneufeld
Biggest barrier?
What can Harriet do?
Environmental Strategies

   • What they are
   • Why they work
Individual Strategies

Knowledge


                            Skills

Attitude
Individual Strategy




                      Flickr: kissyface
Flickr: castaway_in_wales
Remember Harriet?
Environmental Strategies


 1. Physical environment
 2. Social environment
 3. Policies and systems
Physical Environment

• Product Design
• Physical Space
Product Design

Fire-safe cigarettes




         Coalition for Fire Safe Cigarettes
Product Design


                                       Pre-cut carrots




Flickr: Cjdaniel, freddy
Product Design




Provide
feedback.




    Flickr: freegorifero
Flickr: simplerich
A fly


nudges.wordpress.com
Physical Environment


• Product design
• Physical Space
Physical Environment


• Product design
• Physical Space
Placement




www.cdcg.org
Flickr: nnecapa
Minneapolis Star Tribune, 9/2008
Flickr:neilwillsey
Retail Placement




                   Flickr: dallas123
November 2006
Washington Post, 4/2009
Physical environment

Product design: easier or safer

Physical space: change the
                  physical space
Time to help Harriet
Environmental Strategies

       1. Physical environment
       2. Social environment
       3. Policies and systems
We are influenced by others




                        Community norms
                        Social proof
Flickr: marcalandavis   Social networks
Community norms about alcohol?




                         Flickr: matt_grum
About walking?




                 flickr:titicat
About portion size?




Flickr: bourgeoisbee     Flickr: wyscan
Social proof
Flickr: room317
Social proof
Social Networks




The spread of obesity in a large social network over 32 years
             New England Journal of Medicine, July 2007
Smoking behavior spreads through social ties




New England Journal of Medicine, Vol. 358, No. 21, pp. 2249-2258 May 22, 2008
We are influenced by others




                        Community norms
                        Social proof
Flickr: marcalandavis   Social networks
Influence the social environment


 Make it visible
Show people what others are doing




                  Amazon.com
It’s Not Just Wisconsin
   24 states have comprehensive smoke-free air
                      laws




(Date law takes/took effect)            Updated 8/2008
Wisconsin Wants Smoke-Free Air




          69%
Show role models
Show opinion leaders




Source: Community Action for
Tobacco-Free Living
Use social media
My Neighborhood
My Groups
My Friends
Find Friends
SmokeFree
Wisconsin


 “We didn’t
expect these
  results!”
How can Harriet use the social environment



Norms: What everybody else is doing

Social proof: Role models & opinion leaders

Social networks: Connections
Environmental Strategies

       1. Physical environment
       2. Social environment
       3. Policies and systems
Policies and Systems
Policies and Systems

       • Available
       • Affordable
       • Attractive
       • Acceptable
Availability: Smokefree Air Laws
Availability: Minimum Age Laws
Availability




               www.afsz.org
Affordability: Increase taxes
Affordability: Incentives
Attractive
Restrict
advertising
Restrict sponsorship
Acceptable

Parents who host
Enforcement




Flickr: inkyhack
Change Policy and Systems
  Available    Where
               When

  Affordable   Cost

  Attractive   Advertising
               Sponsorship

  Acceptable   Incentives
               Penalties
               Law enforcement
Help Harriet
Competitive
Foods           Farm to School




 Flickr: trp0      Flickr: roswellsgirl
Environmental Strategies


    Make healthy behavior
     easy and popular.
Explaining Environmental Strategies
Environmental Strategies
Strategies that incorporate
 prevention efforts aimed at
 changing or influencing
 community conditions, standards,
 institutions, structures, systems
 and policies.

                             CADCA
Explaining Environmental Strategies


        •Who?
        •What ?
        •Why?
Who?
Individuals     Populations
What?




Knowledge      Physical environment
Skills         Social environment
Attitudes      Policies and systems
Why?

• More people
• Bigger impact
• Faster results
More people

Prevention classes       Increase tax




    Some kids         All kids in Wisconsin
Big Impact

Amount
people
buy




           Price

                   MDK@Klitzner-Assoc.com
Big Impact




No. of
lives




   Fisher: EnvPrevStrategies
Faster Results




Admissions for acute myocardial infarction during six-month periods from June to
November before, during and after the smoke-free ordinance. The law was
implemented on June 5, 2002. Source: BMJ 2004;328:977-80.
Faster Results




Admissions for acute myocardial infarction during six-month periods from June to
November before, during and after the smoke-free ordinance. The law was
implemented on June 5, 2002. Source: BMJ 2004;328:977-80.
Faster Results




Admissions for acute myocardial infarction during six-month periods from June to
November before, during and after the smoke-free ordinance. The law was
implemented on June 5, 2002. Source: BMJ 2004;328:977-80.
Environmental strategies work


   • More people
   • Bigger impact
   • Faster results
Environmental Strategies

                      Product design
Make it easy          Physical space


Make it popular       Community norms
                      Social proof
                      Social networks

Make it the default   Change policies and systems
Environmental Strategies




Make it easy and popular to be healthy.
We can ignore the environment




                          Flickr: strikevenom
We can work with the environment




                             Flickr: nealy-j/
We can change the environment




Flickr: in-the-rainbow
Environmental Strategies
Credits
• Flicker Photos
• WI Tobacco Prevention and Control Program
• Micheal Klitzner CDM 
Environmental Strategies

     • Challenges we face
     • Ideas for next steps
Industry opposition
Fear
Cultural values




Milwaukee Journal Sentinel March 2006
Knowledge and Skills

•   Policy advocacy and lobbying
•   Community organizing
•   Persuasive communication
•   Media advocacy
•   Civics 101
Environmental Strategies

    • Challenges we face
    • Ideas for next steps
Get out of
our silos




     Flickr: zoomzoom
Use social influence
Provide training and tools
Answer questions
Show people what to expect
Change requirements
•   Grant guidelines
•   Program boundary statements
•   Template objectives
•   Reporting requirements

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From Product Design to Policy Change: Environmental strategies in plain language