Social Movement Action Framework

Social Movement Action Framework, Making change happen Public visibility

Building Public Visibility and Promoting Best Practices at Sandy Lake First Nation Authority

A case study on public visibility from one of RNAO's Indigenous-focused BPSOs, Sandy Lake First Nation Authority 

Sandy Lake Health Authority is a designate, Indigenous-focused Best Practice Spotlight Organization® (BPSO®) that manages health programs in Sandy Lake First Nation. Sandy Lake is a fly-in remote First Nation community in Northwestern Ontario. The community is located 600 km northwest of Thunder Bay, Ontario and 450 km northeast of Winnipeg, Manitoba (Sandy Lake First Nation, 2023).  

Image
Sandy Lake First Nation
Image
Map - Sandy Lake First Nation

                                                  Sandy Lake First Nation Logo and nursing station [Shared with permission by Sandy Lake First Nation Health Authority]

Sandy Lake Health Authority has been implementing various best practice guidelines (BPG) from the Registered Nurses’ Association of Ontario (RNAO) since the beginning of its designation in 2021. These implemented BPGs have included: Assessment and Interventions for Perinatal Depression, Person- and Family-Centred Care, and Promoting Smoking Reduction and Cessation with Indigenous Peoples of Reproductive Age and their Communities.

The change team at Sandy Lake has been building public visibility and promoting best practices within its community by:

Image
Sandy Lake First Nation events

Image
Sandy Lake First Nation Smoking Cessation event

Posters created by the Sandy Lake team to promote events and build public visibility of BPSO;  [Shared with permission by Sandy Lake First Nation Health Authority]

  • promoting BPSO and best practice initiatives such on the local community radio show, announcements on internal media page, word-of mouth, and on-going conversations with health care providers,
  • holding several events (e.g., mental health support for prenatal clients, health fairs) to support community wellness and engagement as allowed by pandemic restrictions,
  • creating eye-catching posters to promote the events,
  • using a closed Facebook page and messenger to communicate with prenatal clients, and
  • displaying BPSO logo on Facebook, posters and other materials.

As a result of their collective action, Sandy Lake First Nation Authority has been able to build public visibility, meaning and awareness of their best practice initiatives within their community and region. As an inaugural member of the Indigenous-focused BPSO program, Sandy Lake First Nation has also leveraged provincial and international networks to share their community approaches to promoting prenatal health and wellness with others.

Sandy Lake
Sandy Lake First Nation
Social Movement Action Framework, Making change happen Public visibility

Building Public Visibility and Promoting Best Practices at Sandy Lake First Nation Authority

A case study on public visibility from one of RNAO's Indigenous-focused BPSOs, Sandy Lake First Nation Authority 

Sandy Lake Health Authority is a designate, Indigenous-focused Best Practice Spotlight Organization® (BPSO®) that manages health programs in Sandy Lake First Nation. Sandy Lake is a fly-in remote First Nation community in Northwestern Ontario. The community is located 600 km northwest of Thunder Bay, Ontario and 450 km northeast of Winnipeg, Manitoba (Sandy Lake First Nation, 2023).  

Image
Sandy Lake First Nation
Image
Map - Sandy Lake First Nation

                                                  Sandy Lake First Nation Logo and nursing station [Shared with permission by Sandy Lake First Nation Health Authority]

Sandy Lake Health Authority has been implementing various best practice guidelines (BPG) from the Registered Nurses’ Association of Ontario (RNAO) since the beginning of its designation in 2021. These implemented BPGs have included: Assessment and Interventions for Perinatal Depression, Person- and Family-Centred Care, and Promoting Smoking Reduction and Cessation with Indigenous Peoples of Reproductive Age and their Communities.

The change team at Sandy Lake has been building public visibility and promoting best practices within its community by:

Image
Sandy Lake First Nation events

Image
Sandy Lake First Nation Smoking Cessation event

Posters created by the Sandy Lake team to promote events and build public visibility of BPSO;  [Shared with permission by Sandy Lake First Nation Health Authority]

  • promoting BPSO and best practice initiatives such on the local community radio show, announcements on internal media page, word-of mouth, and on-going conversations with health care providers,
  • holding several events (e.g., mental health support for prenatal clients, health fairs) to support community wellness and engagement as allowed by pandemic restrictions,
  • creating eye-catching posters to promote the events,
  • using a closed Facebook page and messenger to communicate with prenatal clients, and
  • displaying BPSO logo on Facebook, posters and other materials.

As a result of their collective action, Sandy Lake First Nation Authority has been able to build public visibility, meaning and awareness of their best practice initiatives within their community and region. As an inaugural member of the Indigenous-focused BPSO program, Sandy Lake First Nation has also leveraged provincial and international networks to share their community approaches to promoting prenatal health and wellness with others.

Sandy Lake
Sandy Lake First Nation
Social Movement Action Framework, Examples of social movements Preconditions

Mobilizing communities for HIV prevention

Social movement strategies have been effectively applied to advance and advocate for HIV prevention. Read more in this case study. 

Social movement strategies to engage and mobilize communities have been effective at reducing HIV transmission. Community-based interventions have made significant advancements in HIV prevention, including:

  • decreasing discrimination against those who are HIV positive;
  • raising the levels of HIV testing and counseling amongst young adults;
  • improving access to program and service quality; and
  • increasing the uptake of antiretroviral treatment to prevent transmission to non-infected partners.

Engaging and mobilizing communities – including members of stakeholder groups and civil society agencies – has been critical in taking collective action towards the goal of preventing HIV transmission. To be effective, communities were found to need the following three key components:

  1. empowerment through elements, such as leadership, resources, program management and the support of external partners
  2. development of having a collective or shared identity as a community
  3. capacity in health promotion, including the development of knowledge and skills, available resources, civic engagement, values for change and a learning culture
Global
HIV_Prevention
Social Movement Action Framework, Change is valued Preconditions

Rooting the Kahnawake Schools Diabetes Prevention Project in Indigenous values

A diabetes prevention project in a First Nations community in Quebec was effectively implemented through multiple strategies including the integration of Indigenous values and beliefs. 

The Kahnawake Schools Diabetes Prevention Project (ksdpp.org) in the First Nations reserve of the Mohawks of the Kahnawake in Quebec, Canada aims to prevent type 2 diabetes in Kahnawake by empowering community members to care for their health. Project leaders were informed at the outset by evidence that demonstrated a two-fold higher risk of diabetes and diabetes-related complications in adults (Tremblay et al., 2018). 

To be meaningful for community members, the change was rooted in the values and traditions of Kanien’kehá:ka beliefs, incorporating a holistic approach of spiritual, emotional, physical and mental dimensions that reflect wellbeing. The project’s focus aligned with the value of protecting and promoting the health of future generations. By linking the change in values, families and other community members were more invested in the cause.

Kahnawake, Quebec
waves and rocks
Social Movement Action Framework, Change is valued Preconditions

Valuing the need for hospice and palliative care services

Advocacy for humane death and dying care practices led to the valuing and realization of hospice and palliative care services in South Australia. 

Advocacy for humane death and dying care practices led to the valuing and realization of hospice and palliative care services in South Australia in the 1990s (Elsey, 1998). Early hospice and palliative care advocates pressed for comprehensive community services provided by knowledgeable, humane and compassionate care providers who understood and supported the need for an alternative to medical practices in this area.

Advocates also recognized the need for funding, legislation, support of relevant volunteer organizations, and capacity-building in health professionals to ensure effective delivery of hospice and palliative care services.

Australia
Palliative Care
Social Movement Action Framework, Key characteristics Making change happen Public visibility

Using social media to increase public visibility and raise awareness

Social media is used by RNAO regularly to advocate for advancing the rights of Ontarians, including residents of long-term care homes. Read this case study that includes examples of effective social media campaigns advocating for the Nursing home Basic Care Guarantee.  

RNAO uses social media campaigns to increase public visibility and raise awareness of issues. One example: RNAO’s call on the Ontario government to mandate recommendations set out in its Nursing Home Basic Care Guarantee. The campaign incorporated the hashtags #LTC #BasicCareGuarantee and #4Hours4Seniors to raise awareness of the staffing crisis in long-term care (LTC) and to encourage the public, health professionals, the government, LTC residents and their families to mobilize change.

As the campaign evolved, so did the visuals and the messaging. The three examples below show the stages of the campaign as it gained attention and momentum – from “good” through “better” to “best.”

Good example

 Protect nursing home residents Action Alert

RNAO developed an Action Alert (AA) to mobilize collective action to advocate for nursing home residents. The link to the AA, the graphic, the messaging and the hashtag #4Hours4Seniors were all shared on social media to urge others to sign and share the AA. People were also encouraged to use the hashtag to contribute to the dialogue about the LTC crisis.

The social media campaign aimed to support the goal set out in the AA – encourage as many people as possible to add their signatures to urge action from key political leaders.

This is a good example of a social media campaign, incorporating a graphic, supportive messaging, a call-to-action (the link to the AA) and a specific hashtag.  

Better example

 Senior long-term care residents holding signs on a zoom call asking for 4 hours of care

In this example, RNAO staff members are holding signs identifying why #4Hours4Seniors matters to them. The hashtag is used consistently and individual reasons for supporting the cause are illustrated.

This is a better example of a social media campaign – it brings a personal touch to the campaign and allows supporters to share why they want to join the conversation. It also brought life to the hashtag and to the purpose of the campaign. 

Best example

 Long-term care resident in her room holding a sign asking for more care

Image

Long-term care resident in his room holding a sign asking for more care

In this example, RNAO collaborated with F.J. Davey Home in Sudbury, Ontario, Canada to encourage residents to share their “why” for wanting #4Hours4Seniors. Building on the same idea as the “better” example given above, this example truly brought a face to the reason for the campaign in the first place. RNAO shared the photos and quotes from residents on its social media feeds (Instagram, Facebook and Twitter) alongside the hashtag #4Hours4Seniors.

For example, M. Doan, a senior living at the F.J. Davey Home, shared: “I am a very independent person, but my wife on the other hand isn’t and she means the world to me. With four hours of care, it doesn’t need to be rushed. And who wouldn’t want to see her beautiful smile for four hours!" (https://twitter.com/RNAO/status/1336781022780928000).

The photos are powerful as they show a real-life married couple living in a LTC home – two of the many residents RNAO advocated for through its AA and its ongoing call for a Nursing Home Basic Care Guarantee. The posters held by the couple express their personal values of dignity and comfort.

RNAO - Ontario
Action Alerts
Social Movement Action Framework, Key characteristics Making change happen Public visibility

Using communication platforms to mobilize change for persons with diabetic foot ulcers

The collective actions of RNAO, Wound Care Canada and other supporters used public visibility strategies to advocate for diabetes-related foot ulcers care. Read more in this case study. 

In 2014, RNAO, Wound Care Canada, and other supporters organized a coalition and advocated for diabetes-related foot ulcers care from the provincial government in Ontario, Canada. The coalition used evidence, political pressure to demand an integrated system of care with universal access to improve health outcomes, including reduced ulcers and amputations and reduced costs for pressure-alleviating devices. Members of the coalition participated in many activities, including:

  • attending and participating in stakeholder meetings
  • writing a media release and lead article in RNJ
  • meeting with members of provincial parliament (MPPs) at RNAO’s annual Queen’s Park Day (Grinspun et al., 2018a)

The result of these advocacy efforts and changes in health outcomes are also described in an RNAO Evidence Booster measuring the impact of offloading devices for people living with diabetes and foot ulcers (https://rnao.ca/bpg/resources/evidence-booster-assessment-and-management-foot-ulcers-people-diabetes).

RNAO and The Canadian Association of Wound Care
RN
Social Movement Action Framework, Key characteristics Making change happen Public visibility

Increasing visibility to advance the rights of Deaf children

A community coalition in Los Angeles, California took collective action to advocate for the rights of Deaf children in accessing child abuse prevention and treatment services. he coalition took multiple steps to increase visibility, spread awareness and gain support. Read more in this case study. 

A community coalition in Los Angeles, California took collective action to advocate for the rights of Deaf children in accessing child abuse prevention and treatment services. The coalition took multiple steps to increase visibility, spread awareness and gain support. Some examples:

  • one of the member organizations wrote an article published in a magazine for the Deaf community advocating for the protection of Deaf children.
  • A presentation by coalition members was made at a local synagogue that included members of the Deaf community.
  • A local social event included a focus on the collective actions of the coalition and how attendees could financially support their efforts.

These activities drew further attention to the collective action being taken and the urgency for change (Embry and Grossman, 2006).   

United States of America
Case Study
Social Movement Action Framework, Key characteristics Making change happen Momentum

Sustaining a health system change with momentum

To create system level changes in health-care in the United Kingdom, momentum was fostered to achieve goals. Read more in this case study.  

The Health as a Social Movement project for the National Health Services (NHS) developed the Programme Theory of Change to create system-level changes in health care in the United Kingdom.

The project used this theoretical model to provide impetus for change by defining goals for the change. These goals included connecting individuals, groups and organizations acting as change agents with the health system to mobilize local action for health.

Momentum played a pivotal role in achieving system change and transformation. Indicators of momentum included:

  • an increase in social connectedness of individuals, groups and/or organizations 
  • higher levels of control, resourcefulness and resilience in the community
  • an increase in change agents’ confidence and influence over the health system

The sustained momentum arising from the individual and collective action aimed to support a preventable and sustainable health system, characterized as having:

  • improvements in local services
  • an integration of determinants of health into service provision
  • higher levels of health and well-being (Arnold et al., 2018).  
United Kingdom
Momentum
Social Movement Action Framework, Key characteristics Making change happen Momentum

Maintaining momentum to achieve excellence - Unity Health Toronto: St. Michael's Hospital

To keep the momentum as a Best Practice Spotlight Organization® (BPSO®), Unity Health Toronto: St. Michael’s Hospital engaged their Professional Practice team as change leaders. Read more in this case study. 

To keep the momentum as a Best Practice Spotlight Organization® (BPSO®) implementing, evaluating and sustaining RNAO best practice guidelines (BPGs), Unity Health Toronto: St. Michael’s Hospital, https://rnao.ca/bpg/bpso/st-michaels-hospital, an acute care facility in Toronto, Ontario, Canada engaged their Professional Practice team as change leaders. Strategies the Professional Practice team have used to maintain momentum include:

  1. profiling the activities, leadership and achievements of their champions and other change agents
  2. using newsletters, posters and pins to promote BPSO and increase its visibility
  3. participating in poster galleries and nursing rounds
  4. publishing multiple articles in scholarly and professional journals to highlight key accomplishments and deliverables
  5. creating and using an intranet site to update staff on BPSO activities (Ferris, Jeffs, Krock, & Skiffington, 2018).  ​​​​​
Unity Health Toronto - St. Michael's Hospital
Unity Health Toronto
Social Movement Action Framework, Key characteristics Making change happen Networks

Advancing knowledge uptake and sustainability through RNAO's Best Practice Champions Network®

The Best Practice Champions Network® has been engaging change agents for over two decades to facilitate connection, a sense of belonging and a place to continue the implementation of best practice guidelines. 

Launched in 2002, the RNAO Best Practice Champions Network® supports the active engagement of volunteer peer Best Practice Champions in knowledge exchange amongst one another, and between them and RNAO. Through this international network, more than 100,000 champions access tools and strategies such as workshops, webinars and online modules (Grinspun, 2018).   

Best Practice Champions Network - Global
BPSO Champions