Great comment from a good friend in North Carolina on the prior "shovel-ready" post:
Locally we rarely do market research. One survey we do perform is the Community Health Assessment, but only every 4 years. I have recently come to view the community health assessments as looking at what health status people have purchased.
Exactly. What purchasing choices are being made by individuals and by the community? That's a different question than the ones that typically get asked for a health assessment.

Could we instead ask WHY they have made that “purchase”/ lifestyle behavior, or even WHAT would make our public health option “sexier” for them to want to purchase it? For example, instead of asking “have you been diagnosed with diabetes?” could we ask “what stops you from testing your blood sugar every day?”? “How would you like to be physically active?” “What prevents you from doing that?” “What would it take to get you to eat 5 fruits and vegetable servings a day?”

Those are great questions-- and leadership is about asking the right questions.

I'm reading a book called Nudge, by Thaler and Sunstein-- it is about "choice architecture," about the way that policy-makers can "nudge" people to make appropriate choices (and still give people the freedom of options). As Shirin says, maybe that means making the healthy option "sexier," or maybe it means doing the research to find out what choices people are likely to make in certain situations and then adjusting the choice architecture to insure that most people are going to make the best choice for their health.

--Steve Orton


I've been inspired by the term "shovel-ready" in the media reports about the stimulus package. I think that's one of the things we want to foster in public health: organizations that have a set of shovel-ready plans that they would be ready to start quickly.

Maybe some of you have more money than you have ideas-- that's a difficult state of affairs but it can be solved. Innovation is a process you can learn. We've written some about it already.

I'm guessing most of you-- especially now-- don't have lots of extra money to spend. Do you have more ideas than money? Should you?

I think it would be a bad plan to quit brainstorming and quit planning at this point. Because what if someone does offer you some money? What if some stimulus money appears, and needs to be spent in a hurry? What if you wound up with some extra time on your hands, as funding for certain projects dries up?

The answer is this: you will want to have a little folder of "shovel-ready" plans. This is exactly what the business planning structure is about-- getting from the back of the envelope to a fleshed-out, researched, vetted plan with real need, a real chance, a real budget, real partners. A business plan is shovel-ready: ready to get funded and get going.

Let's talk more about developing "shovel-ready" public health ideas-- are you developing plans now? Why or why not? What would constitute shovel-readiness in your organization? Drop me an email or respond here!

--Steve Orton

From the Management Academy Director

On Tuesday, February 10, the current Management Academy for Public Health participants had an opportunity to participate in a webinar presented by Dr. Sergey Sotnikov. Dr. Sotnikov is an Economist and Senior Service Fellow in the Division of Partnerships and Strategic Alliances (DPSA), National Center for Health Marketing (NCHM) at the Centers for Disease Control and Prevention (CDC). He currently serves as Acting Team Lead for the Technical Assistance, Training and Evaluation Team. The presentation, Why Partnerships are Important for Generating Financial Review and How Their Effectiveness Can Be Measured, provided participants an opportunity to know more about the CDC's Division of Partnerships and Strategic Alliances and how partnerships can have many benefits for the field of public health. These benefits include
  • Exchanging Information
  • Better Operational and Strategic Coordination
  • Elimination of Redundancies
  • Knowledge Transfer
  • Client Referrals

Dr. Sotnikov stressed the importance of certain types of partnerships with public health departments. Tune in to find out more information about which partnerships for local health departments (Faith Based Organizations, Non-Profit Organizations, Hospitals, Community Organizations, Universities) tend to be associated with higher revenues.

The next scheduled webinar presented by Dr. Sotnikov is Friday, February 20th at 1:00PM EST. You are welcome to participate. The Call-in Number is 877-298-8255 and the Participant Code is 7249865.
For the internet access information, please contact Monecia Thomas at
or Nancy Cripps at

If you have difficulty with the internet access information, please feel free to call in and listen.

Social Marketing for Public Health

Some current Management Academy scholars were asking us about social marketing recently. It’s something we cover in the program but not so much in the book—there’s a lot of literature out there on it. Social marketing is basically using marketing strategies to change behavior. Besides just getting someone to buy something, it’s selling the behavior change, keeping in mind that the “costs” are not necessarily just monetary, and the "product" is not only the main behavior change you want to effect. The example we use in the book is that a program to supply clean needles to drug addicts has some costs that those of us who don’t do illegal drugs may not think of, like the “cost” of losing friends because they think you don’t trust them enough to use their needles. And, the "product" is not just new needles but a new way of thinking of yourself as worthy of using clean needles. And in the end, the hope is that friends will bring friends along to the new "product." Most of what our scholars do is not quite at the level of difficultly as a needle exchange program in terms of “selling” the change—we’re generally talking day care center preparedness or business-place health programs. But still, there are issues related to product, place, promotion, and price—the Four Ps—that should be considered.

One team this year has a clear social marketing angle. They are setting up a primary care clinic in their health department, and they’re working with a community group called 100 Black Men to attract early adopters and motivate others in the particular target group to care about their health in ways they may not have thought of before. Maybe as a group they think of going to the doctor as not a "manly" thing to do, but if they see the 100 Black Men group going, they'll think differently about it. As the group members begin to understand and believe in the program, they’ll bring their friends, and a peer social marketing network is formed.

In a meeting recently of Executive Education program directors from the NC Institute for Public Health we thought about our programs in similar terms, too. With the economic downturn, we must think about how to save money, maybe change the programs to fit a new budget reality, put our own preaching about fiscal efficiency into practice. But at the same time, one thing our students always say is that they love the on-site time and when they graduate they miss how “cool” it is to be part of this special group that gets to come to Chapel Hill a couple of times over the course of a year. What is lost if we replace some of the on-site time with distance learning components? The cost of those components is a fiscal reality, but there may be a cost in not doing them (or doing less of them) that we have not considered. A lot can be gained if more public health professionals can attend who would not be able to come if they had to travel, but some sense of being part of a special club might be lost. When we are considering the social marketing angle of our program, we will have to think about what, exactly, we are “selling” besides the nuts and bolts of public health management and leadership education.

Please share any thoughts you have about the "product" we call the Management Academy for Public Health. What did you value? For you, how did its "costs" compare with the "product" you received? How can we do it better?

-- Anne Menkens

Industry Analysis and Competitor/Partner Analysis

During a recent webinar, someone raised the question, “What is the difference between industry analysis and analyzing competitors for potential partnerships?” The answer might be worthwhile to share with our larger audience:

When you analyze the industry, you are asking questions about the work you want to do, where you want to do it, how to do it best, and so on. Who else does it (competitors) is part of the analysis, and interviewing them about their experience with the work is an important step, but the questions are broader than that. What types of organizations succeed at doing this, and what exactly did they do that helped them succeed? This last is called a “key success factor” – and it’s very important. One team this year is planning to operate a primary care clinic at the health department. They know it’s needed in their community, mostly by the uninsured, but they’ve learned through their industry analysis that a key success factor for such programs is to include patients who have insurance (but who may not have a primary care doctor) in the mix of clientele. To ensure that they can include this factor in their program, the team is working on the customer service angle of their organization – making the waiting area more welcoming and time-efficient, and making sure that customer service is considered as their organization builds a new facility in the coming months.

Now, making competitors into strategic partners is the next step. Use your industry analysis to figure out what you bring to the table, what you need from your partners, and how you two can most effectively work together, mutually beneficially, to get the job done in a sustainable way. So, you’ve identified you need clientele from a broad range of “ability to pay,” then think about what partners would help you get there. If you only partner with the local hospital, you’ll get all of their uninsured patients and none that can pay. Is there a health network in your area that works to coordinate care for the under-insured poor? Is there a Community Health Center that has trouble keeping providers, or needs a place to send the overflow of patients? Talk to specialists who will take referrals, and private practitioners who will refer to you or work with you to provide care.

This example may not seem exactly like “public health” work, but unfortunately public health providing primary care is a reflection of the current economic times. And ideally, public health brings prevention to the equation, making the whole community healthier over the long haul, than they would be without your participation in primary care.

More to come.