Chapter 6: Case Studies - Society for Public Health Education

Chapter 6 

Case Studies and Examples

Resource 

The Prevention Institute 

highlights examples of worthy 

op-eds: 

http://preventioninstitute.org/ 

focus-areas/reforming-ourhealth-system/projects.html 

This chapter presents a variety of case studies featuring or in collaboration with health 

educators who participated in the SOPHE State Health Policy Institutes. The case 

studies help illustrate the application of the concepts presented in prior chapters. 

We selected institute participants who have been actively implementing their policy 

education action plans so they could share lessons from their experiences. We sought 

to provide a variety of case studies in terms of policy goals, strategies, chronic disease 

prevention focus, organizational characteristics, and experiences. 

Policy Education from Dual Roles 

Kristen Grimes, MAOM, MCHES 

Senior Asthma Manager, Children’s Health Alliance of Wisconsin 

Private citizen 

• Case Study 

• Personal Story 

• Action Plan 

Innovating in Changing Times 

Michele Pfeilschifter, MPH 

Arthritis Foundation, Heartland Region 



Clients Educate Policymakers with Personal Stories 

Omar Sahak, MPH, with Courtney Pearson, MPH, and Ken Horby 

San Francisco AIDS Foundation 


• Personal Story 

Set the Standards Ohio 

Heather Vilvens, MEd, CHES 

Buckeye Healthy Schools Alliance 



Vitals 

Kristen Grimes, 

MAOM, MCHES 

• Senior Asthma Project 

Manager, Children’s 

Health Alliance of Wisconsin 

• Private citizen 

Policy Focus 

Tobacco prevention and 

control 

Overall Goal 

Inform Wisconsin policymakers 

about how implementing 

tobacco control 

policies will help to improve 

asthma management. 

Core Strategy 

Educate Wisconsin Asthma 

Coalition members on the 

importance of advocating 

for tobacco control policies 

that help to improve asthma 

management. 

PAGE 1 . CHAPTER 6 

CHAPTER 6 . PAGE 2

Recommendations 

Policy Education from Dual Roles Case Study :: continued 

Policy Education from Dual Roles Case Study :: continued 

Learn More 

• Develop a clear understanding 

of what you can 

and cannot do in your 

organizational role with 

regards to educating 

policymakers, advocating, 

and lobbying. 

• Take full advantage of 

your rights as a private 

citizen to communicate 

with government 

representatives during 

your personal time. Use 

your personal technology 

to call, send an email, or 

write a blog. 

• Persevere in your policy 

education work even if 

you’re initially uncomfortable 

with the role. 

The more frequently 

you communicate with 

policymakers, the easier 

it becomes. You also 

become more effective 

as you build trust and 

rapport. 

Adapting to the Policy Landscape 

“Hurry up and wait,” is how Kristen characterizes WAC’s recent policy efforts. As featured 

in national media, the Wisconsin political landscape has become highly partisan. 

In coordination with public health advocates, Kristen temporarily sidelined some WAC 

priorities because the current state legislature is unlikely to act on tobacco issues. The 

public health community is also waiting for courts to rule on another tobacco issue. 

To advance other aspects of WAC’s policy agenda, Kristen: 

• Briefed state Medicaid officials on health plan coverage for asthma care as part of 

WAC’s efforts to improve Medicaid coverage of comprehensive asthma care. 

• Strengthened WAC’s ties to the Wisconsin Tobacco Prevention and Control Program 

with regular contact and connections to WAC members. 

Her outreach as a private citizen—which she encourages WAC members to do—is 

building policymakers’ awareness about the threat of new tobacco products in their 

districts. This groundwork will be useful once the policy landscape improves. 

Lessons Learned 

• Coalition members may be reluctant to become active in policy education. Some 

have misconceptions about what they are allowed to do. Others have very busy 

schedules. 

»» 

Give them a range of options to participate, from a quick call to an in-person 

meeting. 

»» 

Make it as easy for them as possible. Train them. Give them handouts. 

»» 

Prioritize when and how you ask them to act. 

• Relationships are everything. Once you have an established relationship with a 

policymaker or policy partner, they are more likely to be open to your messages. 

• Many health promotion policy tools and resources already exist. Use or adapt what 

is already available. 

Kristen’s Personal Story for Educating Policymakers 

Prior to her state legislator’s town hall meeting, Kristen spent 15 minutes visiting four 

nearby convenience stores. There, she observed easily accessible candy-flavored tobacco 

and bought some to show as part of her story. 

Kristen’s story quickly captured the legislator’s attention. “My name is Kristen Grimes, 

and I’m a constituent. I’m also a mom, a Daisy troop leader, and an active member in 

this community. I’m here to talk about this [showed the products].” 

The legislator and other attendees saw what looked like candy. Kristen surprised them 

by saying, “These aren’t candy, but rather tobacco flavored to taste and smell like 

candy.” She explained how the items were not candy made to look like a cigarette or 

shaped like a cigar, but instead contained tobacco and had packaging designed to appeal 

to children. 

“Kids also think these are candy. If they go into any of the four convenience stores 

near here where I got these this morning, kids would see them on the shelves. They are 

cheap. This one [showing] was a $1.39. Wisconsin taxes these types of products less 

than cigarettes.” Kristen passed the products to the legislator and other attendees. 

“As your constituent, I’m here to ask for your leadership to equalize taxes in Wisconsin 

for all tobacco products.” 

This story, complete with props, resulted in the legislator asking Kristen questions and 

directing her staff to get more information from Kristen. After the discussion, Kristen 

submitted written comments with facts and figures. 

Children’s Health Alliance of 

Wisconsin: 

http://www.chawisconsin.org 


CHAPTER 6 . PAGE 4

Kristen Grimes’s Action Plan 

Kristen Grimes’s Action Plan :: continued 


CHAPTER 6 . PAGE 6

Vitals 

Michele Pfeilschifter, MPH 

Vice President of Health 

Promotion and Advocacy 

Arthritis Foundation, Heartland 

Region 

Policy Focus 

• Chronic disease prevention 

• Arthritis 

Overall Goal 

By May 2010, policymakers 

in the Illinois/Heartland 

Region will be informed of 

the benefits of chronic disease 

prevention and health promotion 

policies (specific topics 

to be determined at trainings) 

that will directly impact 

constituents. 

Core Strategy 

Educate key partners on 

issues surrounding chronic 

disease prevention issues and 

empower them to establish 

relationships with policymakers. 

Innovating in Changing Times 

A Case Study Featuring Michele Pfeilschifter, SOPHE Health Promotion 

Policy Expert 

Always striving to improve her expertise, Michele Pfeilschifter applied for the inaugural 

SOPHE State Health Policy Institute as a professional development opportunity. She 

elected to apply her skills in two ways. 

• In her leadership role on the Illinois SOPHE (ISOPHE) board of directors, Michele 

trained other members how to educate policymakers. 

• For the Arthritis Foundation, where she serves as vice president of health promotion 

and advocacy, Michele applied what she learned in the institute to deepen 

policymakers’ understanding of arthritis prevention. 

Initial Plan and Strategies 

Michele’s action plan spanned both organizations. The ISOPHE strategy was straightforward: 

Hold an in-person training on educating state health policymakers about 

evidence-based chronic disease prevention policies. The board scheduled the training to 

follow its morning meeting, which made it convenient for all. To attract a broad audience, 

the training applied to the prevention of any type of chronic disease. 

In her second year as an institute participant, Michele implemented the other parts of 

her action plan. A core strategy was training individuals to educate their state legislators 

on evidence-based arthritis policies. To maximize participation by arthritis 

patients and experts, Michele conducted the first training via conference call. The 

in-person training was part of the then-annual Arthritis Action Day in Springfield, Ill. 

She also created policy folders for participants and legislators. 

Innovating in Changing Times Case Study :: continued 

Transitions 

As our current recession deepened, state legislatures began cutting budgets. In this context, 

few new policy proposals advanced. Michele also found herself in a different organizational 

context when the Arthritis Foundation decided to restructure. It created the 

Heartland Region from the Illinois and five other Arthritis Foundation state chapters. 

Michele adapted her policy education strategy for the new context. Instead of the resource-intensive 

annual action day, she planned regional forums that brought together 

legislators with constituents. 

To get the forums on solid footing, Michele needed a legislative champion. Her creative 

approach to networking was attending a health fair in the northern suburbs of Chicago 

where she eventually met one of the staff organizers. This legislative staff member has 

become an active partner for the regional forums. He arranges many of the logistical 

details and effectively promotes legislators’ attendance. Michele finds arthritis experts 

to speak and rallies Arthritis Foundation members to attend. 

Progress Toward Policy Goal 

Michele readily met her immediate goals for training both arthritis experts and 

patients. Her adapted strategies have kept arthritis in the forefront of policymakers’ 

attention. 


• The regional forums provide legislators with a valuable service (i.e., a venue to 

interact with constituents). Offering a service differentiates your group from other 

advocates who only ask for legislators’ help. 

• Opportunities abound to expand your professional horizons. Regularly research 

ways to participate in training or become involved in educating policymakers, such 

as through your state SOPHE chapter or a public health coalition. 


• Find the right champion. 

Sometimes the best 

champion is a legislative 

staff member. 

• Consider alternatives 

to a major state capitol 

day. For example, find 

an event already being 

sponsored by a coalition 

and ask to become a 

partner. 

Learn More 

Arthritis Foundation, Heartland 

Region: 

http://www.arthritis.org/ 

illinois/ 

Illinois SOPHE Chapter: 

http://sophe.sophe.org/ 

chapter_home.aspCom_ 

Code=C-19-COMM 


CHAPTER 6 . PAGE 8

Michele Pfeilschifter’s Action Plan 

Michele Pfeilschifter’s Action Plan :: continued 


CHAPTER 6 . PAGE 10

Michele Pfeilschifter’s Action Plan :: continued 

Clients Educate Policymakers with 

Personal Stories 

A Case Study of the San Francisco AIDS Foundation (SFAF) 

With contributions by: 

Omar Sahak, SOPHE Health Promotion Policy Expert 

Courtney Mulhern-Pearson, Director of State and Local Affairs, SFAF 

Ken Hornby, SFAF Client and Volunteer 

The HIV/AIDS grassroots movement is a powerful example of how local activists can 

impact health policy. From the early years of the AIDS epidemic to the present, community 

advocates have built policy support for prevention, treatment, and other types 

of care. 

The San Francisco AIDS Foundation (SFAF), a 501(c)(3) organization, has long 

nurtured this tradition of grassroots activism. Specifically, SFAF engages clients and 

volunteers in sharing their personal stories as an integral part of the foundation’s policy 

and media communications strategies. In addition, SFAF is one of the leading providers 

of HIV/AIDS testing, prevention, and care in the city. The organization also collaborates 

with research, clinical, and public health partners, government agencies, donors, 

volunteers, and other stakeholders to confront HIV in communities that are the most 

vulnerable to the disease. 

Overview of Policy Goals and Strategy 

SFAF’s strategic plan provides the overall framework for its policy agenda. Two current 

policy goals are: 

• Reduce new HIV infections in San Francisco by 50 percent by ensuring federal, 

state, and local policies support a climate hospitable to effective HIV prevention. 

• Ensure access to proper care for all HIV-positive San Franciscans by eliminating 

institutional and policy obstacles to treatment and care. 

Vitals 

Policy Focus 

HIV/AIDS 

Overall Goal 

Reduce new HIV/AIDS 

infections, in part by advancing 

policies and institutional 

changes that remove obstacles 

to effective prevention, treatment, 

and care. 

Core Strategy 

In collaboration with clientvolunteers, 

educate policymakers, 

the media, and the 

public about the benefits 

of programs and services 

that improve the health of 

people with HIV and AIDS 

and reduce the likelihood of 

transmission. 


CHAPTER 6 . PAGE 12

Clients Educate Policymakers Case Study :: continued 

The core strategy to achieve these goals is educating policymakers, the media, and the 

public through the personal stories of client-volunteers (see Vitals sidebar). SFAF staff 

work in close partnership with grassroots advocates to ensure that policymakers and 

other audiences hear firsthand how programs and services for people living with HIV/ 

AIDS make a difference in their lives and how proposed changes would affect them. 

Staff then provide policymakers with supporting facts and policy analysis to put the 

stories into a larger context. Together, staff and client-volunteers have educated city, 

state, and federal legislators about effective HIV/AIDS interventions. 

Legislators and journalists frequently mention that they value personal stories about 

how HIV/AIDS programs have a real impact in the community. Because of this effect, 

SFAF has nurtured a small pool of client-volunteers to participate in policy education 

activities. The foundation also published a guide, Every Voice Counts: A Grassroots 

Advocacy Manual for the HIV/AIDS Community. 

Ken’s Story (Example of SFAF Policy Communications) 

Over the years, Ken Hornby, an SFAF client, has become a strong advocate for programs 

and services for people living with HIV/AIDS. SFAF’s policy team recruited him 

as a well-spoken client and volunteer who was interested in sharing his personal story 

with government officials. One recent opportunity was a California Senate committee 

hearing when legislators were discussing a proposal from the governor to institute costsharing 

in the AIDS Drug Assistance Program (ADAP). 

Ken and SFAF staff decided to set a constructive, not a confrontational, tone with the 

committee members to appeal to them as allies. As Ken describes in his own words, “If 

you’re confrontational, they’re not going to listen, and I learned that a long time ago.” 


Ken had written a speech the night before, but after talking with SFAF staff, he understood 

that it would be more beneficial to shift his focus. Now he would relate the 

committee’s decisions to the broader context of what it is like for an individual living 

on a lower income to be faced with further cuts to his or her services at a time when the 

cost of living was rising substantially. 

Ken first introduced himself to the committee, “My name is Kenneth Hornby, and I 

am a constituent, consumer, volunteer in my community, and a recent member of the 

San Francisco HIV Health Services Planning Council.” 

He then explained, “I make $844 a month, and after I pay for rent, utilities, groceries, 

laundry, cleaning supplies, and maybe some clothes, I might be left with $100 or less 

at the end of the month. But I can’t spend it, because I might have an emergency, get 

the flu, or will have to get medication. Since the price of everything is going up and our 

services are being cut, I may not be able to even afford that. Any further cuts would be 

devastating to everyone who is low income, and we are going to have to make choices 

between food and medicine, a roof and medicine. These serious issues are really what 

it comes down to when you’re talking about someone who is making $10,000 a year. 

I personally know that if ADAP wasn’t there, I wouldn’t be able to afford my medications, 

and where would I come up with the rest of the money” 

Ken asked committee members to help him—and other Californians living with HIV/ 

AIDS—by “thinking long and hard about the impact your decisions will have. Though 

cuts need to be made somewhere, try and minimize them as much as possible, because 

it really comes down to life and death for a lot of people. After living with HIV for 32 

years, and being as healthy as I am, I’m a good visual example of the positive impact all 

of these services can have.” 


• Always structure the 

policy education opportunity 

as voluntary. 

• Integrate grassroots advocates 

into your policy 

education and communications 

strategies. 

• Prepare the advocates to 

succeed with training, 

assistance with talking 

points, and background 

information about the 

event. 

Learn More 

San Francisco AIDS Foundation: 

http://www.sfaf.org 

Every Voice Counts: A Grassroots 

Advocacy Manual for 

the HIV/AIDS Community 

(SFAF). To request a copy, 

send an email to 

CPearson@sfaf.org 


CHAPTER 6 . PAGE 14


As they listened to Ken, committee members appeared to remain neutral and later 

thanked him for his testimony. Ken understood that they had heard such stories before, 

yet he knew the importance of showing legislators the real impact of their decisions, no 

matter how unpleasant. Ken plans to follow up with legislators as he is learning more 

about the public sector as a member of the San Francisco HIV Health Services Planning 

Council. 

SFAF staff testified after Ken. They presented data about how ADAP serves San Franciscans, 

findings from research studies, and the foundation’s analysis of the implications 

of ADAP changes for the HIV/AIDS community. 

Ken’s personal story was part of a larger SFAF campaign to educate policymakers about 

ADAP. SFAF also facilitated coverage of ADAP proposals in television, print, and 

social media. Many of these media stories have featured Ken. 


State lawmakers are still debating ADAP options, but SFAF is optimistic that they have 

a better understanding of how the program is an essential component in assuring effective 

treatment. 


• Program beneficiaries have powerful stories and may be looking for volunteer opportunities 

to give back to the community. 

• Grassroots advocacy is one way to empower individuals to be involved in their 

health and health care. 

• Collaboration is the best approach. Structure the policy education events to benefit 

both you and the client-volunteer. Provide any support they need to enter the situation 

with confidence, and seek their input on your points. 


A Case Study Featuring Heather Vilvens, SOPHE Health Promotion 

Policy Expert 

When the Buckeye Healthy Schools Alliance (BHSA) set its sights on promoting 

the adoption of the National Health Education Standards in Ohio, Heather Vilvens, 

BHSA Executive Director, decided to apply for the SOPHE State Health Policy Institute. 

Heather had never talked to a legislator and wanted to learn the nuts and bolts of 

how to effectively educate policymakers. 

Background: The National Health Education Standards outline what children need to 

learn to keep them healthy. 

Not Repeating the Past 

Defining an issue is a critical component in any policy initiative, and the framing must 

focus on the public health benefits. When planning how to frame an issue, take into 

account the history of relevant policy initiatives in the past. In Ohio, more than 10 

years ago, some groups attempted to convey the public health benefits that adopting 

National Health Education Standards could have on Ohio’s children. At that time, 

other groups in Ohio mischaracterized the standards as mandating comprehensive sex 

education. In that context, legislators and some potential advocates refrained from supporting 

the initiative. 

A decade later, as efforts re-ignited to have Ohio adopt the national standards, it was 

critical to Heather and BHSA partners to apply lessons from the previous campaign. A 

central lesson is not only to ensure that legislators and potential supporters understand 

that health education standards provide a framework for learning and that they do not 

mandate the teaching of specific topics, such as sex education, and but also to explain 

how the standards can support child health and wellbeing. Equally important was to 

explain how the standards can empower educators and children to support child health 

and wellbeing. This was an essential first step in ensuring a strong foundation for the 

policy education campaign. 

Vitals 

Heather Vilvens, MEd, 

CHES 

• Executive Director, 

Buckeye Healthy Schools 

Alliance 

Policy Focus 

Childhood obesity, specifically 

the National Health 

Education Standards 

Overall Goal 

By June 2012, policymakers 

in Ohio will be informed 

of the economic impact 

of childhood obesity and 

understand how adopting the 

National Health Education 

Standards as state standards 

can be an evidence-based 

policy that can contribute to 

the reduction and/or prevention 

of childhood obesity. 

Core Strategy 

Educate key stakeholders on 

the benefits of and need for 

adopting state standards for 

health education. 


CHAPTER 6 . PAGE 16


• Understand the policy 

environment about your 

issue as part of your 

planning process. 

• Find a mentor who will 

provide guidance and 

encouragement. 

• Don’t let fear hold you 

back. Get training and 

learn what you can do. 

With experience comes 

confidence. 

Learn More 

Buckeye Healthy Schools Alliance 

(BHSA): 

http://bhsaliance.org 


(BHSA): 

http://www.setthestandards. 

wordpress.com 

National Health Education 

Standards (CDC): 

http://www.cdc.gov/ 

HealthyYouth/SHER/standards/index.htm 

Set the Standards Case Study :: continued 

Strategies and Implementation 

Heather and key BHSA partners made time to: 

• Carefully build a broad, strong grassroots coalition that actively supports the 

standards. 

• Search for effective legislative champions who have the passion and leadership 

skills to shepherd the standards through the policy development process. 

Heather’s action plan has the complementary strategies of educating partners about the 

standards and training them on how to effectively communicate with policymakers, 

the media, and other stakeholders. Also, BHSA developed a new “Set the Standards 

Ohio” website so partners and other interested parties can readily access information 

about the standards (see Learn More in sidebar). 


BHSA started with a small group of core supporters. Together the BHSA core backers 

reached out to well-respected stakeholders to encourage participation. They reached 

out to the state PTA, dietitians, optometrists, environmental health, child and youth 

advocates, and voluntary health associations with an interest in child health. 

As Heather and BHSA partners cultivate additional support, they decided to temporarily 

postpone a full launch of the media relations strategy. However, BHSA is moving 

forward with other aspects of the action plan. For example, individual and organizations 

that have already endorsed Set the Standards Ohio are organizing in-district 

meetings with potential champions. 

Set the Standards :: continued 


• Action plans should factor in plenty of time for potential supporters to vet your 

policy issue. Many organizations’ policy review process moves slowly. 

• Partnerships have been an essential ingredient. Other stakeholders have integrated 

the standards adoption goal into their policy agendas. They have provided invaluable 

in-kind assistance to BHSA and have helped engage additional audiences. 

• As public health professionals, we can and should use our voices to educate policymakers 

about evidence-based policies 


CHAPTER 6 . PAGE 18

Heather Vilvens Action Plan 

Heather Vilvens Action Plan :: continued 


CHAPTER 6 . PAGE 20




CHAPTER 6 . PAGE 22

Chapter 6: Case Studies - Society for Public Health Education

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