In Minnesota, public health experts share a common goal: give every resident the opportunity to live their healthiest life. But the state has been stuck using public health approaches that were designed nearly 50 years ago. These approaches don’t meet the complex needs that communities face today.
To address these challenges—and eventually improve health outcomes across the state—the Minnesota Department of Health (MDH) has embarked on an ambitious systems change effort. This effort will restructure how public health works in Minnesota and provide new opportunities for funding, partnerships, and knowledge sharing.
MDH needed to make sure that public health practitioners, elected officials, and other decision-makers across the state were ready for what was to come and understood its purpose. Communicating about changing a system can be difficult. Early on, we heard a range of concerns from local public health staff—they were anxious about how their jobs might change and wondered if any change was actually possible—further, some long-term staff feared they might be blamed for past problems. Hattaway’s work with MDH led to a flexible message framework that showcased the importance and urgency of this change. The framework was designed both to highlight the need for the upcoming changes and how they would benefit everyone in the state and to help individual leaders tell their own stories about the need for a new approach.
We conducted an extensive qualitative research process, which included interviews and workshops with nearly 70 participants. We spoke with public health professionals and elected officials from across the state who represented a range of roles in the public health system—from local public health directors to state representatives.
We learned that there was unanimous agreement with the vision of the work—making it easier for Minnesotans to make healthy choices. But there was a lack of understanding of how the systems change efforts would achieve this vision and how it could be implemented throughout a state that includes both large cities and rural areas—areas that have very different public health needs and infrastructures.
Local public health workers were also concerned about preserving their community expertise when the state was designing a new statewide system. To become a trusted partner, MDH needed to show that it truly understood how important local decision-making is for communities and how the updated approach would preserve it.
Last, we heard that there were significant functional barriers to succeeding in public health. Public health staff were constantly working to preserve the funding they needed, and they spent significant time and effort building and maintaining the partnerships with other agencies and organizations that were critical to effective local work. Thankfully, these were barriers that the systems change effort intended to solve. MDH just needed messages that showed it understood how local experts could be better supported.
To underscore the urgency of the need, messaging highlighted the role and value of public health. Before we could talk about changing public health, we all needed to work from the same definition.
The messages also showed how the people of Minnesota were not benefiting from all that public health had to offer because of the outdated system. We also captured key concepts with memorable words and phrases such as “fair funding” and “creative collaboration,” highlighting how to position the key concerns of public health staff on the ground right within the language we created.
To ensure the effective use of this framework, we conducted a series of trainings and office hours. These sessions provided hands-on practice, helping participants adapt the framework to their specific needs and contexts and learn how to weave these new ideas into their ongoing work.
Our work has positioned public health leaders to effectively advocate for the new system and its benefits. Although the full impact of the transformation is yet to be seen, early feedback from the trainings has been overwhelmingly positive. One participant remarked that the toolkit we provided is “filling a gap and meeting the moment.”
Our partners at MDH remarked on how the tools we developed will benefit them for the long run:
“[Hattaway] helps people shift the way they think and the way they work. Rather than just giving them new words, Hattaway helps to provide the good soil to create robust projects later on.”
The flexible message framework and accompanying training sessions have empowered public health workers to articulate the importance of a strong governmental system and the envisioned changes. This increased confidence and clarity in communication are critical for building the support needed to implement the new system successfully.
