The role of relationship building in creating change

I came across this post by Craig Lefebvre last year, blogged about it at the time, and have since printed out his list and put it up by my desk – it so eloquently captures what I think should be some of core tenants of public health, and other, work. I felt it was worth revisiting in the context of #occupyhealthcare.

Lefebvre, in the context of things we may all want to start thinking about as we start a new year of social marketing, writes,

“What if we…

  1. didn’t have target audiences – but co-creators
  2. didn’t have distribution systems – but places where people could play
  3. didn’t use focus groups – but designed research to fit the puzzle and people
  4. didn’t assess knowledge and attitudes – but sought insight into people’s motivation and values
  5. didn’t start with analyzing people – but first assumed that it was something in their environment
  6. didn’t create messages and stories – but focused on crafting exchanges
  7. didn’t track program output – but what, how often and from where people saw and heard from us
  8. didn’t aim at target audiences – but served people
  9. didn’t focus on changing behaviors – but offered people new ways to solve problems, meet their needs and reach for their dreams
  10. didn’t focus on evaluation as the end of the process – but sustainability as the start of the next one”

One much under-appreciated aspect of creating change that we discussed at length in a community organizing class I once took is the importance of relationship-building. Ben wrote eloquently on this topic just a few days ago, and I think many of the points on this list get at that same point.

We go in so focused on diagnosis and treatment (in the medical arena) and research and program/business plans (in public health and other arenas) that we forget this most fundamental of things – relationships. And just as Ben pointed out in this post (“When engaged, and a relationship is formed, both the provider and the patient better see the others needs…Different perspectives are taken and new alliances possibly formed”), and just as Lefebvre points out, the keys to relationship building are seeking insight into people’s motivations and values (point #4), and finding the shared values that allow for the exchange (point #6) of resources needed to achieve a common purpose.

So, as we move forward in our efforts to #occupyhealthcare, we must continue to build relationships – not just among medical and public health professionals, but far beyond that – with patients and communities, those working towards similar goals, and those with differing opinions. For only as those relationships are built can we understand the motivations and values of all those that play a part in our health and healthcare systems, and only then can we find the shared values that allow for the action needed to achieve a common purpose.

Vinu Ilakkuvan received her Masters of Science degree in Society, Human Development, and Health from the Harvard School of Public Health in May 2011. She currently works in youth violence prevention in Richmond, Virginia, and blogs about public health at

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