One the key elements of developing the health extension model is building a movement within stakeholder organizations around a state, and then amplifying that to a national movement towards using extension methodology to improve community health.

At right are some further thoughts and ideas about building a movement, as well as links to resources about organizational change.

How Movements Get Started

In the TED talk video below, with help from some surprising footage, Derek Sivers explains how movements really get started.

(Hint: it takes two.)

Sharing Strategic Vision

Because health extension must bridge many existing but disconnected resources for primary care practices, it is important to be accepted by different parties and stakeholders. An effective way is for the health extension agent to identify and celebrate the assets of each, and then “build a movement”, attracting them to work together in a new way.

Movement-building involves inspiring people towards a compelling shared vision of the future that represents a qualitative shift from the present status quo, and is tied to their deepest shared values as a community. Developing a compelling shared vision with clear outcomes is a core strategy for change agents and change leaders as they do the work of movement building.

“Appreciative Inquiry” is an effective methodology for articulating the vision and developing the strategies for collaboration needed to make positive change. The Appreciate Inquiry approach begins with the assumption that every organization has something that works well. In contrast to a more traditional strategic planning approach that begins with an assessment of deficits and barriers, Appreciative Inquiry focuses on identifying the “positive core” of an organization, and then mobilizes and builds upon that asset base to create the energy, vision, and will to move forward and take action.

Click here for more information on Appreciative Inquiry.

Vision 2020: An Example of a Current Movement Across a Large Institution

Since 2010, the University of New Mexico Health Sciences Center has a had a strategic vision to measure its success by the health of its community. Vision 2020 states, “Working with community partners, UNMHSC will help New Mexico make more progress in health and health equity than any other state by 2020”.

This movement started with the appointment of a Vice Chancellor for Community Health and the establishment of an Office for Community Health in 2007. In late 2009, the Vice Chancellor began making personal visits to each of the deans of the College of Pharmacy, College of Nursing, School of Medicine, the department chairs, allied health programs and administrative units within the HSC, to dialogue about community and population health measures, and to find out what programs or projects within each of those units was addressing health beyond the individual. By 2010, the Health Sciences Center had adopted Vision 2020 as its strategic goal for the next ten years, kicking it off with a Symposium that would highlight all the programs working towards improvements in health and health equity around the state. A second Symposium was held nine months later, this time with a focus on inviting community partners who could begin to dialogue around existing partnerships and how to build stronger, more effective collaborations. In 2011, the executive leaders from UNMHSC began making quarterly visits to communities in the hopes of establishing regional academic extension hubs throughout New Mexico, with local health extension agents at each hub helping to bring together the various stakeholders working towards health improvement and linking them with university resources.

Nurturing Institutional Culture & Leadership

Strengthened primary care regarding its quality and its service to community health is of vital interest to our society. It is especially the case in the current environment where resources are increasingly constrained, the supply of primary care physicians and providers cannot meet the demand for those seeking a medical home. So it is imperative that, as an effective way to build capacity, many parallel, poorly communicating systems of health care come together and coordinate their efforts, thereby providing a more efficient, more effective health system with less duplication of services and less neglect of important health needs of our patients and their communities.

Related Literature & Tools

Click on the thumbnail images below to access key literature related building a movement and organizational change:

“Collective Impact”

“Prospective Evaluation of a Bayesian Model to Predict Organizational Change”

“Developing and Testing a Model to Predict Outcomes of Organizational Change”




Metrics and Evaluation Financing Message Mapping Building a Movement Chp6 Sustainability Diverse Populations Critical Health Literacy CHWs Chp5 Population Health Beyond PCMH Shared Resources Community Health Systems Small Practices PCEP Chp4 Primary Care Health Outcomes Core HERO Functions Engagement Perspective HERO Model Chp3 Health Extension Model Public Health Cooperative Extension Academic Health Centers Primer for Engagement Chp2 Engagement What is a Hero General Overview Using the Toolkit Chp1 Getting Started