Adopting principles of this toolkit into practice are necessary, yet with any toolkit the starting place can be overwhelming.  It is essential that your agency’s leadership team read this 86-page document together, out loud.  This is how you will be able to gage your staff’s understanding of the definition of terms, and that everyone is on the same page regarding the action steps.

Remember:  Changing behavior is most challenging because an individual cannot change another person’s behavior; only they can do that.  The only behavior that you can, with certainty, change is your own.

Therefore, how do we inspire others to change?  As providers we must assess whether what we are currently doing is producing the results we desire, or do we need to change our approach.

For example:

We inform a patient he is overweight and must go on a diet.  At the same time, we may say or imply that he is living an unhealthy lifestyle with his eating habits.  His wife sitting next to him as you deliver this news is devasted as she is proud of the way her husband looks, because to her peers within her culture she is a good cook and taking great care of him.

Changing our message within our agency as we deliver this information is important: “How” we say it.  Is this enough?  What if we take an additional step to partner with local restaurants within that ethnic community to post healthy facts about their meals?  Would this inspire healthier eating habits?  Would this also inspire healthier cooking at home because the “community” is engaging in healthier habits?

We must establish trust and demonstrate sincerity in our actions.

On page 19 of the strategic plan, we are told The Upstream Parable Adapted by Rishi Manchanda from a version told by Adewale Troutman

Three friends come to a turbulent river and are alarmed to see people of all ages struggling in the water, approaching a waterfall, crying for help. They jump right in. The first friend goes straight to rescue those in the most urgent trouble, closest to the waterfall. One by one, she helps people in dire need. The second friend builds a raft to help those a little farther upstream, to usher more people to safety before they reach critical danger. But the struggling swimmers keep coming. The two friends, growing exhausted, spot their third friend swimming away from them, far upstream. They shout, “Where are you going? There are more people here to save!”

She shouts back, “I know! I’m going to stop whoever or whatever is throwing these people in the water!”

–Rishi Manchanda, MD, MPH, founder and president of HealthBegins, The Upstream Doctors

Let’s consider for a moment that the people drowning represent those oppressed, or who have faced social injustice.  The three friends represent our colleagues.  All of us want to help, so we post signs that say, “Social Injustice will not be tolerated here!”

Did we do our part?  Did we do enough?  Did we inspire change?  Have we established trust?  Do we appear sincere?

Let’s look at our own practices to better establish that trust.  By scripting ourselves on the phone, at reception, throughout all stages of our service delivery, we can ensure that all clients are treated equally at least in our agency.  These scripts should be crafted with care with input from multiple sources so that we create a universal experience welcoming all people.

Identifying community partners who serve the various ethnic communities within your neighborhoods can help to establish healthier habits and collaboration among multiple ethnic and racial groups of people, such as the restaurant example.

It’s time to swim upstream.  It’s time to be creative.  And, it’s time to inspire the change that leads to social justice for all.