Building Health Promotion into the National Agenda: Progress Report
We are making excellent progress in our Building Health Promotion into the National Agenda effort. When we first announced this plan at our March, 2000 annual conference, this whole project was an amorphous dream. Less than five months later, it is beginning to become a well developed plan that appears to have a good chance of success.

Background
I will provide a brief background summary for those who are not yet aware of this effort....
Despite the fact that modifiable lifestyle factors such as smoking, sedentary lifestyle, poor nutrition, stress, etc. are responsible for over half of the premature deaths in the United States, health promotion remains a minor player in our nation's health care scheme, accounts for less than an estimated 1% of our national health care spending, and has no political clout. To push health promotion to the next level, we must develop some political clout and advance health promotion within the federal agenda. After consulting with over 300 health organizations and individual health promotion leaders, we have decided to advocate for increased funding for health promotion research, and increased funding for dissemination of information on the best science and best practice. If we succeed in securing this increased funding, this will be an important step in advancing our field and give us the enthusiasm and confidence necessary to tackle larger advocacy goals. For more details, see our web site www.HealthPromotionConference.org and click on the "National Agenda" button.

We Have Made Progress
We have made excellent progress in all aspects of our effort. Brief details are below.

Collaborations: We are working with over two dozen professional associations and advocacy groups who have offered to support this effort by providing expert advice, access to key senators and representatives and coordinating elements of the effort. We are just about to start a formal process of securing written endorsements to include in our communications with Congress.

Infrastructure: By the time this is published, our executive committee and steering committee should be in place, and our web site tools for contacting Congress should be operational.

Political Support: We have begun meeting with Senators and Representatives who chair important committees in the Senate and House of Representatives to gauge their interest in our proposal. We have received preliminary indications that a number of them may be interested in introducing and co-sponsoring a bill to support our goals. We need to continue to nurture these relationships and develop similar relationships with other members of Congress.

Plan Refinement: We are working with a number of government agencies within the Department of Health and Human Services to learn how much funding is required to achieve our research and dissemination goals, and where and how this money would be best spent. We plan to have our plan fully developed by November or December, 2000.

Message Development: With the assistance of a number of advocacy groups, we have created a basic template of the "marketing materials" we need to develop to support this effort.

Strategy Development. Our basic strategy is outlined below.
1. President's Request to Congress. Working through members of Congress in January and February, we will introduce our concept to the newly elected president through his policy advisors, and perhaps directly, for inclusion in the President' Budget Request to Congress. This request is usually introduced in the early Spring (March or April).
2. Committee Introduction of a Bill. Working with two to six committees in the House and the Senate, we will draft legislation (a bill) which provides the funding we are seeking. Our position will be strengthened if our concept is included in the President's Request to Congress, but this is not necessary.
3. Favorable Vote in Committee. Only 10% of bills introduced in committee are approved by the committee and sent to the full House and Senate for a vote. To be successful at this stage, we need to have repeated communication with each member of each of the committees that introduces a bill on our behalf. This will require harnessing a large grassroots effort and our February, 12-17, 2001 conference in Washington, DC, will play an important role in this step. The committee vote will probably take place in the spring or summer.
4. Favorable Vote in Congress. Once a bill is approved in committee, it is voted on in both the House and Senate. Approximately half of the bills voted on are approved. To be successful at this stage, we need to have communication with as many of the 100 senators and 435 representatives as possible. This will require harnessing a very large grassroots effort. It is difficult to predict when this vote will take place.
5. Signature by the President. The signature of the President is required for our bill to become law. The President is likely to approve a bill that has strong support in Congress unless it has some strong opponents or other problems. We do not anticipate this type of problem, but to be conservative, we will need to show the President that there is strong support for our request through letters and telephone calls to the White House from our grassroots supporters.
Implementing this plan successfully will be a big challenge that will require a significant grassroots effort. Fortunately, we have a number of things working in our favor. Most importantly, our basic concept makes intuitive sense to all the members of Congress we speak with and it has very few, if any, opponents. Furthermore, our request will be very small relative to most of the requests Congress will be considering. Finally, we are building a large, broad based coalition that will probably be able to harness the grassroots support we need.

What Should You Do Now?

1. Work Through Your Professional Association.
If you are a member of a professional association, contact the executive director and president and ask them to contact me (248-682-0707) to become involved in this advocacy effort.

2. Contact Your Senators and Representative.
Contact the two senators representing your state and the representative serving your congressional district. In most cases, it will be difficult to reach your senator or representative directly on the first attempt, but the staff member responsible for health issues should not be difficult to reach.
Your initial focus should be to find out where they stand on health promotion. Most likely, they won't even know the term "health promotion." The next step is to provide general education on the health and financial benefits of health promotion and give them a sense of health promotion efforts in your district. The third step is to advocate for increased funding for research and dissemination of information. We will share our specific strategy through your professional association as well as on our web page.
The easiest way to make contact with your senators and representative is through telephone calls and letters, and you should do both. The most effective contact is actually visiting the office of your senators and representatives. You should do this as well. You should also attend "Town Meetings" hosted by your representative in your district and publicly ask what he or she is doing to advance health promotion. If you can budget the time, make multiple contacts. You can make a difference with your contacts because most senators and representatives hear from only 5% of their constituency, and those 5% are the ones who shape policy.
To find out how to reach your senators and representatives, call the switchboard of the US Congress at 202-224-3121. As this effort develops, our web page (www.HealthPromotionConference.org and click on the "National Agenda" button) will provide a mechanism for you to send emails directly to members of Congress and provide templates of letters which state our request.

3. Visit our Web Site.
We will post progress reports and briefing materials on our web page as they are developed. Go to www.HealthPromotionConference.org and click on the "National Agenda" button.

4. Join us in Washington DC.
Attend the Art and Science of Health Promotion Conference at the Omni Shoreham Hotel in Washington, DC, February 12-17, 2001 and join almost a thousand other people in a trip to Capitol Hill to visit you senators and representative. For conference details, call 248-682-0707 or visit the conference web page at HealthPromotionConference.org.

5. Serve on a Subcommittee.
If you have well developed skills in grassroots advocacy coordination, message development, issue refinement, or close political contacts in Congress, and have time to devote to this effort, please call us at 248-682-0707 to get involved

Michael P. O'Donnell, PhD, MBA, MPH
Editor in Chief, American Journal of Health Promotion