5

Forming Successful Alliances

Building alliances can be difficult: groups must set aside or ignore differences and agree to act collaboratively, they need outside support to maintain the alliance over time, and they must agree on a coherent and compelling narrative to drive their mutual efforts. Two speakers at the workshop focused on the conditions necessary to create strategic alliances. One emphasized the importance of strategic and structural factors; the other emphasized the importance of trust.

CHARACTERISTICS OF SUCCESSFUL SOCIAL AND IDEOLOGICAL MOVEMENTS AND ALLIANCES

In 1909, an estimated 1.75 million American children between the ages of 10 and 15 were employed, not counting children employed in agriculture, seasonal work, industrial homework, or vacation work. Yet, just 20 years later, the industrial employment of children in the United States was all but eradicated. “The movement to end child labor was a success in the face of long odds and powerful opponents,” said Doug Imig, professor of political science at the University of Memphis and director of the Center for Urban Child Policy at the Urban Child Institute in Memphis, Tennessee. People tend to think of social movements as the inevitable outgrowth of grievances, he noted. But the study of social movements such as the drive to end child labor shows that grievances are a necessary yet far from sufficient condition. Imig therefore set out to explore the conditions from which social movements are likely to emerge.



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5 Forming Successful Alliances B uilding alliances can be difficult: groups must set aside or ignore dif- ferences and agree to act collaboratively, they need outside support to maintain the alliance over time, and they must agree on a coherent and compelling narrative to drive their mutual efforts. Two speakers at the workshop focused on the conditions necessary to create strategic alliances. One emphasized the importance of strategic and structural factors; the other emphasized the importance of trust. CHARACTERISTICS OF SUCCESSFUL SOCIAL AND IDEOLOGICAL MOVEMENTS AND ALLIANCES In 1909, an estimated 1.75 million American children between the ages of 10 and 15 were employed, not counting children employed in agricul- ture, seasonal work, industrial homework, or vacation work. Yet, just 20 years later, the industrial employment of children in the United States was all but eradicated. “The movement to end child labor was a success in the face of long odds and powerful opponents,” said Doug Imig, professor of political science at the University of Memphis and director of the Center for Urban Child Policy at the Urban Child Institute in Memphis, Tennes- see. People tend to think of social movements as the inevitable outgrowth of grievances, he noted. But the study of social movements such as the drive to end child labor shows that grievances are a necessary yet far from sufficient condition. Imig therefore set out to explore the conditions from which social movements are likely to emerge. 35

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36 ALLIANCES FOR OBESITY PREVENTION Key Factors Imig began by distinguishing between protest politics and social move- ments. Protest politics can bring different people together to pursue a cause. The actors in a social movement are connected through dense social networks, they draw on widely shared cultural values and norms, they act collectively for change, and they sustain their campaigns over time. In so doing, Imig explained, social movements can “challenge powerful oppo- nents and dominant ways of thinking.” Historically, collective identification of concerns and collective action have emerged through the workplace, churches, neighborhoods, and other settings that provide lines of communication and organization. Today, said Imig, the contexts in which individuals come to realize that their concerns are shared tend to be self-reflective, such as along the sidelines of their children’s soccer games or in the pickup line at school. As a result, oppor- tunities for collective engagement increasingly reflect pre-existing patterns of economic and racial segregation. Some people are looking to the promise of new technologies, such as Twitter, Facebook, and text messaging, to build social movements. The problem, said Imig, is that electronic means of connection and communica- tion are “hollow at the core.” Research indicates that they have been unable to create the rich bonds of horizontal engagement that inspire people to act together (Kraut et al., 1998; Putnam, 2001). Strategic and Structural Factors Scholars have identified several distinct strategic and structural fac- tors that affect the emergence of social movements (McAdam et al., 2001; Tarrow, 2011; Tilly, 1978). In a sense, said Imig, these factors act as bound- ary conditions for the structuring of effective movements. The first factor Imig discussed is the triggering of events that illus- trate underlying social trends. For example, pediatric X-rays developed in the 1930s often are cited as a critical triggering event in the discovery of unreported fractures in children, which helped launch the modern move- ment against child abuse and led to nationwide regulations for reporting suspected abuse. Similarly, the Triangle Shirtwaist Fire of 1914, in which 146 women and children died, made the country aware of the conditions faced by women and children working in industrial facilities. World War I was critical to the nursery school movement because of the perceived need to Americanize the children of immigrants. And World War II was a critical determinant in the child care movement in America because of the perceived need for women to work. Triggering events “give form and expression to

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37 FORMING SUCCESSFUL ALLIANCES the unease caused by more general, more pervasive, more enduring trends in American society,” said Imig. Ultimately, the power of movements lies in their ability to mobilize the public from complacency to action. Preventing childhood obesity fits with the historical concern for child well-being, Imig noted. However, that con- cern has seldom generated lasting policy changes. Even when policy makers have data indicating the need to change policies, they may be reluctant to act. Issues, however salient, must be understood in a particular way, Imig observed. The good news for the childhood obesity movement is that the public sees it as an issue, said Imig, as revealed by a number of poll results. In a poll reported in the Los Angeles Times (DiCamillo and Field, 2011), California voters cited unhealthy eating habits as the single greatest health risk to children. The Robert Wood Johnson Foundation (Napier, 2006) has reported that 92 percent of all Americans consider childhood obesity a serious national issue. And according to a recent Pew Charitable Trusts study (Pew Research Center, 2011), 57 percent of Americans believe the government should play a significant role in reducing obesity. Even with this level of concern, issues must be framed in a way that highlights injustice, agency, and identity to generate social movements, said Imig. Injustice means perceiving a problem as wrong; agency means condi- tions can be altered through collective action; and identity is something that people can rally around collectively. Several other factors contribute to the emergence of social movements, Imig continued. Such movements are more likely to take shape during moments of political uncertainty. They also are much more likely to emerge when they are supported by influential allies and can build key alliances, which lend prestige and legitimacy. Elites can legitimize, support, or pre- empt citizen activism. With the nuclear freeze movement, for example, the Bulletin of the Atomic Scientists and a letter signed by Nobel Prize winners first brought the issue to national consciousness. Also, members of particu- lar professions, including pediatricians, social workers, nurses, and teach- ers, have long been critical allies in social movements focused on children. Finally, opposition and repression can be critical in the emergence of social movements. Successful movements often define themselves in opposi- tion to their antagonists. Mother Jones, for example, made sure to launch all of her speeches by declaiming against millionaire manufacturers in New York and Philadelphia who built their mansions on the “broken backs and quivering hearts” of children, which Imig said made for an effective campaign.

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38 ALLIANCES FOR OBESITY PREVENTION Lessons for the Prevention of Childhood Obesity Imig drew several lessons for the prevention of childhood obesity from his presentation: • New information or dramatic social events can deliver an external shock to the system, giving form and substance to underlying long- term social trends. • Critical allies give voice and substance to social movements. • Movements are most successful when they are able to frame media appeals that are both emotive and rich in data. • The kinds of coalitions that have been successful in earlier move- ments for children have included likely as well as unlikely allies, “sometimes the more unlikely, the better,” according to Imig. • Issues become policy issues to the extent that they are perceived as both wrong and subject to redress. • Piggybacking on an existing movement can heighten public and political concern and increase the likelihood of action. • Causal narratives can drive successful instances of mobilization. Combinations of these seven conditions can lead to pervasive demands for policy change from both the public and policy makers, said Imig, leading to movements that have long-lasting effects. THE IMPORTANCE OF BUILDING AUTHENTIC TRUST Trust is not a black and white issue, said Diane Finegood, professor in the Department of Biomedical Physiology and Kinesiology at Simon Fraser University. It exists along a spectrum, which Finegood partitioned into simple trust, blind trust, cordial hypocrisy, and authentic trust (Solomon and Flores, 2001). She described each of these types of trust in turn. Simple trust is the kind of trust people take for granted—that the car will start in the morning, or that a neighborhood will be safe. If simple trust is lost, it can be very difficult to regain, Finegood said. Blind trust survives even an act of betrayal. If people continue to trust someone or something once that trust has been violated, then they are blind to the betrayal and are at least partly deceiving themselves. With cordial hypocrisy, people pretend to trust each other, but a façade of good will hides distrust and cynicism. This phenomenon is widespread in the area of childhood obesity, said Finegood. She believes it is “destructive to teamwork and makes it difficult to have the honest conversations that determine whether working together is the right strategy.” Authentic trust is the goal, said Finegood. Authentic trust cannot be

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39 FORMING SUCCESSFUL ALLIANCES taken for granted, is mature and carefully articulated, and is carefully considered. It recognizes the possibility of betrayal or disappointment and must be continuously cultivated. “These are the kinds of relationships that we need to strive for in complex environments.” Lessons from Building Trust Finegood has been working to build trust among a wide variety of organizations, including many food companies, to address obesity (Cana- dian Institutes of Health Research, 2008, 2009). Face-to-face meetings have brought people together to talk about barriers to and strategies for building trust. Finegood listed the identified barriers that have emerged from these meetings, including self-interest and fear, non-constructive criti- cism and closed-mindedness, stereotypes and misrepresentations, system barriers, conflicting world views, and rigidity. Strategies for building trust include partnership-enabling behaviors, honest interactive communication, reciprocal knowledge from dialogue, a collective orientation, and personal and collective leadership. Finegood said she has learned several important lessons from this exer- cise in building trust. One is that building trust within a sector—whether the private sector, government, or academia—or among nongovernmental organizations is more difficult than building trust among sectors. Within sectors, organizations are competing with each other, which she said makes it more difficult to build trust. Another lesson Finegood shared is that regulation is necessary if com- petition is undesirable. Regulation levels the playing field. For example, food companies have been reluctant to reduce sodium or remove trans fats because of their effect on the taste and composition of food. If one company reduces sodium in a product, its sales can drop as consumers purchase a different, higher-sodium brand. Lastly, it is important that efforts to build trust for the purpose of addressing obesity have a safe space where dialogue can occur. A safe space can nurture conversations and catalyze collaboration even when contro- versy and acrimony exist outside the space. Reducing Complexity Authentic trust is critically important to solving complex social prob- lems, suggested Finegood. For example, people can prosper in high-trust societies where they are able to form wide-reaching and successful coopera- tive partnerships. Low-trust situations, in contrast, tend to be economically chaotic and impoverished (Solomon and Flores, 2001). Complex problems have many solutions. But complexity cannot

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40 ALLIANCES FOR OBESITY PREVENTION be wrestled into something that is simple or addressed using a solution designed for a simple problem. Complex problems have different and more appropriate approaches. For example, said Finegood, one approach is to act locally, connect regionally, and learn globally (Wheatley and Frieze, 2008). Acting in local environments keeps people from being overwhelmed, while connecting with others on a local, regional, or global scale makes it possible to apply lessons learned more broadly. Finegood pointed to five levels for intervention in attempts to find solutions in complex systems (Finegood, 2011). At the deepest level is the paradigm under which the system is operating. This can be the most diffi- cult feature of a system to change, but it also can be the most effective. The next level involves the goals of the system. Sometimes these goals are not the ones people involved with the system claim, and they can be determined only by watching the system in action. The next level is the structure of the system, relating to such factors as trust and connectivity. The fourth level involves the feedback loops and delays in the system. It is difficult to think about how solutions may create changes in feedbacks or delays in system interdependencies, so these elements are often overlooked, said Finegood; however, such changes can be particularly influential. The final level encom- passes structural elements, such as subsystems, actors, and specific actions. Most of the evidence base regarding the system relates to this level. This framework makes it possible to envision a broad array of approaches to reducing childhood obesity. On one end of the spectrum, paradigm changes relate to such steps as accepting complexity and adopt- ing integrative approaches. On the opposite end of the spectrum, structural elements include such issues as daily physical education, constraints on food marketing, simplified nutrition labeling, walkable neighborhoods, and affordable healthy food. Assessing Partnerships Finegood has been developing a tool that can help people decide whether to engage in a particular partnership. Among the factors consid- ered by the tool are: • level of authentic trust; • commonality of interests; • brand complementarity; • appropriate authority and mandate to negotiate; • appropriate expertise, capacity, and resources; • feasibility of achieving common goals; • legal accountability throughout; and • risk mitigation (for media attention, public scrutiny).

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41 FORMING SUCCESSFUL ALLIANCES A similar set of issues should be considered while collaboration is ongoing, Finegood continued. In particular, the following factors can be important: • leaders and champions; • clarity of roles, responsibilities, accountabilities, jurisdictions, and commitments to completion; • opportunity for sharing assets (such as reach, resources, and influence); • commitment to and capacity for internal and external communica- tions; and • capacity for project and issue management. In concluding, Finegood listed two issues she believes collaborating organizations should consider once they have achieved their goals: • planning for project closure and celebration, and • evaluation of partnership. DISCUSSION During the discussion period, Mary Story, professor in the Division of Epidemiology and Community Health at the University of Minnesota, asked how the child protection movement of the 20th century, which was premised on the idea that government had a responsibility to protect the health and welfare of children, could be reinvigorated for the 21st century, in which protections have eroded in the face of marketing to children and other threats to their health. Robinson said he shared Story’s frustration that the child protection movement has not been more successful given that the welfare of children is a core value for so many people. This value has not necessarily been manifested in consumer behavior or voting, he observed. Perhaps it is not obvious to the public that its behavior is incon- sistent with its own values. Imig suggested that a tremendous political opportunity is inherent in that tension between perceptions of identity and actual behavior. Based on a tally of stories in the New York Times that addressed poli- cies affecting children from 1901 through 2009 (Imig, 2011), Imig said the national interest in children is currently declining, and he cited several pos- sible reasons for this decline. First, households with children are a shrinking minority. In 1956, families with a child under 18 at home made up a major- ity of the population; today, they constitute about one in three households. Also, one-third of adults self-identify as fundamentalist Christian, and this group often has a “different notion of the best interests of kids.” Imig said

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42 ALLIANCES FOR OBESITY PREVENTION that “there is a real fight for the public mind around these issues. But I think that’s where the opportunity is. There is a compelling story to tell that isn’t just about children’s rights—because that’s a phrase that is fraught with dif- ferent meaning for different groups—but about our responsibility for kids.” Finegood recounted that she had recently attended a conference with representatives of many of the companies with which she has worked on building trust. During a panel discussion on marketing to children, the representative from McDonald’s said that only 4 percent of Happy Meals are sold with apples, even though apples are always available. Because of the authentic trust Finegood had built with individuals in the company, the McDonald’s representative was open to her suggestion that the company make apples the default option rather than forcing customers to request them. Finegood’s point was that having a dialogue and building a relation- ship—not necessarily sponsorship or brand complementarity—can help in navigating challenging issues that must be sorted out before a social move- ment emerges. In response to a question about children’s rights versus children’s behavior, Imig agreed that it is a key distinction. “It can’t just be about behavior,” he said. “It has to be about a conception of what’s in the best interest of kids, and a conception that is widely shared.” All successful social movements have been careful to talk about roles for individuals, families, communities, neighborhoods, businesses, and government. Mak- ing appeals only for policy changes is unlikely to be a successful approach. Finally, Russell Pate, professor in the Department of Exercise Science at the University of South Carolina, asked how to generate a sense of emer- gency about childhood obesity. People talk about how this will be the first generation of children who will not live as long as their parents, he said, “but we don’t really know whether that is true.” Imig agreed that social scientists are poor forecasters because they talk about what will happen if current trends continue. He returned to the idea of triggering events, which may be significant not in and of themselves but instead because they frame a long-term trend. World War II was not significant to the child care move- ment because women were suddenly entering the workforce. Rather, it was significant because suddenly the call for sustainable, affordable, available, quality child care was coming not just from advocates for women and chil- dren but from the broader society. “It was a moment where there was a possibility to create different kinds of alliances around a perceived different kind of need,” Pate noted.