Emergency contraception has come a long way since its start over a decade ago. The most recent policy change that has happened is the removal of the age restriction on the sale of over the counter emergency contraception. Earlier this year the FDA also decided to allow generic versions of Plan B available over the counter in an effort to reduce the out of pocket cost to consumers (Rovner, 2014).
When we talk about change theory, we have to look at policy processes and the elements involved in making the policies effective. Agenda setting is the first process. Agendas are basically a list of problems that policy makers have to decide on (Coffman, 2007). The problems are then drafted into proposals and then to politics. When all three of these items come together, the policy window opens.
I had the pleasure of interviewing a policy maker in District 21, Rep. Rick Gray, when asked about policy changes and the processes that occur, he noted that he relies on the constituents and other policy makers with insight on the particular topic.
So if you have a Bill brought before you and you are unsure of how to proceed or what the details are, you seek advice from other policy makers?
“Yes, I would rather make a change in policy with the right information in front of me. My background is in construction. If I have a health care Bill that I have to make a decision on, I look to those around me that have a good knowledge base regarding the issue, so that an informed decision can be made. That is part of the process when changes are needed.”
Do you think the process that is utilized to change policies is effective? Are there methods that you would like to see changed in the policy making process?
“I believe that the procedures that we have in place have an effective influence on the matters that are important to the public. We have a multitude of issues brought to our attention every time we meet. It is difficult to filter out the issues that maybe can be decided upon at a later date. The process could use some refinement, yes, but overall I think that what we do here is effective at addressing the issues that are important to the public at large.”
Are you familiar at all with the recent public policy changes with regards to the use of emergency contraception?
“Actually, yes, I sit on a few committees that review many health care related Bills. I am familiar with the Bills put in place to make emergency contraception available to more of the public.
Do you think that the policy changes that were made, were reflective of Change Theory and its principles?
“The changes that I am familiar with were made with the appropriate steps in place. The issue was brought to our attention, the problems were noted and acted upon, and then the policy was passed. As far as I know, the policy put into place by the majority has been beneficial and effective.”
The take away from this interview was that it takes many people to bring an issue to the attention of those that have the power to make the changes. It is not without those people that decisions can be made for the better of the public. It also takes an active participation in the issues to get them solved or at least noticed.
Coffman, J. (2007). Evaluation based on theories of the policy process. The Evaluation Exchange, 13(1), 23-26
Rovner, J. (2014). FDA to increase access to generic morning after pills. Retrieved from http://www.npr.org/blogs/health/2014/03/02/284397995/fda-to-increase-access-to-generic-morning-after-pills
Emergency Contraception 
What an interesting interview Nickie, enjoyed reading it. I agree with the congressman that you have to have steps when you’re trying to make a change. Lewin’s theory talks about steps in making a change in his case was 3 stages; Unfreezing, Change and Refreezing. He used a correlation in changing the shape of an ice to explain change. When you have a big cube of ice and realized that what you actually want is a cone of ice, what you do first is to melt the ice to make the change, put the water on the shape you want it to be which the cone and then solidification of the change is achieved by refreezing the shape to obtain cone shape. Thank you!
Every time I read your blog posts and then go read recently published articles regarding the latest news and developments in women’s health, I truly wish I were more involved in fighting for exactly that—women’s rights. In my own personal opinion, I think that this week’s topic—characteristics of innovators—is particularly perplexing when considered in the context of women’s reproductive rights, as often women (myself included) are not even involved in shaping changes that directly affect us. I don’t believe that this necessarily stems from lack of interest in being more involved; I think that modern women a) feel overpowered in the male-dominated worlds of both healthcare and politics, and b) are so busy pursuing higher education, managing careers, being active in their communities, and raising families that an added social responsibility seems overwhelming. By no means do I believe that I am describing all women using these characteristics—I just believe myself to be a modern, progressive/liberal woman and I know that these are the things holding me back from being more politically active.
Unfortunately, whatever the reasons may be, women seem to be lacking representation in the change process; this makes it hard to identify what kind of characteristics are essential to be innovative in the realm of reproductive rights. Although the measure ultimately passed, a disheartening 2012 article regarding the Affordable Care Act’s mandate of contraceptive coverage revealed that no women spoke on the panel in favor of universal contraceptive coverage—but two women testified against the provision (Kliff, 2012). The one woman who was supposed to speak on the panel—a law student from Georgetown—even admitted that she chose to attend her current university despite the fact that its health plan did not cover any form of contraeption (Kliff, 2012). This point underscores a significant problem in the foundation of innovation and change behaviors among women, and one that will not be easily corrected: when women are forced to choose between their reproductive rights and education/career/families/etc., they will often prioritize these other areas and disregard their own rights to health. It’s a catch-22: educated women are often the most empowered and likely to be politically active, but obtaining this education may mean sacrificing the rights they are hoping to protect.
There is a long, interesting article in the Journal of Women’s History about the history of reproductive politics in the United States. I would definitely recommend that women (and men) read this article in an attempt to gain understanding of “a woman’s right to choose” and the personal, social, historical, political, and economic factors that impact these rights (Solinger, 2013). I will cite one particular concept addressed in the article that describes the continual cycle of advancement and regression of women’s reproductive autonomy. The author states that each success women experience related to increased autonomy is met with political resistance derived from concerns about the dissolution of the traditional family and the unravelling of the patriarchal nature of society (Solinger, 2013). In these times, state policies often attempt to limit these advancements by favoring private sector groups over public ones that are based on principles of equality (Solinger, 2013). This article is only one view into the complex universe that is American politics, reproductive rights and women’s health, but it is an interesting starting ground to get women thinking about innovation and change.
References
Kliff, S. (2012 Feb 16). Meet Sandra Fluke: The woman you didn’t hear at Congress’ contraceptives hearing. Retrieved from http://www.washingtonpost.com/blogs/wonkblog/post/meet-sandra-fluke-the-woman-you-didnt-hear-at-congress-contraceptives-hearing/2012/02/16/gIQAJh57HR_blog.html
Solinger, R. (2013). Layering the lenses: Toward understanding reproductive politics in the United States. Journal of Women’s History, 25(4), 101-112. doi: 10.1353/jowh.2013.0040
I wholeheartedly agree that change begins with an agenda or problem list as you explained. What an interesting interview with R. Gray. I think the change theory presented by a commenter above could be improved by added a spot of lemon flavor or Kool Aid while the water is in a melted state thereby actuating transformation (true change) versus reformation (a newer version of the same substance).
Nice job on your interview. JMar