Those who have worked in the health field for any length of time have surely encountered the “stages of change” model, which posits that individual behavior change goes through five stages: precontemplation, contemplation, preparation, action, and maintenance.

It is my observation that foundations go through a similar process as they enter the realm of social media. In more user-friendly terms, Larry Blumenthal, my copresenter at the 10 March 2010 Grantmakers In Health session, conjured a metaphor that became common language for the panelists and session participants alike to talk about the stage they are in. (Larry recently formed his own venture, Open Road Advisors, to help foundations and nonprofits to use the Web more effectively.) The metaphor is that of a diving board. Some foundations mentioned that they are still climbing the ladder; some foundations, nervous about jumping, are hesitantly standing on the board; and others are in the water, swimming along.

I described the Connecticut Health Foundation’s (CT Health’s) decision to work with online communities and social media as one part of a multipronged strategy to motivate the public to eliminate racial and ethnic health disparities in Connecticut over ten years. CT Health spent quite a bit of time in contemplation and preparation and is now ready to “jump off the diving board.” The initiative will go live in early April 2010.

CT Health’s approach differs from that of many foundations in that we are working in partnership with a grantee. The foundation awarded a $200,000 grant to the Society for New Communications Research (SNCR) to implement a diversified, multiplatform approach to stimulating engaging conversations about health equity in the online communities in which our target audiences already participate (for example, Twitter, Facebook, local blogs, and local ethnic online communities).

The initiative is branded “healthjusticect,” so that the focus is on the expression of public will, rather than on the foundation. Initial research revealed limited public conversations about health disparities both online and offline. Therefore, a cornerstone of our approach is that online and offline social networking need to reinforce each other. In other words, real-world events will be used to lead people to the online activities, and social media will be used to organize real-world action.

During the discussion portion of the GIH session, two particular points were raised that I have continued to contemplate. One participant asked what foundations are doing to support grantee use of social media. I answered that SNCR will be offering free social media training to other CT Health grantees, partners, and leadership program graduates. To date, I have not seen an applicant factor social media into a grant budget, but I am open to supporting such use of grant funds if the organization can demonstrate how it will use social media to forward the grant objectives. As Larry Blumenthal and Len Bartel of the Maine Health Access Foundation (other GIH session panelists) emphasized, for most organizations, using social media effectively requires some staff time, but many tools are free or cost very little.

A frequent point of discussion at the GIH session was that because Web 2.0 is a two-way street, there is a fear that it can open foundations up to negative comments and criticism. Larry Blumenthal noted that in the experience of the Robert Wood Johnson Foundation, where he used to work, the first challenge is to get stakeholders to participate. When they do, the result is generally positive.

CT Health tries to maintain this view; however, because our topical issue centers on race, which can be polarizing, we have been bracing for some negativity, which we feel will be inevitable. Online communities each have their own norms, and we hope to participate in those whose community members ensure that respectful debate is part of a vibrant conversation and that expression of racist sentiment is not tolerated.