Culture Change Strategies

Over the years, Sea Change worked with dozens of organizations, artists, and activists, and we learned about a lot of different strategies for shifting culture. Below, we categorize these culture change strategies, summarize their aims, and offer some examples.

Contact

Contact interventions put people who are not stigmatized in contact with people who are stigmatized, and are one of the most effective ways to reduce stigma.

What is the goal?

Contact interventions are generally developed to address negative attitudes, beliefs, and behaviors that affect the stigmatized. In situations where the stigma is not visible, contact can increase visibility for people who are stigmatized and increase awareness among the public about who is harmed by stigma. For people who are stigmatized, contact may also help reduce feelings of shame and isolation and can normalize their experience.  

What are some examples? 

  • Speakers bureaus at organizations like Active Minds train individuals who are affected by stigma to share their stories.
  • Projects like the Tell 3 campaign offer support and encouragement to individuals who want to share their experience with people they know.
  • Conversation projects, like Untold Stories and the Tennessee Stories Project, provide tools and resources to bring conversations based on lived experience into people’s living rooms.
  • #shoutyourabortion engages citizen activists who want to confront stigma, judgment, and discrimination in the culture and in public policy.
Storytelling

Nearly every culture uses stories to convey social norms, taboos, morals, and values. When it comes to experiences that are stigmatized and silenced, storytelling can be especially important for contesting norms and reshaping perspectives. Abortion storytelling may involve first person narratives of abortion experiences, supporting a person who needs an abortion, or other experiences that have shaped a person’s values around abortion. Storytelling often includes “contact” with a person who has experienced stigma (see above), but does not have to.

What is the goal?

Storytelling strategies are often used to reshape social norms, taboos, morals and values in the culture. Stories can be used to surface the negative attitudes, beliefs and behaviors that affect the stigmatized, increase visibility for people who are stigmatized, and increase awareness among the public about who is harmed by stigma. For people who are stigmatized, storytelling can be an empowering way to take control of their own narrative and experience.

What are some examples? 

  • The 1 in 3 Campaign builds on the success of prior social change movements, harnessing the power of storytelling to engage and inspire action and strengthen support for abortion access. By encouraging people who have had abortions to end their silence, share their stories, and start a new and more personal conversation about abortion in our society, the 1 in 3 Campaign will help create a more enabling cultural environment for the policy and legal work of the abortion rights movement.
  • We Testify is dedicated to increasing the spectrum of abortion storytellers in the public sphere and shifting the way the media understands the context and complexity of accessing abortion care. We Testify seeks to build the power and leadership of abortion storytellers -- particularly those of color, those from rural and conservative communities, those who are queer identified, those with varying abilities and citizenship statuses, and those who needed support when navigating barriers while accessing abortion care.
Counseling and Peer Support

Counseling and peer support programs can provide healthcare information, emotional support, and empowerment to people who experience stigma. This can happen in the context of healthcare but also may happen through community agencies and self-help groups. People with stigmatized health conditions are more likely to use the internet for health information and access health care based on what they learn. The assurance of anonymity or confidentiality may improve one’s ability to cope with a stigmatized condition.

What is the goal?

Counseling and peer support programs aim to reduce the stigma that individuals experience, by: reducing feelings of shame, guilt, and self-judgment; normalizing the experience; helping stigmatized individuals develop resilience; helping stigmatized individuals make decisions about disclosure; addressing myths and misperceptions; and increasing confidence in decision-making.

What are examples?

  • In-person support groups and sharing circles  like Emerge,  a secular discussion and support group for anyone who has had an abortion. Emerge was created to fill the gap in after-abortion care – providing non-judgmental, emotional support for anyone.
  • Online support groups with moderation like Resolve, which provides online resources for people who are trying to build a family.
  • Workshops that support resilience and stigma resistance like the Providers Share Workshop aims to support abortion care providers.  
  • Options counseling can help people who are making a decision about pregnancy consider their options in a nonjudgmental and nonstigmatizing way.  
  • Hotlines like All-Options provide confidential, judgment-free support for people in all of their decisions, feelings, and experiences with pregnancy, parenting, abortion, and adoption.
  • Abortion accompaniment like that provided by Las Libres, an NGO in the Mexican State of Guanajuato, helps people to support each other through the process of medical abortion in legal and illegal contexts.
  • Full-Spectrum Doulas provide one-on-one support for multiple pregnancy outcomes including abortion, adoption, stillbirth,  miscarriage, and  birth.
Art and Design

Art and design may combine several or none of the other strategies listed here to generate creative, challenging, engaging works of art focused on stigma reduction.  

What is the goal?

Art and design approaches increase the visibility of people who have experienced stigma, model openness, and ask us to reimagine our understanding of stigmatized experiences.  

What are examples?

  • The Repeal Hyde Art Project raises awareness and creates dialogue about the Hyde Amendment, which blocks people from using Medicaid to pay for abortions. The Project accomplishes its mission through collaborative arts and shareable graphic content.
  • The Abortion Conversations Project has conducted ten grant cycles to fund over 50 individual and small organizations around the United States and internationally who are using creative approaches to address abortion stigma in their communities.
  • Illuminate RJ uses art to highlight how Texans experience reproductive oppression. Past projects have included fashion shows, painting and engraving, storytelling, and a participatory art project.
Integration of services

Service integration is the integration of stigmatized health services into non-stigmatized health services, for example bringing abortion care into primary care settings. For abortion care, service integration includes expanding training opportunities for abortion care or expanding professional roles to provide abortion care or referrals.

What is the goal?

The goal of service integration can be multifaceted. Expanding service provision can increase the diversity of the workforce, cultural competency, and stigma-informed care. It can also expand access to quality care for underserved communities. Since professionals are often agents of stigma reduction themselves, service integration can also build leaders who can shift attitudes, norms and beliefs through contact and storytelling.

What are examples?

  • The Ryan Program provides resources and technical expertise to departments of obstetrics and gynecology to establish a formal, opt-out rotation in family planning, either by establishing or expanding an outpatient family planning service within the academic medical center or by linking institutions with community partners such as Planned Parenthood.
  • Provide is a nonprofit that works in partnership with health and social service providers to build a health system that is equipped to respond to women’s health care needs around unintended pregnancy and abortion. Provide offers CEU-eligible professional development training and technical assistance for health and social service providers on how to give accurate, informed, and non-judgmental referrals for unintended pregnancy and abortion care.
  • The Fellowship in Family Planning is a two-year fellowship focused on subspecialist training in research, teaching and clinical practice in abortion and contraception. Working with respected and innovative leaders in the field, fellows learn about clinical and epidemiologic research, develop clinical and teaching skills, experience reproductive health issues internationally, and establish a connection to a rapidly expanding network of family planning experts.
Transformational Conversations

These strategies focus on engaging people with different perspectives and working to transform stigmatizing beliefs, attitudes and behavior.

What is the goal?

Transformational conversations can have many goals including sharing stories based in lived experiences, surfacing contradictory attitudes and beliefs, learning about different perspectives, or finding common ground across difference.

What are examples?

  • The Leadership Lab in Los Angeles has innovated a form of canvassing called “deep canvassing” in which canvassers have direct, profoundly personal conversations with unsupportive or undecided voters about LGBT rights and in order to guide those voters to reassess their underlying concerns and vote for equality.
  • The National Network of Abortion Funds has put together a Heart-to-Heart Abortion Conversations Kit to support their advocacy network in having transformational conversations about abortion in their own communities.
Stigma Advocacy

Advocacy is an activity by an individual or group that aims to influence decisions within political, economic, and social systems and institutions. Stigma advocacy can target companies, public individuals, the media, and politicians. Stigma advocacy focused on companies may seek improved services for people who experience stigma. Stigma advocacy focused on media generally demands that art and media content accurately represent the experiences and concerns of the stigmatized group. Stigma advocacy focused on politicians generally demands that policies and institutions meet the needs of people who experience stigma. Advocacy tactics can include in-person and online protest, pledges, lobbying, Op-Eds, petitions, publicity events, and more.

What is the goal?

Stigma advocacy aims to draw attention to stigma, increase the power, visibility and pride among stigmatized people, and build accountability into culture change efforts.  

What are examples?

  • Reproaction engages in non-violent direct action to oppose “Crisis Pregnancy Centers” and provides educational resources to encourage others to stand up against CPCs as well.
  • #NoTeenShame is a nationally recognized social movement for and by young parents that seeks to dismantle the policies and norms that lead to stigmatization of young parents.
  • UltraViolet is a culture change movement that leverages high profile media moments to hold decision makers accountable, create a cost for sexism, and shine a light on the people and policies that are improving all women's lives.
Education

Educational interventions include workshops, classroom education, and workforce training aimed at building knowledge about a stigmatized issue, dispelling myths about stigmatized people, building skills for interacting with stigmatized people, and changing stigmatizing behavior.  

What is the goal?

The goal of educational interventions often depends on the audience. For individuals affected by stigma, these interventions can increase uptake of services and reduce internalized stigma. Educational interventions with a skill-building component can be effective at addressing negative attitudes and beliefs in the workforce and improving healthcare experiences for clients.

What are examples?

Culture Change Resources

  • The Culture Change Strategy Group was convened and facilitated by leaders at Sea Change, SisterSong, Advocates for Youth, and CoreAlign. Over six months, 28 creative leaders who were committed to creating culture change around abortion worked to identify key problem areas, research solutions, and make strategy recommendations for the reproductive health, rights, and justice field(s).
  • CultureStrike empowers artists to dream big, disrupt the status quo, and envision a truly just world rooted in shared humanity. As risk-takers with the creative audacity to think beyond today's boxes, artists play a powerful role in inciting conversations, inventing new ways of thinking, and redefining the limits of what's possible -- and that's why CultureStrike believes cultural work is key to creating systemic change.

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