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thinking about unintended consequences -- one aspect of policy change is changing social and cultural norms over time, ideally to empower and improve the health of individuals and communities. however, if a policy that seeks to empower a marginalized group, i.e.  thinking about LGBTQ+ inclusive policies/ anti-discrimination policies that are focused on reducing bullying in schools or improving health outcomes of LGBTQ+ people -- yet are these policy changes always having the impact they seek? for example, policies that are more skeletal such as anti-discrimination policies, versus those policies coupled with training for school staff, parents and students, or curriculum that is LGBTQ+ inclusive, may have a greater impact on social and cultural norm changing and progress. furthermore, policies may impact practices that are intentionally inclusive, i.e. sharing pronouns at the beginning of meetings etc., but also may make some people who are LGBTQ+ uncomfortable (feeling outed, feeling like they need to decide a pronoun when they may not know). I think first hearing from individuals/ needs assessments or other informational methods to collect data/ are really important, and to have some of this advocacy work led by individuals the policy seeks to impact, is really essential to making culturally/socially relevant change

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At times policies are passed and little enforcement or support for enforcement is passed along with it and can lead to little impact.

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Very hard to get policy changes to go through and all policy changes might not be the concern of the entire population versus focusing on an individuals person needs.

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When you have multiple stakeholders that do not share the same vision.
Legislation & local government.

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focus on environmental policy helps to address, situations outside of the individual such as policy on inclusion of some vaccine in the nation's immunization routine. (Availability, accessibility and subsidized)

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Some challenges are that environmental policies might miss variables that are specific to communities and individuals living in it. Environmental policies might also not be useful in ascertaining human behavior and behavior patterns.

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A CMS policy for reimbursement: they are not doing it for fear that it is too broad focused that it ignores little things that affect change.
Unfunded policies! And then enforcement dwindles...
Sometimes environmental changes don't take into account other factors (e.g., distance to that resource).
Policy takes a long time... individual interventions can be implemented more quickly.  And sometimes they don't trickle down
If folks who are trying to implement the policy but are not implementing themselves... behavior diminishes

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Implementation of environmental and policy related changes are difficult compared to individual changes.

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Changing environments and policy can benefit the community as a whole, while a focus on the individual behavior is more specific

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if individuals who are not empowered or included in the spaces of policy or environmental spaces of power, the health needs of individuals could be overlooked or not addressed. allowing policy change to be influenced by an inclusive group of individuals is very important, and yet hard to do because of power in politics, etc.

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I think one benefit of specifically focusing on changing environments & policy versus a focus on individual behavior is that the policy can have a more wide-spread change on a school or organization and an entire population vs. an individual

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"Trickle-Down Effect"
Sustainable/ long-term impact of environmental change that can affect larger number
Broader reach/ culturally competent
"Support from Environment!"
Policy: has multiple effects, including awareness

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Changing policy and environmental aspects can be very difficult due to rules, regulations, and red tape.

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Focusing on environments/policy will facilitate opportunities and access to resources that marginalized populations typically do not have access to. By creating these opportunities, the intent is to reduce barriers that many marginalized communities come across.

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When you focus on changing environments, you might have a better outreach instead of just focusing on one individual. Additionally, environmental policies and changes could also be tailored to more cultures/norms (culturally competent) and it could also address shortcomings that are prevalent in the community.

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It helps support the individual who is trying to make the behavior change

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Focusing on environment and policy help eliminate certain barriers that may hinder performance of health behavior such as cost of health care, access to insurance coverage, developing policies that encourage healthy behaviors.

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changing environments, policy, and systems may have more sustainable/long-term impacts on changing many individuals health behavior through shared resources/spaces, versus trying to reach individuals who vary greatly in health needs. a possibly more focused, broad reaching approach

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Changing policy and environment can contribute positively with regard to a community if culture and and social norms are taken into consideration.
Benefits:
1. Better access to resources.
2. Environmental
3. Community driven

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Challenges to focus on environmental and policy vs. individual include undermining the magnitude/ impact of aspects such as psychosocial determinants of individual behavior undeterred by enacted policies/ availability of resources. E.g., fear and fatalism in diabetes patients persist despite a policy enacted by the Centers for Medicare and Medicaid (CMS) recommending and providing reimbursement for diabetes screening.

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Changes in policies that have obvious ties to health such as access to health insurance may outweigh focus on individual behavior to seek healthcare services by removing barriers to access in the first place. Addressing the larger environmental issue in this instance has the potential to simultaneously address the personal-level determinant.

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Challenges of a specific focus on changing environments and policy vs. a focus on individual behavior

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Challenges of a specific focus on changing environments and policy vs. a focus on individual behavior

# data[].attributes.headline
Benefits of a specific focus on changing environments & policy vs. a focus on individual behavior

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Benefits of a specific focus on changing environments & policy vs. a focus on individual behavior