Implementing Kotter’s 8-Step Change Model to support the Marijuana Opportunity Reinvestment and Expungement

Implementing Kotter’s 8-Step Change Model to support the Marijuana Opportunity Reinvestment and Expungement (MORE) Act of 2019 as an Advanced Practice Registered Nurse (APRN) would involve carefully structured steps to drive awareness, acceptance, and policy support for this act within healthcare settings. The MORE Act, which seeks to decriminalize marijuana, expunge certain criminal records, and promote social justice, intersects with healthcare in terms of medical marijuana access, social equity in health, and patient advocacy. As an APRN, supporting such an initiative would involve educating healthcare providers, advocating for policy changes, and engaging with the community on its implications for health outcomes.

Step 1: Create a Sense of Urgency
As an APRN, the first step would be to highlight the importance and urgency of passing the MORE Act. This would involve presenting data on the health disparities linked to criminalization and the benefits of legalizing marijuana for medical use. You could share evidence from research showing the therapeutic effects of cannabis in treating chronic pain, anxiety, and other conditions. Additionally, you would emphasize the act’s potential to reduce health inequities, particularly among communities disproportionately affected by marijuana-related arrests and convictions.

Action: Organize informational sessions with healthcare providers and community groups, discussing the health implications of marijuana criminalization and how legalization through the MORE Act could improve health equity.
Step 2: Build a Guiding Coalition
Next, you would identify key stakeholders and influencers within your healthcare system who are open to change and can help advocate for the MORE Act. This coalition could include fellow APRNs, physicians, social workers, and community health leaders who have seen the negative effects of criminalization on patients.

Action: Form a task force that includes professionals across different departments and healthcare sectors to collaborate on educational campaigns and outreach efforts supporting the act.
Step 3: Develop a Vision and Strategy
As an APRN, you would develop a clear vision that connects the goals of the MORE Act to improved healthcare outcomes. This vision would focus on how decriminalization could lead to better access to medical marijuana, improved public health, and greater social justice, particularly in marginalized communities. The strategy would include educational programs for healthcare professionals about cannabis use and its therapeutic benefits, as well as community outreach to build support for the legislation.

Action: Create a mission statement that links the MORE Act to health improvements and develop a strategic plan outlining how healthcare providers can advocate for the act and support patients.
Step 4: Communicate the Vision
Effective communication is critical to creating widespread support. You would ensure that the vision is communicated regularly and consistently to all stakeholders, including healthcare professionals, patients, and community leaders. This could be achieved through workshops, webinars, and informational materials. The focus should be on how the MORE Act aligns with public health priorities, such as reducing disparities and expanding access to effective treatments.

Action: Use social media, hospital newsletters, and community forums to promote the benefits of the MORE Act, linking it to concrete health outcomes and social justice reforms.
Step 5: Empower Broad-Based Action
You would work to eliminate barriers that could prevent healthcare providers from supporting the MORE Act. This might involve addressing misconceptions about marijuana use, clarifying legal aspects, and providing training on how to incorporate cannabis as a treatment option where appropriate. Empowering action also means giving healthcare workers the tools to advocate for patients affected by marijuana criminalization.

Action: Host training sessions on medical cannabis and advocate for protocols that allow APRNs and other healthcare providers to recommend marijuana when appropriate.
Step 6: Generate Short-Term Wins
To maintain momentum, you would highlight small successes, such as increased awareness about the therapeutic benefits of marijuana or the support garnered from local healthcare professionals. These wins would show that progress is being made, motivating more people to get involved.

Action: Celebrate milestones, such as hospitals adopting medical marijuana policies or local legislators expressing support for the MORE Act.
Step 7: Consolidate Gains and Produce More Change
As support for the MORE Act grows, you would build on the initial successes by broadening the coalition and encouraging further advocacy. This step would involve pushing for additional policy changes, such as hospital regulations allowing the use of medical marijuana for qualifying patients, or state-level legislation in support of the MORE Act.

Action: Work with local health departments and lawmakers to ensure that the changes you advocate for are adopted into broader policy, including guidelines for safe marijuana use in healthcare.
Step 8: Anchor New Approaches in the Culture
Finally, you would work to ensure that the acceptance of medical marijuana and the principles of the MORE Act are integrated into the culture of healthcare practice. This could involve incorporating marijuana education into nursing curricula, normalizing its use as a legitimate treatment option, and embedding the values of social justice and equity into patient care practices.

Action: Advocate for ongoing professional development that keeps healthcare providers informed about marijuana laws and best practices for its medical use, ensuring long-term acceptance and integration into healthcare.
Conclusion
By applying Kotter’s 8-Step Change Model, APRNs can lead initiatives to support the MORE Act and ensure that healthcare providers, patients, and communities understand and benefit from the changes it proposes. This model provides a structured approach to driving meaningful change and aligning healthcare practices with evolving legal frameworks and patient needs.

References
Kotter, J. P. (1996). Leading Change. Harvard Business Review Press.
National Academies of Sciences, Engineering, and Medicine. (2017). The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. The National Academies Press.
Tetrault, J. M., & O’Connor, P. G. (2021). Medical Marijuana: Legal and Ethical Issues. Journal of Addiction Medicine, 15(1), 6–12.