Empowering everyone to prevent opioid misuse

For WA State Health Care Authority

Millions of media impressions made. Tons of unused medication returned. Thousands of resources downloaded. This is Starts with One in action.


  • Website design & development
  • Advertising design & development
  • Behavior change
  • Brand implementation
  • Brand messaging
  • Brand Strategy
  • Creative strategy
  • Logo development & identity
  • Naming

It was important that Starts with One felt authentic and relevant to all audiences, including Spanish speakers and tribal communities. We made websites in Spanish and with content designed specifically by and for Native people, along with an English-language Start with One site for a general statewide audience.

The challenge

In 2016 the Washington State Health Care Authority needed a large-scale, multifaceted campaign to combat the opioid epidemic. Over several years, the campaign would need to, among other goals, educate residents about the patterns and dangers of prescription-drug misuse; increase awareness about safe storage and disposal; and empower people to engage in new types of conversations about opioids with their doctors, pharmacists, friends and family members. The campaign would need to reach diverse target audiences throughout the state.

HCA and DH agreed that the campaign should be rooted in positive norming — encouraging healthy behaviors as a regular part of life. The opioid epidemic might have seemed insurmountable, but our research showed us that many of us could take specific steps in our daily lives to help prevent opioid misuse.

We wanted to show residents that their power to stop the epidemic lay in those positive actions. Because we wanted individuals to embrace our messages — to see themselves within them — the campaign needed to feel realistic, accessible and put people first. Our campaign also needed to be flexible. We had a lot of ground to cover — every county in the state — in terms of content, audiences and geography.

We built an ambitious statewide media campaign and targeted, localized campaigns with community partners, using customized or one-of-a-kind materials to best reach their audiences.

This video models the kind of everyday conversation about opioids that helps to prevent misuse.

Radio ads target young adults and parents and older adults with factual information and tailored calls to action to prevent misuse.

The strategy

Safe storage. Safe disposal. Honest conversations.

Our research identified those simple but effective ways residents could prevent opioid misuse in their communities. And we’d created a campaign concept: Starts with One — because opioid-misuse prevention starts with one person taking one small action.

Now we had to put our concept to work to normalize those steps, working to identify the most effective media for reaching our audiences and the best tools to put in community partners’ hands.

From the beginning, our campaign had to feel relatable, accessible, contemporary and relevant. So we created a design system featuring a rich color palette and an intimate, candid-feeling photographic style that focused on personal connections. The “characters” in our videos, radio spots, print collateral and other pieces model the behaviors that can make a difference, and we pair their stories with factual information and simple calls to action.

As we created Starts with One materials for tribal audiences, we sought input from tribes and tribal organizations and as the campaign evolved to account for data that uncovered additional populations that were more vulnerable to prescription opioid misuse, we worked with cultural advisory groups to co-create video ads that would resonate with Black and African American, Latinx and LGBTQIA+ communities.

Gas-pump toppers reinforced key messages at the community level.

Drink coasters with Starts with One messaging reached audiences in bars and restaurants.

What we did

We created a comprehensive brand and communication plan and developed campaign assets including an English and Spanish website, several partner toolkits, educational videos, print materials, advertising and social media content.

HCA launched Starts with One with a 30-second scene-setting video that ran throughout the state. The campaign now has dozens of videos assets, including those for Spanish-speaking and tribal communities.

Then we focused on three areas to get the message out:

  • Paid media (more TV, radio, outdoor and digital) to reach targeted demographics with campaign messages and public service announcements.
  • Earned media to educate target audiences through news channels.
  • Activation of a partner program that would provide tools to prevention and treatment organizations, agencies, nonprofits, associations, universities and others for communicating to their audiences. More recently, we created the Pharmacy Safe Storage program and partnered with the Washington State Hospital Association to get campaign messaging out through trusted message carriers with customized materials and innovative social marketing strategies.

Our approach has included ambitious, statewide media buys including TV spots during high-profile events like the Olympics. We created conversational content on SnapChat and Instagram. Subject matter experts at HCA shared their knowledge in televised interviews, panels and Facebook Live Q-and-As.

Our approach has included ambitious, statewide media buys including TV spots during high-profile events like the Olympics. We created conversational content on SnapChat and Instagram. Subject matter experts at HCA shared their knowledge in televised interviews, panels and Facebook Live Q-and-As.

In collaboration with over 80 coalitions through the Community Prevention and Wellness Initiative, we continue to support the campaign in communities across the state. We created rich partner toolkits, and we tailor and translate campaign materials, work with community leaders to share their work in the media, and localize media buys.

In all, Starts with One has involved more than 250 designed pieces, many customized for our state’s diverse audiences. Because it was important that each piece was relevant and felt authentic to each audience, customization included design elements such as color changes and logo placements of partner organizations and content elements such as local resource listings. To reach tribal communities, we needed to ensure the materials were culturally appreciative.

The campaign collaborated with leaders from tribes and tribal organizations working to address opioid misuse. They guided messaging and strategy and made color and photography choices, helping to ensure the materials feel authentic within their communities. Our team has continued to work with individual tribes and tribal organizations to customize materials and develop individual communications plans.

This accessible and customizable partner toolkit makes it easy for organizations to download materials for their own communications programs.


Starts with One remains an active campaign, with results still coming in. By the end of it’s fifth year, it had generated 125 million paid media impressions. It also was the subject of some thirty plus earned-media stories, including a 30-minute news special. Our partner toolkits had seen nearly 5,000 downloads.

All that visibility has lead to tangible results. By the end of the campaign’s fifth year, we’d seen nearly 67,000 “view-through” conversions — people who’d seen a digital ad on their phones and then traveled to a medication drop box area. Into the campaign’s fifth year, more than 38,000 pounds of medication have been collected at take-back sites throughout the state.

And surveys have found our message was reaching residents: Those who’d seen the campaign were more aware of take-back locations, for example, and more likely to talk with friend or family member about opioid misuse.

million paid media impressions

partner toolkit downloads

pounds of medication collected

“view-through” conversions