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Schneider GE, DiOrio A, Asada Y, Hearne SA. Charting the Advocacy Landscape: A Qualitative Content Analysis of Syllabi in Public Health Graduate Education. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:325-335. [PMID: 38330422 DOI: 10.1097/phh.0000000000001889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
CONTEXT Addressing public health challenges necessitates policy approaches, but concerns persist about public health graduates' preparedness to advocate. OBJECTIVE This qualitative study sought to assess advocacy content and skills taught to Master of Public Health students enrolled in US accredited schools and programs of public health (SPPHs) by analyzing 98 course syllabi submitted to the Council on Education for Public Health (CEPH) between 2019 and 2021. Syllabi were submitted by SPPHs during their (re)accreditation process to demonstrate compliance with CEPH's advocacy competency requirement. DESIGN Qualitative content analysis study. Syllabi were analyzed using MAXQDA Qualitative Data Analysis Software using a 2-coder approach. SETTING SPPHs accredited by CEPH. PARTICIPANTS Ninety-eight syllabi submitted to CEPH by 22 schools of public health and 54 programs of public health. MAIN OUTCOME MEASURES Exemplary language from advocacy courses and assignments and aggregate frequency of syllabi advocacy content and skills. RESULTS Most advocacy courses (61%) were survey, health policy, or health care delivery courses, covering policy (66%), policy communication (46%), coalition-building (45%), lobbying (36%), community organizing (33%), and media advocacy (24%) skills. Only 7% prioritized advocacy skill instruction, and 10% addressed how to advocate in an equitable way. CONCLUSIONS Defining public health advocacy and essential skills is crucial. Issuing competency guidelines, supporting advocacy faculty, offering standardized training, and expanding experiential learning are important first steps. More research is needed on how academic institutions are incorporating equity skill training into courses, whether separate from or combined with advocacy skills.
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Affiliation(s)
- Glenn E Schneider
- Author Affiliations: School of Public Health, University of Illinois Chicago, Chicago, Illinois (Mr Schneider and Dr Asada); Horizon Foundation, Columbia, Maryland (Mr Schneider); Department of Family Science, University of Maryland School of Public Health, College Park, Maryland (Ms DiOrio); and Lerner Center for Public Health Advocacy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Hearne)
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Phipps E, Bumstead L, Butt T, Crighton EJ, Desjardins N, Hart R, Oickle D, Sánchez-Pimienta CE, Schlonies R, Schonauer M, Umbach J, Masuda JR. 'It doesn't happen any other way': relationship-building and reflexivity for equity-focused intersectoral practice (EquIP). Health Promot Int 2023; 38:daad142. [PMID: 37966158 DOI: 10.1093/heapro/daad142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Abstract
Intersectoral processes that bring together public institutions, civil society organizations and affected community members are essential to tackling complex health equity challenges. While conventional wisdom points to the importance of human relationships in fostering collaboration, there is a lack of practical guidance on how to do intersectoral work in ways that support authentic relationship-building and mitigate power differentials among people with diverse experiences and roles. This article presents the results of RentSafe EquIP, a community-based participatory research initiative conducted in Owen Sound, Canada, in the midst of a housing crisis. The research explored the potential utility of equity-focused intersectoral practice (EquIP), a novel approach that invests in human relationships and knowledge co-creation among professionals and affected members of the community. The three-phase EquIP methodology centred the grounded expertise of community members with lived/living experience of housing inadequacy to catalyze reflexive thinking by people in professional roles about the institutional gaps and barriers that prevent effective intersectoral response to housing-related inequities. The research demonstrated that EquIP can support agency professionals and community members to (i) engage in (re)problematization to redefine the problem statement to better include upstream drivers of inequity, (ii) support reflexivity among those in professional roles to identify institutional practices, policies and norms that perpetuate stigma and impede effective intersectoral response and (iii) spark individual and collective agency and commitment towards a more equity-focused intersectoral system. We conclude that the EquIP methodology is a promising approach for communities seeking to address persistent health equity and social justice challenges.
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Affiliation(s)
- Erica Phipps
- University of Ottawa, Ottawa, Ontario, Canada, K1N 8Z4
- Centre for Environmental Health Equity, Queen's University, Kingston, Ontario, Canada, K7L 3N6
- Canadian Partnership for Children's Health and Environment/RentSafe, Ottawa, Ontario, Canada
| | - Lynda Bumstead
- Grey Bruce Healthy Communities Partnership, Owen Sound, Ontario, Canada, N4K 0A5
| | - Tanya Butt
- RentSafe Tenants' Rights Advocate, Owen Sound, Ontario, Canada
- Community Voices, Owen Sound, Ontario, Canada, N4K 1P1
| | | | | | - Robert Hart
- Grey Bruce Public Health, Owen Sound, Ontario, Canada, N4K 0A5
| | - Dianne Oickle
- National Collaborating Centre for Determinants of Health, Antigonish, Nova Scotia, Canada, B2G 2W5
| | - Carlos E Sánchez-Pimienta
- Centre for Environmental Health Equity, Queen's University, Kingston, Ontario, Canada, K7L 3N6
- University of Toronto, Toronto, Ontario, Canada, M5T 3M7
| | - Renee Schlonies
- RentSafe Tenants' Rights Advocate, Owen Sound, Ontario, Canada
- Community Voices, Owen Sound, Ontario, Canada, N4K 1P1
| | - Misty Schonauer
- RentSafe Tenants' Rights Advocate, Owen Sound, Ontario, Canada
| | - Jill Umbach
- Bruce Grey Poverty Task Force, Owen Sound, Ontario, Canada, N4K 1P1
| | - Jeffrey R Masuda
- Centre for Environmental Health Equity, Queen's University, Kingston, Ontario, Canada, K7L 3N6
- University of Victoria, Victoria, British Columbia, Canada, V8W 2Y2
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Sykes S, Watkins M, Bond M, Jenkins C, Wills J. What works in advocating for food advertising policy change across an english region - a realist evaluation. BMC Public Health 2023; 23:1896. [PMID: 37784142 PMCID: PMC10544363 DOI: 10.1186/s12889-023-16829-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 09/25/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND With increasing recognition of the role of commercial determinants of health, local areas in England have sought to restrict the advertising of products high in fat, salt and sugar (HFSS) on council-owned spaces, as part of wider strategies to reduce obesity. While there is some evidence of the impact of such policy change on behaviour, little is known about what works in the process of implementing this policy change. METHODS Guided by a realist evaluation framework that explores the interaction between context, mechanism and outcomes, this study aims to investigate the factors that influence the restriction of outdoor advertising of HFSS products in one region in England. It refines a programme theory co-produced with stakeholders from 14 local authorities within a region and uses multiple data sources from each area with an in-depth examination of four case study sites. Data sources include longitudinal realist interviews, focus groups and surveys with policy advocates and policy stakeholders. Data were analysed retroductively to understand the causal link between context, mechanism and outcomes. RESULTS Outcomes were driven by five dominant mechanisms: a strategic and staggered approach to stakeholder engagement, gathering intelligence, identifying policy champions, building relationships, reframing the issue; and two secondary mechanisms of amplifying the issue and increasing public will. These led to varied outcomes with no changes in formal policy position within the evaluation period but draft policy guidance in place and changes in political will demonstrated. Dominant context factors influencing change included having a named and resourced policy advocate in place supported by an external Community of Improvement and having existing aligned local objectives. Organisational complexity and change, financial concerns, lack of local examples, ideological positions and the pandemic were also influencing contextual factors. CONCLUSION Effecting policy change in this area requires the commitment of an extended period and the valuing of short-term policy outcomes, such as increasing political will. The importance of a resourced and well-supported policy advocate to lead this work is fundamental and the commercially sensitive nature of this policy change means that a complex interplay of mechanisms is required which may be dominated by a strategically staggered approach to stakeholder engagement.
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Affiliation(s)
- Susie Sykes
- London South Bank University, 101 Borough Road, SE1 0AA, London, England.
| | - Megan Watkins
- London South Bank University, 101 Borough Road, SE1 0AA, London, England
| | - Matthew Bond
- London South Bank University, 101 Borough Road, SE1 0AA, London, England
| | - Catherine Jenkins
- London South Bank University, 101 Borough Road, SE1 0AA, London, England
| | - Jane Wills
- London South Bank University, 101 Borough Road, SE1 0AA, London, England
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Sykes S, Watkins M, Wills J. Public health practitioners as policy advocates: skills, attributes and development needs. Health Promot Int 2023; 38:daad102. [PMID: 37703396 PMCID: PMC10499303 DOI: 10.1093/heapro/daad102] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
Effecting policy change is a key strategy in tackling wider determinants of health. In England, public health sits within Local Authorities (LAs) and responsibility for ensuring health is considered across directorates increasingly falls to public health practitioners. While international professional standards expect competence in understanding policy processes, the advocacy role has been under-explored. This paper explores the professional skills, role characteristics and learning needs of practitioners advocating for the restriction of advertising high-fat, salt and sugar products in a region of England. A series of three interviews were conducted at three time points over 10 months with policy advocates leading this policy change from four LAs. Three focus groups were also held with 12 public health advocates from 10 LAs at the end of the 10-month period of data collection. Data were transcribed and analysed retroductively. Data showed that practitioners felt inexperienced as policy advocates and saw this work as different from other public health approaches. Successful advocates required interpersonal skills, knowledge of policy-making and local governance, determination, resilience, confidence, belief in their work's value and leadership. These skills were difficult to acquire through formal education, but advocacy training, mentorship and role modelling were seen as important for professional development. To successfully implement a Health in all Policies approach and address wider determinants of health, public health practitioners need to be equipped and supported as policy advocates. The advocacy role and the complex skills required need to be more fully understood by the public health profession and prioritized within workforce development at both local and national levels.
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Affiliation(s)
- Susie Sykes
- School of Allied and Community Health, London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - Megan Watkins
- School of Allied and Community Health, London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - Jane Wills
- School of Allied and Community Health, London South Bank University, 101 Borough Road, London SE1 0AA, UK
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Laari L, Duma SE. Barriers to nurses health advocacy role. Nurs Ethics 2023; 30:844-856. [PMID: 36999769 DOI: 10.1177/09697330221146241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
BACKGROUND Speaking up to safeguard patients is a crucial ethical and moral obligation for nurses, but it is also a difficult and potentially dangerous component of nursing work. Health advocacy is gaining impetus in the medical literature, despite being hampered by barriers resulting in many nurses in Ghana remaining mute when faced with advocacy-required situations. We explored situations that thwart nurses from performing their health advocacy role. RESEARCH QUESTION What would cause nurses to take no action when they witness situations that require them to act as health advocates for their clients or communities? RESEARCH DESIGN An inductive, descriptive qualitative design was used to collect and analyse data on barriers that prevent nurses from practising their health advocacy role in Ghana. Individual one-on-one in-depth interviews were conducted using a semi-structured interview guide. The data were analysed using qualitative content analysis. PARTICIPANTS AND RESEARCH CONTEXT Twenty-four professional nurses and midwives registered with the Nursing and Midwifery Council were recruited from three regional hospitals in Ghana. These public hospitals were chosen from the upper, middle and coastal regions. ETHICAL CONSIDERATIONS The UKZN Ethics Review Committee in South Africa and the GHS Ethics Review Committee in Ghana both gave their approval for this study. FINDINGS Intrapersonal barriers, interpersonal barriers, and structural barriers emerged as major obstacles that nurses experience when performing their health advocacy role. CONCLUSIONS Barriers to health advocacy have undermined nurses' ability to function as health advocates and are preventing them from utilising their health advocacy position in nursing practise. Giving nursing students positive role models in the classroom and in the clinic can help them become more effective health advocates.
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Affiliation(s)
- Luke Laari
- School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Sinegugu E Duma
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Halliday E, Tompson A, McGill E, Egan M, Popay J. Strategies for knowledge exchange for action to address place-based determinants of health inequalities: an umbrella review. J Public Health (Oxf) 2023; 45:e467-e477. [PMID: 36451281 PMCID: PMC10470361 DOI: 10.1093/pubmed/fdac146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/05/2022] [Accepted: 10/31/2022] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Place-based health inequalities persist despite decades of academics and other stakeholders generating ideas and evidence on how to reduce them. This may in part reflect a failure in effective knowledge exchange (KE). We aim to understand what KE strategies are effective in supporting actions on place-based determinants and the barriers and facilitators to this KE. METHODS An umbrella review was undertaken to identify relevant KE strategies. Systematic reviews were identified by searching academic databases (Medline, Embase, Scopus, Web of Science) and handsearching. Synthesis involved charting and thematic analysis. RESULTS Fourteen systematic reviews were included comprising 105 unique, relevant studies. Four approaches to KE were identified: improving access to knowledge, collaborative approaches, participatory models and KE as part of advocacy. While barriers and facilitators were reported, KE approaches were rarely evaluated for their effectiveness. CONCLUSIONS Based on these four approaches, our review produced a framework, which may support planning of future KE strategies. The findings also suggest the importance of attending to political context, including the ways in which this may impede a more upstream place-based focus in favour of behavioural interventions and the extent that researchers are willing to engage with politicized agendas.
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Affiliation(s)
- E Halliday
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YG, UK
| | - A Tompson
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - E McGill
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - M Egan
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - J Popay
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YG, UK
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Laari L, Duma SE. A call for total nursing role reformation: Perceptions of Ghanaian nurses. Nurs Inq 2023:e12549. [PMID: 36938779 DOI: 10.1111/nin.12549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/21/2023]
Abstract
Nurses in Ghana believe that training, practise, practitioner and policy reforms are required for total nursing profession reform to be effective. Their views for role reformation in the nursing profession, which is currently needed, are not only academic but also clinically relevant in the pursuit of health equity and quality nursing care. We explored and described nurses' views on their roles in the profession using data collected from 24 professional nurses in three regional hospitals in Ghana. Using an inductive descriptive qualitative design, data were gathered and analysed using a qualitative content analysis to describe the views of the nurses. Four major themes, namely practise reforms, practitioner reforms, training reforms and policy reforms have emerged in relation to role reformation in the nursing profession. Three strategic areas, practitioner attitudes, new training modalities and policy realignment, must be reviewed and remodelled for better positioning of the nursing profession before its entire role reformation.
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Affiliation(s)
- Luke Laari
- School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
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Soto-Ponce B, Garcia-Ramirez M, Jiménez L. Romani Girls Matter: Developing a Participatory Action Research Protocol for Reproductive Justice. Healthcare (Basel) 2023; 11:healthcare11050755. [PMID: 36900760 PMCID: PMC10001154 DOI: 10.3390/healthcare11050755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
Despite the last few decades' advances towards social and gender justice, reproductive decisions are still a source of oppression for many European Romani women and girls. This protocol aims to propose a model to empower Romani women and girls' reproductive decisions, inspired by Reproductive Justice-the recognition of women and girls' ability to make safe and free decisions about their bodies and reproduction. Through Participatory Action Research, 15-20 Romani girls and their families, two Romani platforms, and key agents from a rural and an urban context in Spain will participate. They will (1) contextualize Romani women and girls' inequities, (2) build partnerships, (3) implement Photovoice and advocate for their gender rights, and (4) assess the initiative's related changes, using self-evaluation techniques. Qualitative and quantitative indicators will be collected to assess impacts among participants, while tailoring and assuring the quality of the actions. Expected outcomes include the creation and consolidation of new social networks, and the promotion of Romani women and girls' leadership. For this, Romani organizations must be transformed into empowering settings for their communities, spaces where Romani women and girls assume responsibility of the initiatives, being these tailored to their real needs and interests, and guaranteeing transformative social changes.
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Affiliation(s)
- Belen Soto-Ponce
- CESPYD, Department of Social Psychology, University of Seville, 41018 Sevilla, Spain
- Correspondence:
| | - Manuel Garcia-Ramirez
- CESPYD, Department of Social Psychology, University of Seville, 41018 Sevilla, Spain
| | - Lucía Jiménez
- Department of Developmental and Educational Psychology, University of Seville, 41018 Sevilla, Spain
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Teaching Strategies for Health Advocacy for Undergraduate Nursing Students: A Scoping Review. Nurs Educ Perspect 2023; 44:92-97. [PMID: 36652660 DOI: 10.1097/01.nep.0000000000001085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
AIM The goal of this study was to identify strategies for teaching health advocacy for undergraduate nursing students. BACKGROUND Although health advocacy is a core skill of professional nursing practice, there are challenges in the health advocacy approach in nursing education. METHOD The databases LILACS, IBECS, BDENF, Medline, Web of Science, CINAHL, and the Cochrane Library were searched, without limit of time and language, for this scoping review; 11 articles were included. Data were analyzed and synthesized in a narrative form. RESULTS The following teaching strategies emerged: theoretical exposition and supervised clinical internship, technology-enhanced simulation, clinical experience, experiential learning, simulated social experiences, digital story making, and narrative pedagogy. The topic was taught according to several themes: economic disparity, health legislation, LGBTQ+ population, elder health, mental health, health policies, concept of advocacy, and nontechnical skills. CONCLUSION Teaching strategies for health advocacy should be based on constructivist education linked to social reality.
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Neves FB, Vargas MADO, Brehmer LCDF, Luz KRD, Grespi LDO, Bitencourt JVDOV. Ações de um grupo técnico de vigilância do câncer na perspectiva do advocacy. Rev Esc Enferm USP 2023. [DOI: 10.1590/1980-220x-reeusp-2022-0421pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
RESUMO Objetivo: Analisar as ações de vigilância epidemiológica para pessoas com câncer na perspectiva do advocacy. Método: Estudo qualitativo, do tipo Pesquisa Convergente Assistencial, aliado ao referencial da advocacia em saúde. Realizado na Vigilância Epidemiológica da Secretaria de Saúde de um município na região Sul do Brasil. Resultados: Participaram 11 profissionais de serviços de saúde, entre junho de 2020 a julho de 2021, perfazendo 14 reuniões do grupo. Discutiram-se dois aspectos: (1) problemas envolvendo a gestão do processo de trabalho nos serviços da rede, que influenciam diretamente na assistência ao usuário; e (2) problemas relacionados à gestão da formação do profissional que atende nestes serviços, onde o desconhecimento relativo às legislações traz consequências graves para os usuários. Conclusão O advocacy fortaleceu conceitos e concepções de defesa à saúde, mobilizando ações relativas ao câncer, atuando como uma ponte entre os membros do grupo e os setores que detêm poder para modificar circunstâncias que impeçam o cumprimento das políticas públicas e da legislação vigente.
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Hodge L, Raymond C. Code poverty: An adaptation of the social-ecological model to inform a more strategic direction toward nursing advocacy. Nurs Inq 2023; 30:e12511. [PMID: 35801387 DOI: 10.1111/nin.12511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 06/14/2022] [Accepted: 06/18/2022] [Indexed: 01/25/2023]
Abstract
The purpose of this discussion paper is to explore how nurses can be strategically poised to advocate for needed policy change in support of greater income equality and other social determinants of health. We adapted Bronfenbrenner's social-ecological model to highlight how four broad pervasive subsystems shape the opportunities that nurses have to engage in advocacy at the policy level. These subsystems include organizations (the microsystem), professional bodies (the mesosystem), public policies (the exosystem), and societal values (the macrosystem). On the basis of this adapted model, we recommend changes among modifiable elements of the microsystem and mesosystem that can help position nurses (ecologically and collectively) to advocate for public policy change and use examples from a Canadian context to illustrate these points. We believe that the ideas arising from this model can be widely used where policy action on the social determinants of health is needed to inform, guide, and frame change efforts and advocacy work.
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Affiliation(s)
- Lesley Hodge
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Christy Raymond
- Faculty of Nursing, MacEwan University, Edmonton, Alberta, Canada
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Neves FB, Vargas MADO, Brehmer LCDF, Luz KRD, Grespi LDO, Bitencourt JVDOV. Actions of a cancer surveillance technical group based on the perspective of advocacy. Rev Esc Enferm USP 2023; 57:e20220421. [PMID: 36972325 PMCID: PMC10081599 DOI: 10.1590/1980-220x-reeusp-2022-0421en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/27/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE To analyze epidemiological surveillance actions for people with cancer based on the perspective of advocacy. METHOD Qualitative study, Convergent Care Research type, combined with the framework of health advocacy. It was carried out in the Epidemiological Surveillance of the Health Department of a municipality in the southern region of Brazil. RESULTS Eleven health service professionals participated in the study, from June 2020 to July 2021, making up 14 group meetings. Two aspects were discussed: (1) problems involving the management of the work process in the network services, directly influencing user assistance; and (2) issues related to the training management of the professional who works at these services, where the lack of knowledge regarding the legislation leads to serious consequences for the users. CONCLUSION The advocacy strengthened health defense concepts and ideas, mobilizing actions related to cancer, acting as a bridge between the members of the group and the sectors holding power to change circumstances that prevent compliance with public policies and current legislation.
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Nyemcsok C, Pitt H, Kremer P, Thomas SL. "Drugs and alcohol get talked about, why not betting?" Young men's qualitative insights about strategies to prevent gambling harm. Health Promot J Austr 2022; 34:276-283. [PMID: 35833313 DOI: 10.1002/hpja.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 11/06/2022] Open
Abstract
ISSUES ADDRESSED Research is needed to understand young people's perspectives about public health promotion strategies relevant for their health and wellbeing. This study provides suggestions from young male gamblers about sports betting harm prevention and reduction strategies. METHODS In-depth interviews were conducted with sixteen young men aged 18 to 24 years, from Melbourne, Victoria, who regularly engaged in sports betting. A critical qualitative inquiry approach, using methods of constructivist grounded theory guided the study. Reflexive thematic analysis was used to interpret and construct themes from the data. RESULTS Participants indicated three main harm prevention strategies. These were: online consumer protection and regulatory strategies; public education campaigns that highlighted sports betting risks and harms; and the creation of formal and informal support networks to reduce stigma and encourage help seeking. They also supported being engaged in the development of harm prevention strategies and suggested ways to help reduce barriers to engagement. CONCLUSION Young men recognise the need for regulatory, education, and engagement responses to counter the risks posed by new gambling products. Young men may be difficult to engage in formal prevention activities, however youth-led and informal interactive mechanisms may help to overcome this barrier, and contribute to a comprehensive public health approach to gambling harm prevention. SO WHAT?: Young men can draw upon their lived experiences of gambling to provide insights relevant for public health promotion. Mechanisms should be developed to engage young people in the co-production of strategies and policies aimed at gambling harm prevention and reduction.
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Affiliation(s)
- Christian Nyemcsok
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Hannah Pitt
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Peter Kremer
- Centre for Sport Research, School of Exercise & Nutrition Sciences, Faculty of Health, Deakin University, Geelong, Australia
| | - Samantha L Thomas
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
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Golden TL. Innovating Health Research Methods, Part II: Arts-Based Methods Improve Research Data, Trauma-Responsiveness, and Reciprocity. FAMILY & COMMUNITY HEALTH 2022; 45:150-159. [PMID: 35639790 DOI: 10.1097/fch.0000000000000337] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Accumulating US studies indicate gender inequities in youth violence research and responses. Improving youth health thus requires greater understanding of how girls and young women perceive and experience violence, and gathering such data demands research methods that are trauma-informed and assets-based. This mixed-methods study addresses these dual needs. To support gender equity in youth violence research, it incorporated 4 violence surveys and 3 arts-based methods to examine girls' and young women's experiences and perceptions of violence. Then, to advance trauma-informed, assets-based research, it used study findings to generate an assessment of all methods employed. Results are presented in a 2-part article, with Part I (published separately) conveying findings about the population's experiences, needs, and assets related to violence and safety. Part II (here) details the development of the arts-based methods, assesses them alongside the surveys, and compares the effectiveness of all methods. Despite overlap across methods, the arts-based strategies offered critical knowledge that was missed by surveys, including actionable data about the population's priorities, experiences, and recommendations. The arts-based methods were also trauma-informed and offered reciprocity via assets-based, community-centered programs and platforms. This study provides justification and a template for further integration of creative practices into research, and for continued innovation to advance access, data quality, and health equity.
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Affiliation(s)
- Tasha L Golden
- International Arts + Mind Lab, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Health Promotion and Behavioral Sciences, University of Louisville, Louisville, Kentucky
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Heck LO, Carrara BS, Mendes IAC, Arena Ventura CA. Nursing and advocacy in health: An integrative review. Nurs Ethics 2022; 29:1014-1034. [PMID: 35172646 DOI: 10.1177/09697330211062981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The practice of health advocacy in nursing has been defined as a process aimed at promoting the independence and autonomy of users of health services, in addition to providing information on healthcare decision-making and offering support for decisions taken. ETHICAL CONSIDERATIONS Ethics approval was not required to conduct this review. AIM This integrative review aims to synthesize evidence in the literature on health advocacy in professional nursing practice. METHODS An integrative review methodology guided by Whittemore and Knalf was used. Studies were identified by conducting searches on PubMed, Scopus, Web of Science, CINAHL, and LILACS databases. Of 2179 records, 34 studies matched the inclusion criteria. RESULTS The main aspects involved in the practice of health advocacy by professional nurses are related to the ethical principles of the nursing profession, such as protecting patients seeking autonomy and care. Furthermore, the practice of health advocacy by nurses requires an empathetic attitude, responsibility, and assertive communication. CONCLUSION The diverse possibilities for the practice of advocacy synthesized in this study allow nurses to approach and become familiarized with the topic, being able to acquire and complement knowledge that will reflect on their professional practice in different work environments such as the educational field, in hospital practice, or basic health care.
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Marcellus L, Pauly B, Martin W, Revai T, Easton K, MacDonald M. Navigating conflicting value systems: a grounded theory of the process of public health equity work in the context of mental health promotion and prevention of harms of substance use. BMC Public Health 2022; 22:210. [PMID: 35100999 PMCID: PMC8805448 DOI: 10.1186/s12889-022-12627-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/19/2022] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Promoting health equity and reducing heath inequities is a foundational aim and ethical imperative in public health. There has been limited attention to and research on the ethical issues inherent in promoting health equity and reducing health inequities that public health practitioners experience in their work. The aim of the study was to explore how public health providers identified and navigated ethical issues and their management related to promoting health equity within services focused on mental health promotion and preventing harms of substance use. METHODS Semi-structured individual interviews and focus groups were conducted with 32 public health practitioners who provided public-health oriented services related to mental health promotion and prevention of substance use harms (e.g. harm reduction) in one Canadian province. RESULTS Participants engaged in the basic social process of navigating conflicting value systems. In this process, they came to recognize a range of ethically challenging situations related to health equity within a system that held values in conflict with health equity. The extent to which practitioners recognized, made sense of, and acted on these fundamental challenges was dependent on the degree to which they had developed a critical public health consciousness. Ethically challenging situations had impacts for practitioners, most importantly, the experiences of responding emotionally to ethical issues and the experience of living in dissonance when working to navigate ethical issues related to promoting health equity in their practice within a health system based in biomedical values. CONCLUSIONS There is an immediate need for practice-oriented tools for recognizing ethical dilemmas and supporting ethical decision making related to health equity in public health practice in the context of mental health promotion and prevention of harms of substance use. An increased focus on understanding public health ethical issues and working collaboratively and reflexively to address the complexity of equity work has the potential to strengthen equity strategies and improve population health.
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Affiliation(s)
- Lenora Marcellus
- School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Bernie Pauly
- School of Nursing and Scientist, Canadian Institute for Substance Use Research, University of Victoria, Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Wanda Martin
- College of Nursing, University of Saskatchewan, Health Science Building - 1A10, Box 6, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada.
| | - Tina Revai
- First Nations Health Authority, 501-100 Park Royal South Coast Salish Territory, West Vancouver, BC V7T-1A2, Canada
| | - Kathy Easton
- Island Health, 345 Wale Rd, Victoria, BC, V9B 6X2, Canada
| | - Marjorie MacDonald
- School of Nursing, and Scientist, Canadian Institute for Substance Use Research, University of Victoria, Box 1700 STN CSC, Victoria, Canada
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Heck LO, Carrara BS, Ventura CAA. NURSING AND HEALTH ADVOCACY: DEVELOPMENT PROCESS OF AN EDUCATIONAL MANUAL. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0364en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to describe the development and validation of an educational manual for nurses on the practice of health advocacy in their professional experience. Method the method used to develop the manual was composed of three stages carried out from 2018 to 2020: an integrative review of studies published from 2010 to 2018, development of the content, and validation of the educational manual by experts. Results: based on the integrative literature review, 91 final articles related to the theme of advocacy in health and nursing were selected, which subsidized the definition of four themes: The meaning and fundamental elements for the practice of advocacy in nursing; Advocacy in teaching and the involvement of other care actors; Advocacy as a professional, moral, and ethical obligation; Advocacy about specific population groups. The themes contributed to the development of the educational manual content. After submission and validation by specialists, it was possible to define the layout, size, number of pages, and final design of the educational manual, which will be printed and handed out to nursing professionals and students, and made available online. Conclusions: the elaboration and validation of the manual help to build knowledge related to the professional practice of the nursing team and the exercise of advocacy in health.
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Heck LO, Carrara BS, Ventura CAA. ENFERMAGEM E A ADVOCACIA EM SAÚDE: PROCESSO DE ELABORAÇÃO DE CARTILHA EDUCATIVA. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0364pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: descrever a elaboração e validação de uma cartilha educativa para enfermeiros sobre o exercício da advocacia em saúde em sua prática profissional. Método para a elaboração da cartilha foi utilizado o método composto de três etapas realizadas de 2018 a 2020: revisão integrativa de estudos publicados no período de 2010 a 2018, construção do conteúdo e validação da cartilha educativa por especialistas. Resultados com base na revisão integrativa de literatura, foram selecionados 91 artigos finais relacionados ao tema de advocacia em saúde e enfermagem e que subsidiaram a definição de quatro temas: Do sentido e elementos fundamentais para a prática de advocacia em enfermagem; Advocacia no ensino e o envolvimento de outros atores do cuidado; Advocacia como obrigação profissional, moral e ética; Advocacia com relação a grupos específicos da população. Os temas contribuíram para a construção dos conteúdos da cartilha educativa. Depois de realizar o envio e a validação por especialistas, foi possível definir a diagramação, dimensão, quantidade de páginas e o design final da cartilha educativa, que será impressa e distribuída aos profissionais e estudantes de enfermagem e disponibilizada online. Conclusões: a elaboração e validação da cartilha contribui para a construção de conhecimentos relacionados à prática profissional da equipe de enfermagem e o exercício da advocacia em saúde.
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Purtell R, Tam RP, Avondet E, Gradick K. We are part of the problem: the role of children's hospitals in addressing health inequity. Hosp Pract (1995) 2021; 49:445-455. [PMID: 35061953 DOI: 10.1080/21548331.2022.2032072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/17/2022] [Indexed: 06/14/2023]
Abstract
Racism is an ongoing public health crisis that undermines health equity for all children in hospitals across our nation. The presence and impact of institutionalized racism contributes to health inequity and is under described in the medical literature. In this review, we focus on key interdependent areas to foster inclusion, diversity, and equity in Children's Hospitals, including 1) promotion of workforce diversity 2) provision of anti-racist, equitable hospital patient care, and 3) prioritization of academic scholarship focused on health equity research, quality improvement, medical education, and advocacy. We discuss the implications for clinical and academic practice.Plain Language Summary: Racism in Children's Hospitals harms children. We as health-care providers and hospital systems are part of the problem. We reviewed the literature for the best ways to foster inclusion, diversity, and equity in hospitals. Hospitals can be leaders in improving child health equity by supporting a more diverse workforce, providing anti-racist patient care, and prioritizing health equity scholarship.
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Affiliation(s)
- Rebecca Purtell
- Assistant Professor of Pediatrics, Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Reena P Tam
- Assistant Professor of Pediatrics, Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Erin Avondet
- Assistant Professor of Pediatrics, Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Katie Gradick
- Assistant Professor of Pediatrics, Division of Pediatric Palliative Care, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Wihlborg M, Avery H. Global Health in Swedish Nursing Curricula: Navigating the Desirable and the Necessary. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9372. [PMID: 34501962 PMCID: PMC8431060 DOI: 10.3390/ijerph18179372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 11/16/2022]
Abstract
Global health challenges are likely to be aggravated in the coming years by rapid climate change and environmental degradation. To address the resulting health inequities, nurses need an integrated understanding of environmental and social determinants of health. This study adopts an explorative inductive approach to examine how global health and sustainability are expressed the course syllabi of undergraduate nursing programmes (n = 24) in Sweden. After excluding biomedical and other unrelated content, 67 syllabi were selected for a thematic analysis. Results indicate that global health, the social determinants of health and sustainability tend to appear in a fragmented manner in the syllabi. Global health content is often limited, relegated to elective courses, or altogether missing. A theoretical framework is lacking, and focus lies on an individual rather than structural perspective. Based on international policy, earlier studies on undergraduate nursing education and theoretical work, suggestions are made for how global health and sustainability content could be integrated into nursing education, notably by using a structural competency approach.
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Affiliation(s)
- Monne Wihlborg
- Department of Health Sciences, Integrative Health Research, Faculty of Medicine, Lund University, 22210 Lund, Sweden;
| | - Helen Avery
- Centre for Environmental and Climate Science (CEC), Faculty of Natural Sciences, Lund University, 22210 Lund, Sweden
- Centre for Advanced Middle Eastern Studies (CMES), Faculty of Social Sciences, Lund University, 22210 Lund, Sweden
- Department of Languages, Faculty of Arts and Humanities, Linnaeus University, 35195 Växjö, Sweden
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Dupin CM, Estaquio C, Nabi H. Theoretical conceptions of intervention research addressing cancer control issues. Health Promot Int 2021; 36:206-215. [PMID: 32243507 DOI: 10.1093/heapro/daaa032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Population health intervention research (PHIR) involves the use of scientific methods to produce knowledge about policy and program interventions that operate within or outside of the health sector and have the potential to impact health at the population level. PHIR is a relatively new research field that has gained momentum internationally. When developing PHIR, it is important to have a program theory with the potential to increase intervention success by identifying underlying mechanisms, areas of failure and unintended outcomes. Since 2010, the French National Cancer Institute (Institut National du Cancer-INCa) has supported a national, competitive, dedicated call for proposals in PHIR to tackle cancer control issues. After 5 years of activity, specific analysis of the proposals submitted for funding and/or funded (n = 63) from descriptive and analytic perspectives was called for. Analysis of the data revealed diversity in terms of targeted populations, partnerships engaged and methodological approaches. Projects were more likely to be funded (n = 15) if presented with a robust methodological approach and diversity in methodology, and/or with research objectives at different levels of action. The analysis also revealed that researchers do not explicitly describe theoretical constructs underpinning their interventions to combat cancer. PHIR still needs improvement to better incorporate social, institutional and policy approaches to cancer control. Researchers should apply a theory-driven approach to distinguish between 'program failure' and 'theory failure'. Following up the funded projects will allow successes and failures to be evaluated with respect to the use (or non-use) of theory-driven approaches.
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Affiliation(s)
- Cécile-Marie Dupin
- Department for Research in Social and Human Sciences, Public Health and Epidemiology, Institut National du Cancer, Boulogne-Billancourt F-92513, France.,Faculty of Medicine and Nursing Science, Aix Marseille Université, Marseille, F-13000, France
| | - Carla Estaquio
- Department for Research in Social and Human Sciences, Public Health and Epidemiology, Institut National du Cancer, Boulogne-Billancourt F-92513, France.,Strategic Evaluation and Impact Program, Institut National du Cancer, Boulogne-Billancourt F-92513, France
| | - Hermann Nabi
- Department for Research in Social and Human Sciences, Public Health and Epidemiology, Institut National du Cancer, Boulogne-Billancourt F-92513, France.,Axe Oncologie, Centre de Recherche du CHU de Québec, Québec, Canada.,Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval, Québec, Canada.,INSERM, Centre for Research in Epidemiology and Population Health, U1018, F-94807 Villejuif, France
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Laliberte S, Varcoe C. The benefits of a historical-dialectical ontology to critical mental health promotion research. Health Promot Int 2021; 36:262-273. [PMID: 32361754 DOI: 10.1093/heapro/daaa024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In this article, we explore challenges and opportunities in research oriented to understanding the relations among elements of socio-economic life and mental health (MH) and the development and evaluation of mental health promotion (HP) initiatives. We review the population health intervention research (PHIR) literature and respond to recommendations regarding social determinants of health and health inequities-focused research. We discuss three inter-related issue areas: first, the continued dominance of linear and individually oriented theories within predominantly quantitative research approaches and the underdevelopment of ontological and theoretical perspectives that capture complexity; second, the inconsistent use of measures of socio-economic status and health with a lack of attention to taken for granted assumptions; and third, the continued focus on measuring MH challenges to the neglect of exploring the meaning of MH in a positive sense. We extend recommendations within the PHIR literature by sharing our application of a historical-dialectical ontological perspective within a process of social praxis with diverse Canadian young people with varying degrees of access to socio-economic resources. Young people were engaged to explore the relations among socio-economic processes, young people's MH and implications for mental HP. We argue that this ontological perspective can support the development of structurally oriented critical qualitative research approaches in PHIR.
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Affiliation(s)
- Shari Laliberte
- School of Health Sciences, Vancouver Community College, 1155 East Broadway, Vancouver, BC Canada V5T 4V5
| | - Colleen Varcoe
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC Canada V6T 2B5
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Laari L, Duma SE. Facilitators of the health advocacy role practice of the nurse in Ghana: A qualitative study. Health Sci Rep 2021; 4:e220. [PMID: 33458254 PMCID: PMC7797165 DOI: 10.1002/hsr2.220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 10/04/2020] [Accepted: 11/10/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Identifying facilitators of health advocacy role practice of nurses is important in reducing health disparities and inequities in Ghana. The struggle to reducing these disparities and inequities needs a combination of bravery, courage, and professionalism. In many instances, many barriers hinder nurses from practicing their health advocacy role in Ghana. Facilitators that motivate nurses who would perform this health advocacy role have not been identified and adequately described in Ghana. AIM To explore and describe the facilitators of the health advocacy role of nurses in Ghana. METHODS This qualitative study used Strauss and Corbin's grounded theory approach to collect and analyze data from 2018 to 2019 in three regions in Ghana. Semistructured interviews (n = 24) and field notes were used to collect data. RESULTS Professional influence emerged as a core category among other three facilitators that motivate nurses to perform the health advocacy role. The other three are clientele influence, intrinsic influence, and cultural influence. CONCLUSIONS Facilitators to the health advocacy role practice of nurses are multidimensional and hidden. In this respect, educating hospital managers on these facilitators should be done through workshops and seminars to enhance the managers' strategies of motivating nurses to advocate for the less privileged and the disadvantaged of the society.
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Affiliation(s)
- Luke Laari
- Department of Nursing and MidwiferyPresbyterian Nursing and Midwifery Training CollegeBawkuGhana
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Neves FBD, Vargas MADO, Zilli F, Trentin D, Huhn A, Brehmer LCDF. Advocacia em saúde na enfermagem oncológica: revisão integrativa da literatura. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Identificar a produção científica acerca do tema advocacia do paciente por enfermeiros no contexto da oncologia. Método revisão integrativa com busca e seleção dos estudos primários realizadas em fevereiro de 2020 em quatro bases de dados relevantes na área da saúde: Lilacs, SciELO, Cochrane e PubMed. A amostra foi composta por 11 estudos de um universo de 395 artigos. Os 11 estudos foram agrupados em duas categorias. Resultados A partir da síntese das evidências foi possível elaborar as categorias conforme as temáticas mais abordadas, são elas: “Situações vivenciadas pelos pacientes e enfermeiros em que é necessária a advocacy” e “Estratégias que aprimoram o exercício de advocacy” que foi subdividida em três subcategorias: Self-advocacy; Sistemas de apoio e advocacy para os pacientes; Comunicação centrada no paciente (CCP) e Tomada de decisão compartilhada (TDC). Conclusões e implicações para a prática A importância do exercício de advocacy pelos enfermeiros em oncologia é evidente nos estudos, pautando-se na necessidade da comunicação, educação, apoio e reconhecimento da necessidade para intervir quando necessário, considerando a ética como guia para auxiliar na tomada de decisões, reforçando a necessidade de reflexões sobre a temática fortalecendo e embasando tecnicamente a prática profissional.
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Affiliation(s)
| | | | | | | | - Andréa Huhn
- Instituto Federal de Educação Ciências e Tecnologia de Santa Catarina, Brasil
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Jones D, Randall S, White D, Darley LM, Schaefer G, Wellington J, Thomas A, Lyle D. Embedding public health advocacy into the role of school-based nurses: addressing the health inequities confronted by vulnerable Australian children and adolescent populations. Aust J Prim Health 2020; 27:67-70. [PMID: 33264584 DOI: 10.1071/py20155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022]
Abstract
There has been a growth in Australian school-based nurses to address the inequities confronted by vulnerable students and school populations. Failure to address inequities can be evidenced in intergenerational poverty, poorer health and educational attainment and diminished life opportunities. School-based nurses are ideally located to advocate for public health policies and programs that address social determinants that detrimentally affect the health of school populations. However, school-based nurses can confront professional and speciality challenges in extending their efforts beyond individual student advocacy to effect change at the school population level. Guidance is required to redress this situation. This paper describes public health advocacy, the professional and speciality advocacy roles of school-based nurses and the barriers they confront in advocating for the health of school populations and strategies that can be used by key stakeholders to enhance school-based nursing public health advocacy efforts. School-based nurses who are competent, enabled and supported public health advocates are required if we are to achieve substantial and sustained health equity and social justice outcomes for vulnerable school populations.
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Affiliation(s)
- Debra Jones
- Broken Hill University Department of Rural Health, The University of Sydney, PO Box 457, Broken Hill, NSW 2880, Australia; and Corresponding author
| | - Sue Randall
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, The University of Sydney, Room A5.23, Building M02, 88 Mallett Street, Camperdown, NSW 2050, Australia
| | - Danielle White
- Broken Hill University Department of Rural Health, The University of Sydney, PO Box 457, Broken Hill, NSW 2880, Australia
| | - Lisa-Marie Darley
- Far West Local Health District, PO Box 457, Broken Hill, NSW 2880, Australia
| | - Gabrielle Schaefer
- Far West Local Health District, PO Box 457, Broken Hill, NSW 2880, Australia
| | - Jennifer Wellington
- Far West Local Health District, PO Box 457, Broken Hill, NSW 2880, Australia
| | - Anu Thomas
- Far West Local Health District, PO Box 457, Broken Hill, NSW 2880, Australia
| | - David Lyle
- Broken Hill University Department of Rural Health, The University of Sydney, PO Box 457, Broken Hill, NSW 2880, Australia
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Miranda DE, Gutiérrez-Martínez A, Vizarraga Trigueros E, Albar-Marín MJ. [Training for Roma health advocacy: a case study of Torreblanca, Seville]. GACETA SANITARIA 2020; 36:118-126. [PMID: 33234337 DOI: 10.1016/j.gaceta.2020.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/23/2020] [Accepted: 09/05/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The objective of this study is to build advocacy capacity among a group of gipsy Roma neighbours living in contexts of risk of social exclusion. METHODS A Community Based Participatory Action Research design was used, in which 4 members of the community participated in the process of collecting evidence by photo-voice, analysing it using the ReACT method and disseminating the results. RESULTS A total of 96 pieces of evidence were collected and analysed for qualitative data analysis. These were categorised according to (a) the type of unhealthy conditions and (b) the area of the neighbourhood where they were located. The subsequent thematic grouping made it possible to identify the causes: (a) the abandonment of public services; (b) discrimination; and (c) the lack of Roma presence in community spaces. The consequences identified were (a) mental and physical health problems and (b) the normalisation of undignified living conditions. The plan was designed to advocate for the presence of Roma in community spaces. CONCLUSIONS Our study highlighted the relevance of the photo-voice to transcend the biomedical perspective and develop advocacy actions based on the knowledge created by the community. Future research should look more deeply into the impact of health advocacy on reducing inequalities and consider the importance of involving researchers, public health professionals and the community in addressing it.
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Affiliation(s)
- Daniela E Miranda
- Departamento de Psicología Social, Facultad de Psicología, Universidad de Sevilla, Sevilla, España.
| | - Ana Gutiérrez-Martínez
- Departamento de Psicología Social, Facultad de Psicología, Universidad de Sevilla, Sevilla, España
| | | | - María J Albar-Marín
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, España
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Mah CL, Knox B, Lynch M, McIntyre L. Who Is Food Insecure? Political Storytelling on Hunger, Household Food Choices, and the Construction of Archetypal Populations. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2020.1807434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Catherine L. Mah
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Bruce Knox
- Recreation Division, Community Services Department, City of St. John’s, NL, Canada
| | - Meghan Lynch
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lynn McIntyre
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Ortiz K, Nash J, Shea L, Oetzel J, Garoutte J, Sanchez-Youngman S, Wallerstein N. Partnerships, Processes, and Outcomes: A Health Equity-Focused Scoping Meta-Review of Community-Engaged Scholarship. Annu Rev Public Health 2020; 41:177-199. [PMID: 31922931 PMCID: PMC8095013 DOI: 10.1146/annurev-publhealth-040119-094220] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In recent decades, there has been remarkable growth in scholarship examining the usefulness of community-engaged research (CEnR) and community-based participatory research (CBPR) for eliminating health inequities.This article seeks to synthesize the extant literature of systematic reviews, scoping reviews, and other related reviews regarding the context, processes, and research designs and interventions underlying CEnR that optimize its effectiveness. Through a scoping review, we have utilized an empirically derived framework of CBPR to map this literature and identify key findings and priorities for future research. Our study found 100 reviews of CEnR that largely support the CBPR conceptual framework.
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Affiliation(s)
- Kasim Ortiz
- Department of Sociology and Criminology, University of New Mexico, Albuquerque, New Mexico 87131, USA;
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
- Institute for the Study of "Race" and Social Justice, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Jacob Nash
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Logan Shea
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - John Oetzel
- Waikato Management School, University of Waikato, 3240 Hamilton, New Zealand
| | - Justin Garoutte
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
- Behavioral Health Research Center of the Southwest (BHRCS), Pacific Institute for Research and Evaluation (PIRE), Albuquerque, New Mexico 87106, USA
| | - Shannon Sanchez-Youngman
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
- Center for Social Policy, University of New Mexico, Albuquerque, New Mexico 87131, USA
- School of Public Administration, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Nina Wallerstein
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
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Plamondon KM, Caxaj CS, Graham ID, Bottorff JL. Connecting knowledge with action for health equity: a critical interpretive synthesis of promising practices. Int J Equity Health 2019; 18:202. [PMID: 31878940 PMCID: PMC6933619 DOI: 10.1186/s12939-019-1108-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 12/10/2019] [Indexed: 11/12/2022] Open
Abstract
Connecting knowledge with action (KWA) for health equity involves interventions that can redistribute power and resources at local, national, and global levels. Although there is ample and compelling evidence on the nature, distribution, and impact of health inequities, advancing health equity is inhibited by policy arenas shaped by colonial legacies and neoliberal ideology. Effective progress toward health equity requires attention to evidence that can promote the kind of socio-political restructuring needed to address root causes of health inequities. In this critical interpretive synthesis, results of a recent scoping review were broadened to identify evidence-informed promising practices for KWA for health equity. Following screening procedures, 10 literature reviews and 22 research studies were included in the synthesis. Analysis involved repeated readings of these 32 articles to extract descriptive data, assess clarity and quality, and identify promising practices. Four distinct kinds of promising practices for connecting KWA for health equity were identified and included: ways of structuring systems, ways of working together, and ways of doing research and ways of doing knowledge translation. Our synthesis reveals that advancing health equity requires greater awareness, dialogue, and action that aligns with the what is known about the causes of health inequities. By critically reflecting on dominant discourses and assumptions, and mobilizing political will from a more informed and transparent democratic exercise, knowledge to action for health equity can be achieved.
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Affiliation(s)
- Katrina M Plamondon
- School of Nursing, The University of British Columbia, 1147 Research Rd., ART 360, Kelowna, BC, V1V 1V7, Canada.
| | | | - Ian D Graham
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Canada
| | - Joan L Bottorff
- School of Nursing, The University of British Columbia, 1147 Research Rd., ART 360, Kelowna, BC, V1V 1V7, Canada
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30
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Albar Marín MJ, Miranda DE. [Advocacy for Roma health: in-service training of professionals from the Seville Health District]. GACETA SANITARIA 2019; 34:411-414. [PMID: 31767201 DOI: 10.1016/j.gaceta.2019.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/14/2019] [Accepted: 07/15/2019] [Indexed: 10/25/2022]
Abstract
This article describes a workshop whose objective was to build Roma health advocacy capacity among a group of health professionals. Health advocacy is recommended by international organizations and public health experts to overcome the health inequities that Roma populations suffer. Sixteen professionals from three health centres located in neighbourhoods with a high Roma population participated. The workshop was organized in three sessions aimed at raising awareness, sharing an advocacy framework and methodology and designing an advocacy plan. We highlight the utility of spaces for reflection and analysis, the need to advocate for Roma health with Roma leaders and community sectors, identification of opportunities and utilization of community resources. Future research should strengthen the development of intersectoral advocacy plans, disseminate them and facilitate their implementation in other contexts with similar characteristics.
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Affiliation(s)
- María Jesús Albar Marín
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, España.
| | - Daniela E Miranda
- Departamento de Psicología Social, Universidad de Sevilla, Sevilla, España
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31
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David JL, Thomas SL, Randle M, Daube M. A public health advocacy approach for preventing and reducing gambling related harm. Aust N Z J Public Health 2019; 44:14-19. [PMID: 31777133 DOI: 10.1111/1753-6405.12949] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 09/01/2019] [Accepted: 09/01/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To develop a framework to guide the application of public health advocacy strategies aimed at preventing and reducing gambling-related harm. METHODS A narrative review of theories of change and public health advocacy literature. RESULTS An eight-step public health advocacy framework was created, which outlines the critical steps and considerations when developing and implementing successful change efforts. Implications for public health: To date, a clear public health advocacy approach to gambling harm prevention and reduction has not been well established. This study proposes a gambling-specific framework to guide future public health advocacy efforts to prevent and reduce gambling harm.
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Affiliation(s)
- Jennifer L David
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Victoria
| | - Samantha L Thomas
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Victoria
| | - Melanie Randle
- School of Management, Operations and Marketing, Faculty of Business, University of Wollongong, New South Wales
| | - Mike Daube
- Faculty of Health Sciences, Curtin University, Western Australia
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32
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Rideout K, Oickle D. Glossary of health equity in the context of environmental public health practice. J Epidemiol Community Health 2019; 73:806-809. [PMID: 31171580 DOI: 10.1136/jech-2018-210843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 02/21/2019] [Accepted: 05/23/2019] [Indexed: 11/04/2022]
Abstract
Health equity is increasingly present as an overarching goal in public health policy frameworks across the globe. Public health actions to support health equity are challenging because solutions to the root causes of health inequities often lie outside of the health sector, and a specific role for environmental public health practitioners has not been clearly articulated. The regulatory nature of the environmental public health profession means that their role is particularly ambiguous. Still, environmental public health practitioners are well situated to identify and respond to factors that contribute to health inequities because of their role as front-line professionals who interact with a wide cross-sector of the population. This Glossary, rooted primarily in the Canadian context but drawing on lessons from elsewhere, describes environmental public health regulatory practice in relation to health equity, including approaches that practitioners can use to contribute to addressing the social determinants of health.
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Affiliation(s)
- Karen Rideout
- Karen Rideout Consulting, Vancouver, British Columbia, Canada.,National Collaborating Centre for Environmental Health (NCCEH), Vancouver, British Columbia, Canada.,Environmental Health Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Dianne Oickle
- National Collaborating Centre for Determinants of Health (NCCDH), Antigonish, Nova Scotia, Canada
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33
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Buckton CH, Fergie G, Leifeld P, Hilton S. A discourse network analysis of UK newspaper coverage of the "sugar tax" debate before and after the announcement of the Soft Drinks Industry Levy. BMC Public Health 2019; 19:490. [PMID: 31046718 PMCID: PMC6498658 DOI: 10.1186/s12889-019-6799-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 04/11/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND On 6th April 2018, the UK Government introduced the Soft Drinks Industry Levy (SDIL) as a mechanism designed to address increasing prevalence of obesity and associated ill health by reducing sugar consumption. Given that the successful introduction of upstream food and nutrition policies is a highly political enterprise involving multiple interested parties, understanding the complex network of stakeholders seeking to influence such policy decisions is imperative. METHODS Media content analysis was used to build a dataset of relevant newspaper articles, which were analysed to identify stakeholder agreement or disagreement with defined concept statements. We used discourse network analysis to produce visual representations of the network of stakeholders and coalitions evident in the debate as it was presented in UK newspapers, in the lead up to and following the announcement of the Soft Drinks Industry Levy in the UK, from May 2015 to November 2016. RESULTS Coding identified 3883 statements made by 214 individuals from 176 organisations, relating to 47 concepts. Network visualisations revealed a complex network of stakeholders with clear sceptical and supportive coalitions. Industry stakeholders appeared less united in the network than anticipated, particularly before the SDIL announcement. Some key industry actors appeared in the supportive coalition, possibly due to the use of corporate social responsibility rhetoric. Jamie Oliver appeared as a dominant stakeholder, firmly embedded with public health advocates. CONCLUSION This study highlights the complexity of the network of stakeholders involved in the public debate on food policies such as sugar tax and the SDIL. Polarisation of stakeholders arose from differences in ideology, focus on a specific policy and statements about the weight of evidence. Vocal celebrity policy entrepreneurs may be instrumental in gaining public and policy makers' support for future upstream regulation to promote population health, to facilitate alignment around a clear ideology.
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Affiliation(s)
- Christina H. Buckton
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3AX UK
| | - Gillian Fergie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3AX UK
| | - Philip Leifeld
- Department of Government, University of Essex, Colchester Campus, Colchester, CO4 3SQ UK
- School of Social and Political Sciences, University of Glasgow, University Avenue, Glasgow, G12 8QQ UK
| | - Shona Hilton
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3AX UK
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34
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Plamondon KM, Pemberton J. Blending integrated knowledge translation with global health governance: an approach for advancing action on a wicked problem. Health Res Policy Syst 2019; 17:24. [PMID: 30832660 PMCID: PMC6399857 DOI: 10.1186/s12961-019-0424-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 02/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The persistence of health inequities is a wicked problem for which there is strong evidence of causal roots in the maldistribution of power, resources and money within and between countries. Though the evidence is clear, the solutions are far from straightforward. Integrated knowledge translation (IKT) ought to be well suited for designing evidence-informed solutions, yet current frameworks are limited in their capacity to navigate complexity. Global health governance (GHG) also ought to be well suited to advance action, but a lack of accountability, inclusion and integration of evidence gives rise to politically driven action. Recognising a persistent struggle for meaningful action, we invite contemplation about how blending IKT with GHG could leverage the strengths of both processes to advance health equity. DISCUSSION Action on root causes of health inequities implicates disruption of structures and systems that shape how society is organised. This infinitely complex work demands sophisticated examination of drivers and disrupters of inequities and a vast imagination for who (and what) should be engaged. Yet, underlying tendencies toward reductionism seem to drive superficial responses. Where IKT models lack consideration of issues of power and provide little direction for how to support cohesive efforts toward a common goal, recent calls from the field of GHG may provide insight into these issues. Additionally, though GHG is criticised for its lack of attention to using evidence, IKT offers approaches and strategies for collaborative processes of generating and refining knowledge. Contemplating the inclusion of governance in IKT requires re-examining roles, responsibilities, power and voice in processes of connecting knowledge with action. We argue for expanding IKT models to include GHG as a means of considering the complexity of issues and opening new possibilities for evidence-informed action on wicked problems. CONCLUSION Integrated learning between these two fields, adopting principles of GHG alongside the strategies of IKT, is a promising opportunity to strengthen leadership for health equity action.
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Affiliation(s)
- Katrina Marie Plamondon
- University of British Columbia, 3333 University Way, Kelowna, BC Canada
- Interior Health, 505 Doyle Avenue, Kelowna, BC Canada
| | - Julia Pemberton
- McMaster University, 1280 Main Street West, Hamilton, ON Canada
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35
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Oickle D, Clement C. Glossary of health equity concepts for public health action in the Canadian context. J Epidemiol Community Health 2019; 73:802-805. [PMID: 30765491 DOI: 10.1136/jech-2018-210851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 12/04/2018] [Accepted: 01/22/2019] [Indexed: 11/04/2022]
Abstract
Despite increased interest in addressing health equity through public health initiatives, practitioner and decision maker comprehension of core concepts is limited and inconsistent. Absence of a shared understanding of equity and related terminology contributes to lack of coordinated solutions as practitioners focus on individual level issues, unrelated to social justice. Taking action to decrease population health inequities requires a comprehension of where inequities are rooted, who is affected and interventions that consider the complexity of inequities being addressed. Public health decision making would be strengthened with greater common understanding of health equity concepts and terminology as an initial step to collaborative action. This glossary defines key concepts related to health equity in public health practice as well as broad-level approaches for taking action on health inequities at a population health level. Exploring terminology in this way supports going beyond individual practitioner responsibility and shifts towards organisational accountability for action.
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Affiliation(s)
- Dianne Oickle
- National Collaborating Centre for Determinants of Health, Antigonish, Nova Scotia, Canada
| | - Connie Clement
- National Collaborating Centre for Determinants of Health, Antigonish, Nova Scotia, Canada
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36
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Power E, Belyea S, Collins P. "It's not a food issue; it's an income issue": using Nutritious Food Basket costing for health equity advocacy. Canadian Journal of Public Health 2019; 110:294-302. [PMID: 30734246 DOI: 10.17269/s41997-019-00185-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 01/20/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Ontario's public health units (PHUs) face considerable challenges in addressing the social determinants of health, even though "reducing health inequities" is a primary population health outcome in the Ontario Public Health Standards (OPHS). Since 1998, the OPHS mandated PHUs to use the Nutritious Food Basket (NFB) protocol to document food costs, a requirement that was removed in 2018. This study examined how the NFB advanced health equity advocacy by Ontario PHUs, and why some have used this tool more strategically than others. METHODS Semi-structured qualitative phone interviews were conducted with 18 public health dietitians (PHDs) and three key informants between May and October 2017. Interviews were audio-recorded, transcribed, inductively coded, and analyzed. RESULTS The PHDs agreed that the NFB tool provides essential localized evidence of inadequate incomes for people living in poverty, and supports the health equity mandate of PHUs in Ontario. Factors that support NFB research and advocacy work include strong PHU leadership regarding health equity, participation in community coalitions, and engagement with Ontario Dietitians in Public Health (ODPH). Interviewees identified lack of support at the PHU level and lack of coordination of food insecurity work at the Ministry of Health as significant barriers to PHUs' use of the NFB to advance health equity mandates. CONCLUSION This study offers compelling evidence for reinstating NFB costing in the Ontario Public Health Standards as a mandatory requirement of PHUs. Without this requirement, the already-limited capacity of PHUs to advance health equity in Ontario will be further compromised.
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Affiliation(s)
- Elaine Power
- School of Kinesiology & Health Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada.
| | - Susan Belyea
- School of Kinesiology & Health Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Patricia Collins
- Department of Geography and Planning, Queen's University, Kingston, Ontario, K7L 3N6, Canada
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37
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Glandon D, Meghani A, Jessani N, Qiu M, Bennett S. Identifying health policy and systems research priorities on multisectoral collaboration for health in low-income and middle-income countries. BMJ Glob Health 2018; 3:e000970. [PMID: 30364329 PMCID: PMC6195136 DOI: 10.1136/bmjgh-2018-000970] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 02/06/2023] Open
Abstract
Introduction While efforts to achieve Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) have reinvigorated interest in multisectoral collaborations (MSCs) among the global health and development community, there remains a plethora of questions about how best to conceptualise, plan, implement, evaluate and sustain MSCs. The objective of this paper is to present research priorities on MSC for health from researchers and policymakers around the globe, with an emphasis on low-income and middle-income countries. Methods The authors identified 30 priority research questions from two sources: (1) 38 review articles on MSC for health, and (2) interviews and focus groups with a total of 81 policymakers, including government officials (largely from ministries of health and state/provincial departments of health, but also offices of planning, public service, social development, the prime minister and others), large multilateral or bilateral organisations, and non-governmental organisations. In a third phase, questions were refined and ranked by a diverse group of researchers from around the globe using an online voting platform. Results The top-ranked questions focused predominantly on pragmatic questions, such as how best to structure, implement and sustain MSCs, as well as how to build stakeholder capacity and community partnerships. Despite substantial variation between review articles, policymakers’ reflections and online ranking by researchers, two topics emerged as research priorities for all three: (1) leadership, partnership and governance structures for MSCs; and (2) MSC implementation strategies and mechanisms. The review articles underscored the need for more guidance on appropriate study designs and methods for investigating MSCs, which may be a prerequisite for other identified research priorities. Conclusion These findings could inform efforts within and beyond the health sector to better align research objectives and funding with the evidence needs of policymakers grappling with questions about how best to leverage MSCs to achieve UHC and the SDGs.
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Affiliation(s)
- Douglas Glandon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ankita Meghani
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nasreen Jessani
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mary Qiu
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sara Bennett
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Blenner SR, Lang CM, Prelip ML. Shifting the Culture Around Public Health Advocacy: Training Future Public Health Professionals to Be Effective Agents of Change. Health Promot Pract 2017; 18:785-788. [DOI: 10.1177/1524839917726764] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is a critical need to build the capacity of our current and future public health workforce and the communities we serve to engage in public health advocacy. Advocacy should be an integral piece of our intervention strategies and public health discourse. Incorporating public health advocacy into public health training, practice, and research serves as a long-term investment for the public’s health. Advocacy can achieve systemic change by addressing the social determinants of health. We developed an advocacy training program that embeds students in community-based organizations (CBOs) for 9 months, providing students with experiential education through the application of advocacy skills and CBOs with opportunities to expand and broaden their advocacy efforts. We have three priority populations: graduate students, CBOs serving Los Angeles County, and the broader Los Angeles County community, focusing on vulnerable populations. Our multifaceted approach addresses the necessity of public health advocacy among the health professions. Through changing how we train students and how communities and universities collaborate, we can strengthen the public health workforce and build healthier communities.
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Affiliation(s)
| | - Cathy M. Lang
- UCLA Fielding School of Public Health, Los Angeles, CA, USA
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Buck-McFadyen E, MacDonnell J. Contested Practice: Political Activism in Nursing and Implications for Nursing Education. Int J Nurs Educ Scholarsh 2017; 14:/j/ijnes.2017.14.issue-1/ijnes-2016-0026/ijnes-2016-0026.xml. [PMID: 28749781 DOI: 10.1515/ijnes-2016-0026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 07/09/2017] [Indexed: 11/15/2022]
Abstract
Canadian nurses have a social mandate to address health inequities for the populations they serve, as well as to speak out on professional and broader social issues. Although Canadian nursing education supports the role of nurses as advocates for social justice and leadership for health care reform, little is known about how nurse educators understand activism and how this translates in the classroom. A comparative life history study using purposeful sampling and a critical feminist lens was undertaken to explore political activism in nursing and how nurse educators foster political practice among their students. Findings from interviews and focus groups with 26 Ontario nurse educators and nursing students suggested that neoliberal dynamics in both the practice setting and in higher education have constrained nurses' activist practice and favour a technical rational approach to nursing education. Implications and strategies to inspire political action in nursing education are discussed.
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Cairney P, Oliver K. Evidence-based policymaking is not like evidence-based medicine, so how far should you go to bridge the divide between evidence and policy? Health Res Policy Syst 2017; 15:35. [PMID: 28446185 PMCID: PMC5407004 DOI: 10.1186/s12961-017-0192-x] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 03/12/2017] [Indexed: 11/10/2022] Open
Abstract
There is extensive health and public health literature on the ‘evidence-policy gap’, exploring the frustrating experiences of scientists trying to secure a response to the problems and solutions they raise and identifying the need for better evidence to reduce policymaker uncertainty. We offer a new perspective by using policy theory to propose research with greater impact, identifying the need to use persuasion to reduce ambiguity, and to adapt to multi-level policymaking systems. We identify insights from secondary data, namely systematic reviews, critical analysis and policy theories relevant to evidence-based policymaking. The studies are drawn primarily from countries such as the United States, United Kingdom, Canada, Australia and New Zealand. We combine empirical and normative elements to identify the ways in which scientists can, do and could influence policy. We identify two important dilemmas, for scientists and researchers, that arise from our initial advice. First, effective actors combine evidence with manipulative emotional appeals to influence the policy agenda – should scientists do the same, or would the reputational costs outweigh the policy benefits? Second, when adapting to multi-level policymaking, should scientists prioritise ‘evidence-based’ policymaking above other factors? The latter includes governance principles such the ‘co-production’ of policy between local public bodies, interest groups and service users. This process may be based primarily on values and involve actors with no commitment to a hierarchy of evidence. We conclude that successful engagement in ‘evidence-based policymaking’ requires pragmatism, combining scientific evidence with governance principles, and persuasion to translate complex evidence into simple stories. To maximise the use of scientific evidence in health and public health policy, researchers should recognise the tendency of policymakers to base judgements on their beliefs, and shortcuts based on their emotions and familiarity with information; learn ‘where the action is’, and be prepared to engage in long-term strategies to be able to influence policy; and, in both cases, decide how far you are willing to go to persuade policymakers to act and secure a hierarchy of evidence underpinning policy. These are value-driven and political, not just ‘evidence-based’, choices.
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Affiliation(s)
- Paul Cairney
- Politics and Public Policy at the University of Stirling, Stirling, United Kingdom. .,Division of History and Politics, University of Stirling, Stirling, FK9 4LA, United Kingdom.
| | - Kathryn Oliver
- Departmental Lecturer in Evidence-Based Social Intervention and Policy Evaluation, Oxford University, Oxford, United Kingdom.,Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
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Cepanec D, Humphries A, Rieger KL, Marshall S, Londono Y, Clarke D. Building Graduate Student Capacity as Future Researchers Through a Research and Training Award Program. J Nurs Educ 2016; 55:284-7. [PMID: 27115456 DOI: 10.3928/01484834-20160414-08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 02/19/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND With the global shortage of doctor of philosophy-prepared nursing faculty and an aging nursing professorate, the nursing profession is at risk of having fewer nurses doing research and fewer faculty to supervise the next generation of nurse researchers. METHOD A research training award for graduate nursing students was piloted with the intent of providing a research-intensive experiential learning opportunity that would contribute to graduate students' future roles as nurse researchers. This article describes the program design, implementation, and evaluation. FINDINGS The Graduate Student Research Training Awards afforded students an opportunity to develop research and methodologic skills and achieve student-centered outcomes. These awards build their capacity as future researchers by both empowering them and increasing their confidence in research. The input and evaluation from graduate students was integral to the success of the program. CONCLUSION Graduate student research training awards can be a valuable experiential learning opportunity in research intensive graduate programs. [J Nurs Educ. 2016;55(5):284-287.].
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