Developing Advocacy Programs for Adults and/or Youth Presentation for APHA CEI Workshop #2019 November 5, 2006 Caroline H. Sparks, Ph.D., Associate Professor of Prevention and Community Health, School of Public Health and Health Services, The George Washington University 2175 K St. NW, Washington DC

Advocacy in Public Health Since public health is population-based, our solutions must also be population-based; The greatest public health advances have generally been environmental change for the public’s health; Advocacy interventions remind us that prevention requires broad social and environmental change.

SOCIAL ACTION Improving public health on a population basis requires social and environmental change for the public’s benefit; Even a small number of community advocates can create change;

ROLE OF HEALTH PROMOTERS The public health professional’s role is one of being a CHANGE AGENT in the community rather than a service provider; To act as a consultant to those in the community who seek change; To work with the “have nots” to assist them in creating change.

DEFINITIONS OF ADVOCACY “Organized social action to improve social conditions” – Larry Wallack For advocacy programs, we used a simple definition: TO ACT TO PERSUADE OTHERS TO SUPPORT A CAUSE e.g. For tobacco control – to act to persuade others to support a smoke free environment

Advocacy prepares adults and/or youth to be responsible citizens by teaching skills for creating change - in our case, change that improves public health.

How Advocacy Works Citizen action is based on the idea that, in a democracy, the will of the people counts. People have the right to influence public policies and decisions. All advocacy programs employ change strategies that rely upon widespread community support for the change Community coalitions and media advocates work together to create POLICY CHANGE and changes in SOCIAL NORMS;

Advocacy Steps STEP 1: Needs assessment Just as in individual or small group interventions, before we begin a social action campaign, we assess the need for change; Assessing need is identifying the gap between the current situation and an ideal situation; Example: workplace exposure to tobacco smoke vs workplaces free of second-hand smoke.

Needs Assessment ( Con’t.) Advocacy programs must be built on data and a clear analysis of an issue. Sources of data include: REPORTS SURVEYS OBSERVATIONS PREVALENCE STUDIES

Developing action plans STEP 2: Develop an Action Plan Advocacy programs need clear goals and specific objectives; What is the desired health status change? What are the campaign (program) objectives – e.g. what norms, policies, or behaviors must be altered?

Develop Strategies &Tactics Remember that strategies are broad ways to achieve your health status objective while tactics are actions that achieve each of your program objectives. E.g. Goal: Tobacco free environment in your town Strategy: Smoke-free coalition advocates for clean air Objective 1: Clean air policy in local schools Tactic 1: Approach each school principal about adopting clean air policy in school Tactic 2: Testify for clean air policy at school board meeting

Decide what resources you need What resources would help in your campaign? Do you need a coalition? Who are your likely allies? Who are your likely opponents? Do you need a media campaign? How will you frame your position?

Developing Skills What skills will the members of your action group need to develop or who already has skills to carry out the action plan? Develop a plan that fits your group but that also encourages people to develop leadership skills. E.g. to plan meetings? to make speeches? to develop a persuasive argument? to write letters to editors? to approach decision-makers? to plan and carry out direct actions? Create ways for people to practice skills

COMMUNITY ACTION STRATEGIES “If you don’t have power through money, you must amass people (sic)…” Saul Alinsky Community action strategies: – Use the power of the people; – Rely upon people’s experiences; – Recognize that change must be based on self interest; – Use power tactics to create social change.

Implement Campaign STEP 3: Take action Once you have an action plan, set a date for your first action. Try to make it a quick win. Remember Alinsky’s motto: “ If you aren’t having fun, change your tactic.”

Community Coalitions Coalitions are usually groups of organizations and individuals who come together around a shared interest to work for change; Social action teams can work on specific issues; In schools, teams of students and faculty can plan advocacy actions toward an identified goal. E.g. Smoke free school grounds

MEDIA ADVOCACY “Creates shifts in public opinion…and policy” Larry Wallack USES THE POWER OF THE NEWS FOR CHANGE THE MEDIA IS TODAY’S PUBLIC FORUM FOR DEBATING ISSUES THAT WILL HAVE AN EFFECT ON POLICY CHANGE MEDIA ADVOCACY IS ONLY A TOOL TO SUPPORT PUBLIC HEALTH POLICY INITIATIVES

MEDIA ADVOCACY SKILLS Agenda setting – influencing the gate keeping function of the press. Making your issue salient to press people so they give it more coverage; Priming – Using the power of the media to influence what people think about an issue; Framing – Shaping the way that people perceive an issue or event. Influencing the press to cover an event from your point of view.

Evaluate Your Success STEP 4: How will you assess your success? Create measures for success prior to taking action. Consider your assessment part of enforcing (monitoring) change. E.g. Did local restaurants adopt a free air policy? What evidence indicates they are following the new policy? Are there measures that monitor progress? Are there measures that monitor health change- e.g. fewer restaurant workers with smoking related illnesses over time?

Build on Lessons Learned Evaluating success includes: –Increased confidence (self-efficacy) among group members; – Increased advocacy skills; – Partial success if not full success of actions; – Assessing lessons learned from success and failure; –Perseverance and determination; –Regrouping for another action; –CELEBRATING CHANGE!!