To be an effective advocate and to develop a successful health advocacy campaign, you must have a clear idea of the goals of your campaign program and be able to communicate those goals to others. In addition, it is the nature of nurses to want to help, but it is important to make sure that the vision you develop is manageable in size and scope. By researching what others have done, you will better appreciate what can realistically be accomplished. It is also wise to determine if others have similar goals and to work with these people to form strategic partnerships. If you begin your planning with a strong idea of your resources, assets, and capabilities, you will be much more likely to succeed and truly make a difference with those you hope to help.
To prepare:
�Select a population health issue of interest to you and identify the population affected by the issue.
�Locate two scholarly articles, each of which provides a description of an effective health advocacy program that addresses your issue.
�Analyze the attributes of the programs to determine what made them effective.
�Reflect on a policy you could propose or a change to a current policy to further improve the health of the population you selected with regard to the issue.
�Consider how you could develop an advocacy program, applying the attributes identified in similar, effective programs.
To complete:
For this section of your paper (approximately 3–4 pages in length) address the following:
�Describe your selected population health issue and the population affected by this issue.
�Summarize the advocacy programs you researched in this area.
�Explain the attributes that made those programs effective.
�Develop a plan for a health advocacy campaign that seeks to create a new policy or change an existing policy with regard to the issue and population you selected. Be sure to include in your plan:
A description of the public health issue and proposed policy solution
Specific objectives for the policy you want to be implemented
The means by which you will convey information to various stakeholders on the need for this policy change
Be sure your proposed need is substantiated by data and evidence.
Methods of establishing support for the policy, including how to influence policymakers
�Explain how the attributes of the effective advocacy programs you researched could be applied to your proposed advocacy campaign.
To prepare:
�Review Chapter 3 of Health Policy and Politics: A Nurse’s Guide (3rd ed.) to determine methods of influencing the political process.
�Reflect on whether the policy you would like to promote could best be achieved through the development of new legislation, or a change in an existing law or regulation.
�Contemplate in what ways existing laws or regulations may impact how you proceed in advocating for your proposed policy.
�Consider how you could influence legislators or other policymakers to enact the policy you would like to propose.
�Think about the obstacles of the legislative process that may prevent your proposed policy from being implemented as intended.
To complete:
For this section of your paper (approximately 3–4 pages in length) address the following:
�Explain whether your proposed policy could be enacted through a modification of existing law or regulation or the creation of new legislation/regulation.
�Explain how existing laws or regulations could impact your advocacy efforts.
�Provide an analysis of the methods you could use to influence legislators or other policymakers to support your policy. In particular, explain how you would use the “three legs” of lobbying in your advocacy efforts.
�Summarize the obstacles you anticipate arising in the legislative process and how you could overcome these hurdles.
To prepare for this final portion of your paper:
�Review provisions 7, 8, and 9 of the ANA Code of Ethics in relation to advocacy for population health.
�Reflect on the ethical considerations you may need to take into account in your advocacy campaign.
�Research the ethical considerations, laws, and reporting requirements (with respect to lobbying) that are relevant to the location where your advocacy campaign will occur.
�Consider potential ethical dilemmas you might face in your campaign.
To complete:
For this section of your paper (approximately 3–4 pages in length), address the following:
�Explain any ethical dilemmas that could arise during your advocacy campaign, and how you would resolve them.
�Describe the ethics laws and reporting requirements that are applicable to your advocacy campaign.
�Evaluate the special ethical challenges that are unique to the population you are addressing.
Developing a Health Advocacy Campaign
Section 1
The selected population health issue is rising childhood obesity epidemic. The population affected by this issue is the country’s youth and children. Today, poor health habits in the country are contributing to an increasing trend with regards to obesity, which in essence, serves to increase the risk of cardiovascular disease. It also threatens to gravely shorten next generation’s life expectancy. In addition, there is increasing evidence that the burden of life-long illness falls unduly on both the financially disadvantaged and the minority groups (Tanner, 2012). Considering the fast advances in public health and medical knowledge, there is totally no rationale that this needs to be a reality for children in this country.
The two advocacy programs in this area include: First is Advocacy to Reverse Childhood Obesity, which promotes active living within the community as well as healthy eating with the aim of reversing childhood obesity. This advocacy program is committed to support advocates as they endeavor to reverse the epidemic of childhood obesity. The second advocacy program is called Childhood Obesity Prevention and Advocacy Program (COPA) and it takes health education to a high level since it guides students to both learn about, and tackle the health challenges that they face. This second advocacy program aims at improving the physical activity as well as the food environments of a neighborhood whilst at the same time improving the exercise habits and nutrition of the whole families (Alemanno, 2013).
The attributes that made the aforementioned two programs effective are as follows: first, they had clearly defined objectives, which were attained; secondly, they had partnerships with the relevant national, regional and local organizations to promoting active living as well as healthy living of children within the community. Third, those advocacy programs also focused on regulating industry practices. Fourth, they had an effectual community-wide outreach plan that engaged and supported capacity within communities of minorities and communities of low income persons so that advocacy campaigns correctly reflect the requirements identified by the individuals most affected by childhood pandemic. The proposed policy solution entails creating a policy that will help to resolve the issue of increasing childhood obesity in the United States. The proposed policy that I want to be implemented is entitled: Reducing childhood obesity and improving diet of children.
The objectives for the policy that I want to be implemented are as follows:
- To encourage parents/guardians to give children more healthy food and drinks.
- To give people advice regarding children’s physical activity and children’s healthy diet.
- To improve labeling on drinks and foodstuffs in order to help parents and the youth make healthy choices. A reliable front of pack labeling system would be developed that would make it clear what is inside the drink and food.
- To give parents guidance regarding how much physical activity that their children should be doing.
- To ban school sales of sweetened drinks and junk foodstuffs.
- To increase the access to inexpensive, high quality drinks and foodstuffs through improved or new healthier corner stores and/or grocery stores.
- To make sure that every beverage and food sold and served in schools satisfy or surpass the latest dietary guidelines in the country.
- To increase the duration, intensity as well as time of physical activity in the school day as well as out-of-school programs.
- To reduce the exposure of the youth to the advertising of unhealthy foodstuffs with the use of policy, regulation as well as effectual industry self-regulation.
- To utilize pricing strategies in promoting the buying of healthier foods.
- To increase the physical activity of children through improving the built environment within communities.
The proposed policy is very imperative since the rates of childhood obesity in the United States are increasing dramatically. Over the previous 20 years, changes made to schools, neighborhoods and communities have made it hard for children to be active and have a healthy diet. At present, many families lack access to safe places where their children could play, bike or walk, or inexpensive healthy beverages and foods (Pham, 2010). It is noteworthy that in schools throughout the United States, sugary beverages and junk foods are commonly accessible, whilst physical education has been squeezed from the curriculum. These alters have made a considerable impact on the health of the country’s population and are contributing to the growing childhood obesity epidemic.
The rates of obesity have more than quadrupled amongst children of 6 to 12 years of age over the last few decades. At present, over 25 million teenagers and children in the United States – roughly 1 in 3 youngsters – are obese or overweight (Tanner, 2012). It is of note that minority communities as well as lower income communities are overly affected by the childhood obesity epidemic. Childhood obesity is threatening the health of the country’s youngsters currently and their future potential. Youths who have obesity, in relation to their healthy-weight peers, have an increased risk of developing health complications including asthma, heart disease as well as type II diabetes. Additionally, they have a higher likelihood of being obese as adults; having greater psychological stress; and missing more school (Pham, 2010). Preventing childhood fatness is crucial with regards to protecting the viability of the healthcare system of the United States. It is noteworthy that childhood obesity is a risk factor for several expensive life-long illnesses which tremendously strain the country’s healthcare system. Obesity epidemic costs the country roughly $118 billion every year in direct medical expenditures as well as indirect costs, including lost productivity (Alemanno, 2013). As such, this policy whose aim is to reduce childhood obesity and improving diet of children is very important.
Conveying information to various stakeholders on the need for this policy would be conducted through face-to-face meetings; telephone conversations; and using emails. The methods to establish support for the policy including how to influence policymakers are: (i) meeting directly with legislators and expressing my views to them about the policy and convince them to support it; (ii) informing and educating constituents at the grassroots level about the policy so that they can support the policy and contact their elected officials and tell them to support the policy and vote for the legislation (Coulby, 2008). (iii) Stating to those concerned the objectives of the policy and benefits that the policy would bring; and (iv) involving the affected persons/stakeholders in developing the policy and encouraging them to support the policy.
The attributes of the effective advocacy programs that I researched could be applied to my proposed advocacy campaign in the following ways: first, partnerships will be created with the appropriate national, regional and local organizations to promoting active living as well as healthy living of children within the community. These partners would include schools; physicians; community members; parents; childcare organizations including early childhood, after school and pre-school settings; healthcare organizations; health centers as well as restaurants. Secondly, the proposed advocacy campaign would also focus on regulating industry practices by requiring that every beverage and food sold and served in schools satisfy or surpass the latest dietary guidelines in the country. It will also require proper labeling on drink and food so that parents and the youth could make informed and healthy choices. Third, the advocacy campaign would entail community outreaches. There would be an effectual community-wide outreach plan that would engage and support capacity in communities of minorities and low income persons so that the advocacy campaign correctly mirrors the requirements identified by the communities that are greatly affected by childhood pandemic.
Section 2
My proposed policy effectively addresses children’s physical activity, school nutrition standards and quality of food. The policy could be enacted through the creation of new regulation/legislation. This is because in the United States today, there are no laws that strictly curb school sales of sweetened drinks and junk food (Tanner, 2012). Moreover, there are no laws that effectively improve the food environment for children in the country today. With the enactment of this policy, energy balance would be improved – calories consumed by children would be equivalent to those expended –, and there would be a reduction in the prevalence of obesity amongst children and the youth in the country. The policy holds potential because of its capacity to expand upon individual effects to sway people. This way, the policy would provide an effectual way of protecting and improving health of children. In the United States, each state has a lot of power to influence legislations and policies. With the enactment of the policy, state governments would be able to exercise considerable power over particular actions that impact childhood obesity.
Some of the existing laws that could have an effect on my advocacy efforts include the Food Safety Law, which significantly toughens the Food and Drug Administration. This legislation is meant to keep unhealthy foods including the salmonella-tainted eggs from getting to the markets and eating places (Pham, 2010). The other legislation is the Child Nutrition and WIC Reauthorization Act, which covers a number of food programs that relate to food insecurity and healthy food. However, this piece of legislation does not discourage the sale of unhealthy beverages and food for children. There is also the Nutrition Labeling Education Act (NLEA), which requires manufacturers to label content, place of manufacture and nutritional value of foodstuffs. However, it does not establish the everyday recommended value for sugar. In addition, food corporations often put uninformative and varied symbols on packs and some tout low standards of nutrition. The National School Breakfast Program (SBP) and the National School Lunch Program (NSLP) legislations greatly favor packed foodstuffs that are usually made with excessive amounts of fructose corn syrup, salt and sugar. Finally, the Farm Bill or the Food Conservation and Energy Act essentially subsidizes foodstuffs that are of negligible or poor nutritional quality (Tanner, 2012).
The aforementioned existing laws could impact my advocacy efforts in the sense that they would act as hindrances since some of them are not in line with the objectives of my proposed policy, which include discouraging selling and serving unhealthy and unsafe beverages and foodstuffs for children. For instance, the SBP, NSLP and the Child Nutrition and WIC Reauthorization legislations support the sale and consumption of unhealthy beverages and foods in schools. These three laws do not align with one of my policy’s objectives, which stipulate that every beverage and food sold and served in schools must satisfy or surpass the latest dietary guidelines in the United States. The NLEA legislation impacts my advocacy efforts since it does not require food manufacturers to put informative symbols and other useful information on the packaging label. This does not align with one of the objectives of my advocacy programs that strive to ensure that all food manufacturers place informative label on drinks and foods in order to help parents and the youth make healthy choices.
The methods I would use to influence policymakers such as legislators to support my policy are direct lobbying, and grassroots lobbying. Direct lobbying will involve communicating with a legislative employee, or a legislator referring to the specific legislation and expressing a viewpoint on that legislation. Grassroots legislation will entail expressing my viewpoint on that legislation and urging the public/constituents to contact their legislator (Lewis, 2009). I would effectively use the three legs of advocacy in my advocacy efforts. Essentially, this method entails three crucial legs: professional lobbying; money; and grassroots. Without any of the 3 legs, the stool will fall. Professional lobbying – this leg will entail having a professional lobbyist who will be concerned with raising issues with the relevant lawmakers. The professional lobbyist could gain the ear of lawmakers due to continuing trusting relationships (Lanier, 2006).
Grassroots largely encompasses constituents, who in this case include school administrators, parents, community members, physicians and the general public. Lawmakers or legislators usually listen to constituents (Coulby, 2008). Grassroots advocacy will entail communicating with the general population regarding the specific legislation – which is about preventing childhood obesity. With regards to money, I would seek financial contributions that would help to move ahead my legislative agenda. Money is essentially a crucial leg of the stool since it has a great influence on who would lose or win an election. The amount of money expended in a legislative or regulative process is substantial and sometimes raises questions regarding whether the entire legislative process is being sold to the individual or organization that has the deepest pockets (Lanier, 2006). It is of note that a re-election or generally an election could be very costly costing millions of dollars. Financial contributions are vital to spearheading the legislative agenda forward and would play a major role in strengthening efforts of advancing the positive aspects of the proposed policy.
The obstacles which I anticipate arising in the legislative process are as follows: (i) difficulties that powerful lobbyists who represent manufacturers of unhealthy drinks and foods pose. (ii) Misinformed constituents – it is of note that there are widespread misconceptions as well as fears in a significant number of schools across the country about the negative consequences of regulating school beverages and foods as well as changing school vending machine practices. School administrators and parents could oppose the promising legislation because of fears of how schools might suffer; the convincing arguments of the lobbyists; and poor understanding of the issues. (iii) Cost – this in particular refers to the cost associated to community as well as school programs aimed at providing information on the prevention of childhood obesity (Coulby, 2008). I would overcome these hurdles by providing education regarding the benefits of the policy that is simply designed to reduce and prevent childhood obesity. Concerned parties will be informed that in preventing obesity of children, every party including the affected youth, their parents, healthcare providers, the government, and schools stand to gain whenever successful measures are undertaken. Improving public education on the subject matter will greatly help concerned citizens become informed and be positively influenced. This may considerably have an effect on political will as well as policy decisions. Thus, the efforts would be aimed at educating concerned citizens and demystifying myths regarding the problem of childhood fatness and the probable policy solution. The hurdles would also be overcome through using well-respected advocates of the cause and creating more awareness of the issue using media.
Section 3
The ethical dilemmas that could arise during my advocacy campaign are as follows: first is unfairness. Rewarding a lawmaker after a vote with valuable considerations or paying them to vote in a particular way is both an illegal and unethical practice connected to lobbying (Coulby, 2008). If this practice were allowable, then rich organizations and individuals would be always wining the day. However, even with outright gifts to legislators forbidden, there are other ways that people utilize in buying undue influence such as lobbyists making payments for congressional sumptuous meals and travel. It is of note that questions on fairness also come about whenever some lobbyists have easier access to legislators compared to other lobbyists. The problem of revolving door lobbyists is also common; this is where individuals who previously worked as public officials and moved into the private sector work to sway their previous workmates. Other than relationships with legislators, these individuals might still utilize legislators’ exercise facilities, possess access codes to offices, or might be having easier entrée to the corridors of power. Other than collegiality, other types of relationships might undermine fairness. On the local level in particular, legislators are usually lobbied by persons whom they know socially. It is upon lawmakers to shun influence which may come up out of their friendships (Lewis, 2009).
The second ethical dilemma is when I make campaign contributions and then ask my friends and clients to also make contributions to the campaign. In this situation, the ethical problem is that the majority of individuals see the involvement of finances in the system as innately corrupt (Lewis, 2009). I would resolve the ethical dilemma of unfairness by avoiding bribing any lawmaker in order to vote for the legislation that I support. I will also resolve it through transparency; this is whereby all sources of influence will be visible to the general public. This will entail requirements that would necessitate lobbyists to register and file reports regarding the issues that they have talked about with the legislators. On the local level, I would require the public to have access to legislators’ appointment books so that they can see whom I met and what we discussed. I would resolve the second dilemma by not making money the key issue in the advocacy campaign. After making sufficient campaign contributions, I would not go ahead and then make further campaign contributions from friends and clients since that would be outright unethical. This would ensure that I do not get involved in any corrupt practice in any manner.
The ethics laws are all-inclusive and address several issues such as campaign finance activity; improper gifts; contingent fees; concealment of clients; improper encouragement of legislation; embargos against loans; deliberate misstatement of fact among other unethical and illegal practices. In my advocacy campaign, the ethics law and reporting requirements applicable include the following:
- Registration as a grassroots lobbyist – any business entity, person, organization or group which spends $2,000 including telecommunication services, salaries, advertising, postage, electronic services, delivery and printing services, within a reporting period of time for the purposes of asking other people to communicate with any legislator to sway any regulative or legislative action must register as a grassroots lobbyist (State Ethics Commission, 2014).
- Gifts – every gift that is valued at least $75 made for the purposes of lobbying should be reported. Gifts comprise valuable things such as lodging, travel, services, discounts and meals associated with lodging or travel. Lobbyists should report the gross amounts of gifts in the appropriate categories of reporting on the lobbying Activity Report (State Ethics Commission, 2014).
- Loans – every loan or forgiveness of a loan made for the purpose of lobbying by the filer needs to be reported (State Ethics Commission, 2014).
- Other disbursements – every other disbursement, contribution or expense incurred for lobbying purposes must be reported. Insignificant overhead expenses should not be reported.
- Reporting activity reports – an individual required to register must also report every expense that relates to lobbying activity. Moreover, a lobbying activity report is needed at any time of a 6-month reporting period in which the lobbyist is registered. The periods of reporting lobbying activities start on 1st November to 30th April (State Ethics Commission, 2014).
- Contents of activity reports – every activity report must be carefully documented and there should also be careful record keeping. Any information which has changed from the time when the registration form was filed must be updated. There must be disclosure about research help; witness fees; gifts; compensation; publications; official expenditures as well as every other cost that relates to the lobbying effort. Moreover, wherever possible, the explanation of the subject that is lobbied must comprise numbers of the legislative bill (State Ethics Commission, 2014).
- Special reports – a regulated lobbyist should file a report that identifies the permanent address and name of all entities that gave at least 5 percent of the regulated lobbyist’s receipts in the last 1 year.
- Business transactions with officials – regulated officials must file a report if, in a 6-months lobbying reporting period, was involved in a business transaction with an Attorney General, Governor, Secretary of State, Comptroller or member of the General Assembly.
- Campaign contributions from lobbyists – regulated lobbyists must reveal contributions made by the lobbyist indirectly or directly in the period of reporting for the benefit of an elected official (State Ethics Commission, 2014).
The population being addressed comprises the youth and children who are obese. The special ethical challenges that are unique to the population being addressed are as follows: first is soliciting money from them and/or their parents or guardians for the advocacy campaign. As the lobbyist, I could raise adequate funds for the advocacy program from other sources and yet ask for money from parents with obese children and from obese youth. This is something this clearly unethical. The second ethical challenge is compelling obese children and youth to support me in my advocacy campaign so that legislators and lawmakers could see that I have adequate support from the affected population, and thereby enact the legislation. Third is that I might decide to offer lawmakers bribes in the form of gifts, cash or other incentives in order to support me and vote for the legislation that I support.
References
Alemanno, A. (2013). Food Marketing Regulation and Childhood Obesity Prevention. Prentice Hall: Cleveland, OH.
Coulby, H. (2008). Advocacy and Campaigning. AMACOM: Austin, TX.
Lanier, J. K. (2006). Facing the Future. Washington, DC: Nurses Association.
Lewis, M. (2009). Ethics and Advocacy. McGraw-Hill: Seattle, WA.
Pham, S. (2010). Food, Obesity, and Regulation: Simmering Culture War Boils Over. Springer Publishers: Crescent City, CA. State Ethics Commission. (2013). Lobbying Law Requirements