Developing a Health Advocacy Campaign

WEEK 8
Over the next 3 weeks, you will develop a 9- to 12-page paper that outlines a health
advocacy campaign designed to promote policies to improve the health of a population of
your choice. This week, you will establish the framework for your campaign by identifying
a population health concern of interest to you. You will then provide an overview of how
you would approach advocating for this issue. In Week 9, you will consider legal and
regulatory factors that have an impact on the issue and finally, in Week 10, you will
identify ethical concerns that you could face as an advocate. Specific details for each aspect
of this paper are provided each week. The Final Paper will be due in Week 10. This paper
will serve as the Portfolio Application for the course.
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

Developing a Health Advocacy Campaign

Section 1

The health population issue to use here is chronic diseases that affect a big part of the
population ranging from young children to the elderly (Christoffel, 2000). We look at a health

HEALTH ADVOCACY CAMPAIGN 2
advocacy campaign to prevent chronic diseases. This advocacy campaign has been developed
because of the ease of local health professionals to work with the individuals, communities, and
policy makers but they work less with the media. We are going to look at this advocacy
campaign that was put into place by the media to fight against chronic diseases by putting across
appropriate measures that can be put in place for the prevention of the chronic diseases
(Christoffel, 2000).
In this case, we will look at chronic diseases in Contra Costa County where chronic
diseases are the leading killer and the main cause of diminished cause of quality life. The belief
that chronic diseases such as cancer and cardiovascular diseases affect only the old people are
misleading because these diseases can affect anyone. However, these are the leading causes of
death for those 40 years of age. This campaign is aimed at informing people that chronic diseases
can be managed and prevented with early diagnosis and appropriate education and treatment
(Christoffel, 2000).
Public health professionals are able to use the media to promote chronic disease
prevention. Although local health departments vary in their ability to pursue media advocacy,
any health department can do so to some degree. This county contains a very high concentration
of ethnic minorities. Fully, in the west, 70% are African American population, 43% are Asian,
and pacific islanders, and 30 percent of Latinos. The south is predominantly Caucasian, with
colored people constituting barely 10% of the communities there. A big percentage of people
here live in poverty and ethnic concentration (Christoffel, 2000).
This campaign was carried out using a comprehensive based approach whereby the
chronic disease prevention program resources were typically designated based on a pre-
determined population, disease or risk factor (Nutbeam, 2000). Collaboration among

HEALTH ADVOCACY CAMPAIGN 3
categorically funded programs requires that health departments first assess existing resources and
identify successful projects. This approach in the campaign facilitated collaboration with
communities to set a broader shared agenda and coordination of internal resources to develop
more comprehensive and integrated chronic disease prevention program (Nutbeam, 2000).
This campaign was also based on a participatory evaluation approach by mobilizing
neighborhoods. This team work enables a successful prevention of chronic diseases. This
approach is used because it is impossible for the local health departments alone to accomplish
much without the help of the people surrounding them who are the ones at risk and the affected.
Another approach applied in this campaign was working with health coalitions. Local health
departments approach a variety of coalitions to participate in the campaign. The medical staff,
advisory boards, commission, and task forces, they are in a good position to help these groups
collaborate (Wallack, 1993).
Another approach used is working with community-based organizations whereby they
exist as neutral partners in the prevention of chronic diseases. Local agencies are good at
working effectively with under-served, low-income, and ethnically diverse communities. Local
health departments have a record of working well with these groups on issues like HIV/AIDS
and smoking and can as well work successfully with them on the prevention of chronic diseases.
These approaches are the attributes that made the campaign to be successful (Nutbeam, 2000).

Developing a plan for a health campaign that seeks to create a new policy or change an

existing one

The health issue is chronic diseases, their prevention, treatment and management. The
proposed health policy solution is provision of information to people on how to prevent the

HEALTH ADVOCACY CAMPAIGN 4
diseases, how to seek treatment and how to manage the condition. The goals of this plan is to
increase the volume of positive health messages and decreases volume of negative messages
such as beliefs that chronic diseases are only for the elderly (Sagrillo, 2013). This leads to
increased awareness of and support for health-promoting behaviors, policies and choices. This
also reduces barriers to community using health promoting services, programs, products and
activities. This health policy improves awareness in the community about early medical
screening and prevention, healthy products such as affordable, accessible, and nutritious food
choices. It also improves awareness about safe outdoor places for physical activity and work site
exercise programs. Another goal of this program is to reduce the availability of unhealthy
activities, products, particularly in low income and ethnically diverse communities, among the
youth, seniors, and pregnant women (Sagrillo, 2013).

Convincing the stake holders

In order to convince the stakeholders, there is need to develop a message about the
program that is attractive and has a convincing message. Building a vision and commitment will
help in convincing the stakeholders that the program will be successful and that their
contribution is necessary (Sagrillo, 2013). There is need to present to the identified stakeholders
with a written action plan that contains the goals, objectives, and activities that are to be carried
out in the program. It needs to contain leaders for each activity and for overall coordination,
short-term, intermediate, and long-term benchmarks, and mechanisms of accountability
including who will monitor and accomplish this task of monitoring. There is a need to convince
the stakeholders to support the program because a survey of staff carried out indicated that most
of them need training. As a result, the stakeholders and health departments should work as a
coalition for the success of the program (Sagrillo, 2013).

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The attributes of effective advocacy programs can be used to make the program a
success. A comprehensive based approach, participatory evaluation approach, and working with
health coalitions help in making the program a success (Sagrillo, 2013).

Part 2

Explain whether your proposed policy could be enacted through a modification of existing

law or regulation or the creation of new legislation/regulation.
The policy of providing information on the prevention of chronic diseases can be enacted
through modification of existing laws and regulations. Health advocacy campaigns mostly
focuses on influential people who have power to change policies and public opinion. These
influential policy makers include national, regional, local government officials, traditional
leaders, school officials, parent-teacher associations, religious figures, businesses, or members of
finding organizations. These people have the potential of making decisions that are very crucial
in people’s lives. The public is also a targeting in the changing of existing laws and regulations.
The public opinion affects political decisions, which is another important advocacy target. These
influential people and audiences facilitate the changing of existing policies so as to make it easy
to enact the proposed policies easily and faster (Wallack, 1993).
Explain how existing laws or regulations could impact your advocacy efforts.
The existing laws are rigid and without any changes being made, it would be difficult to
implement the suggested policy (Wallack, 1993). The existing laws do not make it possible to
enact new policies because they are not structured to accommodate new policies and strategies.
The new policy is based on making changes in the health departments according to the new
alarming trends of chronic disease. The existing laws are based on measures on chronic diseases
data that was found long time ago. In order tackle the problem of chronic diseases in the right

HEALTH ADVOCACY CAMPAIGN 6
way, new policies that match the current data must be put in place. Therefore, trying to
implement the policy without changing these laws will mean that not much will be accomplished
(Tones, & Tilford, 1994).

Lobbying

Lobbying utilizes all the techniques uses in advocacy and applies primarily to directly
influence individuals who have the power to make the policy changes for which advocates are
campaigning (Tones, & Tilford, 1994). Advocates need to first identify what tactics or
combination of tactics are the most effective in the implementation of the policy. Lobbying
consists of who, what, where and when of the policy. The actions constituting lobbying are;

  1. Knowing the primary target whereby you find out who has the primary responsibility for
    making decisions about issues or resources being targeted by the campaign. You need to
    gather information about and prioritize lobbying towards the most relevant decision-
    makers and their advisors.
  2. The timing has to be right; contact the identified influential people in good time for them
    to have adequate time to respond to requests of information, opinions and also be able to
    adjust their schedule for meetings. One should be aware of the timetable of particular
    activities such as legislative hearings and votes and most importantly annual general
    meetings. Meetings with some decision makers should be scheduled immediately before
    the decision is implemented so that the campaign arguments are still fresh in their minds.
    However, some decision makers prefer being contacted in advance so that they can have
    the time to examine all the arguments tabled to them
  3. Direct contact should be made with the identified decision-makers. This is best done
    through writing in a formal letter.

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  1. Be specific in requesting action. You should know exactly what you want from decision
    makers and present it to them with competence.
  2. Demonstrate how supporting the campaign would be in the interest of decision-makers. A
    decision maker whose support is likely to generate controversy needs to be convinced
    that support is more likely to boost their career than undermine it.
  3. Be aware of your rights; a case is strong if it relates to legal entitlement.
  4. Follow the etiquettes of official meetings; be flexible such that you are able to schedule
    meetings at the legislators’ convenience.
  5. Document the meeting, build relationships, and thank the key persons after a meeting.

The three legs of lobbying in advocacy

These are the legs that hold up the stool of advocacy to make sure it is successful; these
are legislative advocacy, media and grassroots mobilization (Tones, & Tilford, 1994).
The legislative advocacy/capitol is the leg that refers to everything that goes on where
the laws and policies are made, that is, city or county council, state legislature, or the congress.
This is where you have full time or part time lobbyists where lobby days are held and you go and
testify. Regular ALERTS are sent and citizens go and meet with their legislators during the
legislative sessions (Tones, & Tilford, 1994).
The grass roots or community leg constitutes everything that goes on in the community.
Here, telephones and email lists are set out for those responding to alerts that come out of the
capitol.
The media leg; This leg refers to whatever is done to spread the word to people whether
traditional media, T.V or newspapers.

Obstacles in the legislative process

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The obstacles in the legislative process are that decisions may take too long to be enacted and
thus spending a lot of time in this process. The legislators may also mot be readily available at all
times to look into the issues raised. The ideas of the decision makers and legislators may differ
making it difficult to settle on a particular idea (Snyder, 2007).

Part 3

Ethical dilemmas that could arise during the advocacy campaign and how to resolve them
Some of the ethical dilemmas that may arise may include whether by campaigning against new
policies the nurses are protecting and promoting the health of patients and the public. Because
the nurses are entitled to protecting and promoting the health of patients and the public, it can be
questionable whether the new plan will be successful or will fail to jeopardize the health of the
patients (Snyder, 2007).
The main dilemmas to experience are: fairness, this is illegal and it may happen if policy
makers are paid to vote in a favorable way, rewarding his vote with valuable considerations.
Transparency: The process of legislative may not be 100 percent transparent and thus making it
illegal (Snyder, 2007). These dilemmas can be resolved by analyzing the environment that the
advocators and legislators are working on so that they can examine the possible challenges and
the possible solutions that can be used to solve them.
Describe the ethics laws and reporting requirements that are applicable to your advocacy

campaign

In an advocacy campaign, it is necessary to follow some ethics in order for the campaign
to be acceptable according to the standards of the ethics laws (Snyder, 2007). There should be
fairness in the whole procedure from the beginning to the end. Undue influence should not be
used to push the campaign. Bias should not be used by the legislators and law makers because

HEALTH ADVOCACY CAMPAIGN 9
this would mean that they are favoring their preferable decisions. Some lobbyists have easier
access to law makers than others and however easy they may access the law makers, the
lawmakers are expected to be fair in handling them equally with those who do not have easy
access to them. The relationships between law makers and lobbyists should not interfere with a
fair and just advocacy process (Snyder, 2007).
Transparency

This is another way that improves fairness of the lobbying process by making sure that
the sources of influence are visible to the public (Snyder, 2007). This is the goal behind various
states and federal requirements that lobbyists register and file reports on the issues that they have
discussed with law makers. Transparency has also been facilitated by increasing the frequency of
reporting and the number and variety of organizations to qualify as lobbyists. There is also
another step taken in the local level to ensure that there is transparency in the offices of law
makers. There is access to law makers’ appointment books so that the public can know who they
met with and what they discussed (Snyder, 2007).
Common good

Lobbyists are advocates and they represent a particular side of an issue. They can be
compared to lawyers and they present the views of the public to the federal policy makers. They
do this for the common good of the general public. Lobbyists are expected to do anything on
behalf of their clients as long as it is not immoral or illegal. This is drawn from the ethical
approach of the lobbyists to ensure that they stand up for the common good (Sagrillo, 2013).
The special ethical challenges unique to the population being addressed
Fairness is one of the main ethical challenges in the prevention of chronic diseases. This
is because these diseases are many and collecting for all of them may not be very accurate.

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Again, some chronic disorders may be left out or handled with less emphasis. This will in turn
affect the kind of policies put in place for that condition and also the extent of advocacy
campaign carried out (Sagrillo, 2013).
The other ethical challenge in this population is the exercise of common good. It this
situation of chronic disease, some lobbyists and law makers may have personal interests and be
biased on a particular side of the issue. Since this is a concern that has been ignored for a long
period of time, they may not contribute their maximum effort into seeing that the campaign is
successful. The difference in ideas in different people may also be a challenge because
determining the appropriate idea is difficult (Sagrillo, 2013).
Conclusion

Developing a health a health advocacy campaign is complex but this complexity depends
on the specific population and the health issue being addressed. For the prevention of chronic
diseases, it necessary to follow all the necessary procedures for the policy recommended to be
successful. A great deal of information needs to be collected so that the policy can be based on
all the possible information available.

References

Christoffel, K. K. (2000). Public health advocacy: process and product. American journal of
public health, 90(5), 722.
Nutbeam, D. (2000). Health literacy as a public health goal: a challenge for contemporary health
education and communication strategies into the 21st century. Health promotion
international, 15(3), 259-267.

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Sagrillo, D. (2013). Developing a Health Advocacy Campaign. Plastic Surgical Nursing, 33(3),
109-115.
Snyder, L. B. (2007). Health communication campaigns and their impact on behavior. Journal of
Nutrition Education and Behavior, 39(2), S32-S40.
Tones, K., & Tilford, S. (1994). Effectiveness, efficiency and equity. London: Chapman and Hall.
Wallack, L. (Ed.). (1993). Media advocacy and public health: Power for prevention. Sage.

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