Week 7 Flashcards
define: advocacy
- a critical population health strategy that emphasizes collection action to effect systemic change
- the act or supporting or recommending a cause or course of action, undertaken on behalf or persons or issues
what does advocacy focus on? what does it recognize?
- changing upstream factors related to SDoH & the need to improve systems and societal structures to create greater equity and better health for all
- recognizes the importanc of engaging in political process to effect desired policy changes at organizational & system levels
what are 3 strategic areas of work identified by WHO that strengthen PHC & its principles worldwide?
- providing a “one-stop” mechanism for PHC implementation support, tailored to country context and priorities
- producing PHC-oriented evidence & innovation, with a sharper focus on people left behind
- promoting PHC renewal thru policy leadership, advovacy & strategic partnerships with gvmts, non-gvmtal organizations, civil society orgnizations, development partners, UN sister agencies, donors, and other stakeholders at global, regional, and country lvls
what are the 5 principles of PHC
- accessibility
- public participation
- health promotion
- approp technology
- intersectoral collab
describe the PHC principle of “accessibility”
- healthcare is universally available to all people regardless of geographic location
describe the PHC principle of “public participation”
- pts are encouraged to participate in making decisions about their own health & in identifying the needs of the community
describe the PHC principle of “health promotion”
- health education, nutrition, sanitation, maternal and child healthcare, immunization, prevention & control of disease, acting on the SDoH
describe the PHC principle of “appropriate technology”
- models of care are adapted to the community’s social, economic, and cultural development
- innovative models of healthcare
describe the PHC principle of “intersectoral collab”
- health & wellbeing is linked to economic and social policy
- people from different disciplines
- collaborate in policy development and healthcare services
what is upstream advocacy? midstream? downstream?
- upstream = policy focused
- midstream = community
- downstream = individual
which PHC principle is closely related with upstream interventions?
- intersectoral collab
which PHC principles are closely related with upstream /midstream interventions (in the diagram on slide 8, its kinda between the two) (2)
- appropriate technology
- health promotion
which PHC principles are closely related with midstream/downstream interventions (in the diagram on slide 8, its kinda between the two) (1)
- public participation
which PHC principle is closely related to downstream interventions
- universal access
what are 5 types of public participation
- inform
- input
- engage
- collaborate
- empower
describe the public participation “inform”
- information out
- information goes from a health organization to the public
describe the purpose of the public participation “inform” (2)
- creating awareness
- public education
describe an example of a the public participation “inform”
- a social marketing campaign is used to increase public awareness about active living strategies
describe the public participation strategy “input”
- information in
- input comes from the public to a health organization
what is the purpose of the public participation strategy “input”
- getting citizen and/or stakeholder input, advice, and feedback
what is an example of the public participation strategy “input”
- a broad community survey is used to obtain public input on playground safety
describe the public participation strategy “engage”
- a health organization and the public talk and understand each other
what is the purpose of the public participation strategy “engage” (2)
- in-depth exploration of views, perspectives, and interests
- emphasis on listening and achieving mutual understanding
what is an example of the public participation strategy “engage”
- a structured public consultation day is held to explore a geographic community’s perspectives on the DOH
describe the public participation strategy “collaborate”
- a health organization and the public work together over a period of time
what is the purpose of the public participation “collaborate” (2)
- to make decisions
- to develop policy on an issue
what is an example of the public participation strategy “collaborate”
- a health organization works collaboratively with community partners on issues
ex. comprehensive school health, smoke-free municipalities
describe the public participation strategy “empower”
- a health organization works with the public to build capacity
what is the purpose of the public participation strategy “empower”
- to enable the public to make decisions & take action in areas that affect health
what is an example of the public participation strategy “empower”
- communities make decisions in areas that impact health thru community development and social action
define: collaboration
- process in which parties with a stake in the issue actively seek a mutually determined solution or plan
define: partnership
- occurs when purpose of collaboration is to advance a shared vision of need and the expected outcome is to develop and implement a joint agreement to address the problem and bring the vision to reality
what is the difference between collaboration & partnership
- partnership is a type of collaboration
- collaboration is often short term & less formal
- partnership is usually longer term & more formal
what is the advantage of collaboration & partnerships?
- collectively, we can achieve something that could not have been achieved by any one individual, group, or organization working alone
partnership is characterized by… (4)
- shared authority, responsibility, and mngmt
- shared liability, risk-taking, accountability, and rewards
- detailed communication strategies
- joint investment of resources (time, work, funding, material, expertise, info)
partnerships require… (4)
- building trusting relationships
- constant evaluation
- ability to respond/adapt to change
- re-negotiate purpose & revise action plan, if necessary
what are the guiding principles of partnerships (6)
- same mission, goals, objectives, and guiding principles
- partners are recognized by their unique, essential contributions
- all partners agree to share risks, responsibilities, rewards, and power
- the partnership should enhance capacity of partners while achieving a common purpose
- flexible structure to accomodate changing needs
- all communication & activities undertaken embody principles of social justice & equity
describe the difference between networking, coordination, cooperation, and collaboration
during the community health needs assessment process, the WRHA sends a survey to households in each one of the 12 community areas of Winnipeg to find out the concerns that residents have about the health and QOL in their neighborhood. This is an example of which type of public participation?
- input (???no answers in slide)
during the community health needs assessment process, the WRHA sends a survey to households in each one of the 12 community areas of Winnipeg to find out the concerns that residents have about the health and QOL in their neighborhood. This is an example of which type of public participation?
- input (???no answers in slide)
the WRHA sets up a series of meetings with representatives of agencies that serve the Black community (or Indigenous community) to talk about how racism has affected the health & wellbeing of the community. This is an example of which type of public participation?
- engage (???)
you are a CHN on a housing committee in Point Douglas neighborhood. You represent the public health perspective. At monthly meetings, area police officers share crime reports, and the Bear Clan shares info about people experiencing homelessness. The City has representation on the committee and provides admin support. This is an example of what lvl of collaboration/partnership?
partnership (???)
what are important aspects of collaborative partnerships? (6)
- connect (reach out to new partners)
- foster shared understanding (get to know one another & build deeper understanding)
- create a shared vision (common ground between all)
- plan collaboratively (appreciate diversity)
- work together for change (documentation of workplan)
- celebrate, evaluate, and renew (celebrate the impacts you might never have achieved alone)
describe a participatory approach (3)
- community is involved in planning & problem solving
- members have ownership of initiative
- commitment is to long-term change
describe a directive/prescriptive approach
- change process imposed by outside force (ex. health professional)
advocacy is a strategy both in… (2)
- ottawa charter strategy (building healthy public policy requires developing it & advocating for it)
- empowerment strategy –> coalition advocacy, political action
what CHN standards of practice are fullfilled with advocacy? (2)
- capacity building
- healthy equity
how is “capacity building” fulfilled thru advocacyq
- uses a comprehensive mix of strategies such as coalition building, intersectoral collab, community engagement, and mobilization, partnerships, and networking to build community capacity to take action on priority issues
how is “health equity” fulfilled thru advocacy
- advocates for healthy public policy and social justice by participating in legislative and policy-making activities that influence DOH and access to services
define: public health advocacy
- a critical population health strategy that emphasizes collective action to effect systemic change
what does public health advocacy focus on?
- on changing upstream factors related to the SDOH
what does public health advocacy explicitly recognize?
- the importance of engaging in political processes to effect desired policy changes at organizational and system lvls
what are 4 types of advocacy
- representational or client advocacy
- community development advocacy
- social policy reform advocacy
- community activism advocacy
what is representational or client advocacy
- advocating for education & behavior change
- representing the rights & health needs of those unable to speak or act for themselves
what is community development advocacy
- the goals of health promotion are enablement and empowerment for action rather than protection/prevention
community development advocacy activities include…
- working individuals and groups to identify their needs and addressing them at the local lvl
what is social policy reform advocacy
- seeks to redress health inquities at the lvl of social structure and to influence policy making
social policy reform advocacy activities generally require…
- cross-sectoral alliances and may focus on legislative reform to advance policy change for social transformation
what is community activism advocacy
- enabling communities to challenge the causes of poor health more directly at the policy-making and structural lvl
what is the goal of community activism advocacy
- to provide the community with political advocacy skills rather than individual skills to make ‘better choices’
community activism advocacy activities include…
- coalition building, links across local & national lvls
what are 4 advocacy actions?
- strengthening individuals
- strengthening communities
- improving living and working conditions
- promoting healthy macro-policies
describe the advocacy action “strengthening individuals”
- actions that are aimed at strengthening individuals in disadvantaged circumstances, and using-person based strategies
describe the advocacy action “strengthening communities”
- interventions aimed at strengthening communities thru building social cohesion and mutual support
describe advocacy action “improving living and working conditions”
- initiatives that work to improve living and working conditions, including access to care & services
describe advocacy action “promoting healthy macro-policies”
- interventions that locate the causes of health inequalities int he overarching macroeconomic, cultural, and environmental conditions and work to promote healthy macro-policies
advocacy action “strengthening individuals” is related to which type of advocacy?
- representational or client advocacy
advocacy action “strengthening communities” is related to which type of advocacy?
- community development advocacy
advocacy action “improving living & working conditions” is related to which type of advocacy?
- social policy reform advocacy
advocacy action “promoting healthy macro policies” is related to which type of advocacy?
- community activism advocacy
the typical policy development model is…
- linear
what is an alternate policy development model
- non-linear Howlett’s (2009) policy cycle
non-linear policy development approach
in the Three-Phase, Eight-Step Policy-Making Process for developing a healthy public policy, what are the 3 phrases?
- planning
- implementation
- evaluation
in the Three-Phase, Eight-Step Policy-Making Process for developing a healthy public policy, what steps fall under planning?
- identify, describe, and analyze the problem
- identify and analyze policy options
- determine and understand decision makers and influencers
- assess readiness for policy development
- develop an action plan
in the Three-Phase, Eight-Step Policy-Making Process for developing a healthy public policy, what steps fall under implementation
- implement the action plan
- facilitate the adoption and implementation of the policy
in the Three-Phase, Eight-Step Policy-Making Process for developing a healthy public policy, what step falls under evaluation
- evaluate the policy
3 phase, 8 step policy making process diagram
in which two ways do CHNs influence the policy process?
- direct
- indirect
how do CHNs directly influence the policy process (3)
- developing
- implementing
- and/or evaluating policy
how do CHNs indirectly influence policy process? (3)
- conducting policy-relevant research
- advocating for policy change
- facilitating/enabling a community to identify its health or social needs and health or public policies to fulfill these needs
what are examples of how CHNs influence the policy process? (4)
- expanding vaccine clinic hours so all parents have opportunity to attend
- improving sanitation services in isolated communities to prevent infectious diseases
- advocating for supervised consumption sites to reduce spread of STBBI and reduce overdose rate
- expand NP scope in rural communities to reduce wait times & increase quality service
what are 3 lvls of advocacy
- low profile
- medium profile
- high profile
what are examples of low lvls of advocacy (4)
- meeting/speaking to/writing to decision makers on behalf of a client
- sharing info (ex. research findings)
- preparing non-public briefing note
- publishing policy recommendations from research findings
what are examples of medium profile advocacy (5)
- “feed” the opposition
- deputations at committee meetings with elected officials/decision-makers
- alliances/partnerships w other groups
- letters to elected officials/newspapers
- use of social media/blogs
what are examples of high profile advocacy (3)
- ad campaigns
- media interviews (especially radio/TV)
- demonstrations & rallies
for successful advocacy, you need to be prepared to… (2)
- respond to or deal with counterarguments
- need to convince decision makers
to prepare to convince decision makers, you must: (6)
- build as many plausible links as you can between the health issues and the desired solution
- your solutions need to be clearly linked to a compelling problem
- clearly explain the proposed solutions/policies
- build coalitions and stimulate debate in various venues
- identify the barriers to implementation you are likely to encounter
- look for signs that indicate a need for change (ex. dissatisfaction with the status quo)
some counterarguments you may hear when advocating are:
- “the proposed change is too costly”
- “increased legislation/regulations restrict individual freedoms of addressing the issue”
- “there is an alternative (non-policy) means of addressing the issue
- there is a philosophical difference about the origin of, or the needed response to, the problem
community-based participatory research action addresses…
- an issue, concern, or topic raised by the community
with community-based participatory research action research is… (4)
- co-led
- designed
- conducted
- dissiminated
with community-based participatory research action, action is aimed at…
- change
with community-based participatory research action, you get creation or production of knowledge based on..
- systematic study
in the reading “participatory action research: Mosque based exercise for South Asian women in Canada”, what two categories of barriers were experienced while working with this community
- practical
- cultural
in the reading “participatory action research: Mosque based exercise for South Asian women in Canada”, what practical barriers were experienced? (2)
- lack of time (at the mosque, excess with public transit, 3 classes per week)
- childcare
in the reading “participatory action research: Mosque based exercise for South Asian women in Canada”, what practical barriers were experienced (4)
- religious modesty (led by senior female Muslim students from the faculty of kinesiology and together with 30 other women)
- avoidance of mixed-sex activity
- fear of going alone
- inhibit participation
in the reading “participatory action research: Mosque based exercise for South Asian women in Canada”, in what way did this community-based research partnership incorporate a community developemnt approach? (5)
- establish women groups
- community involvement
- provision of social supports
- imam leadership
- women’s college hospital
in the reading “participatory action research: Mosque based exercise for South Asian women in Canada”, which Ottawa Charter health promotion strategies were used? (4)
- create supportive enviro for health by offering health services at the mosque
- strengthening community action for health by involving the women in the mosque in working on their health
- develop personal skills by giving participants tools to improve their health
- re-orient health services by meeting individuals where they are at
in the reading “participatory action research: Mosque based exercise for South Asian women in Canada”, which principles of primary healthcare are demonstrated (4)
- accessible: by doing it in a place where individuals feel comfortable
- public participation: community participates
- health promotion
- intersectoral cooperation by working w the kinesiology department and the mosque
describe a neoliberal perspective on poverty, homelessness, and food insecurity
- healthcare consequences of neoliberal policies have been far-reaching and include rising poverty rates, increased homelessness, rising unemployment, and increased consumption of obesogenic food as food costs rise
-has a consequence the individualization of blame = interventions aimed at individuals and not upstream barriers
describe a social justice/social determinants of health/health equity perspective on poverty, homelessness, and food insecurity
- this approach sees that there are social factors that put individuals in their position = aimed at upstream barriers
describe the collaboration spectrum (7)
compete –> co-exist –> communicate –> cooperate –> coordinate –> collaborate –> integrate
describe “compete”
- competition for clients, resources, partners, public attention
describe “co-exist”
- no systematic connection between agencies
describe “communicate”
- as needed, often informal, interaction, on discrete activities or projects
describe “coordinate”
- organizations systematically adjust and align work with each other for greater outcomes
describe “collaborate”
- longer term interaction based on shared mission, goals, shared decision makers, and resources
describe “integrate”
- fully integrated programs, planning, and funding
community-based participatory research diagram
