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Introduction to Advocacy

Community PediatricsColumbia University

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What is Advocacy?

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What is Advocacy?

“Act of pleading for, supporting orrecommending…”—Webster’s DictionaryFrom the Latin advocare: “to call to one’said”--voc: voice

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What is Advocacy?

“Advocacy is an attitude, plan of action and behavior that have as specific goal(s) the improvement of the physical, emotional, or environmental condition of an individual child or adolescent, family or their community.”

--Dyson Initiative working definition

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What is Child Advocacy?

Advocacy for children is “an attempt to improve the lives of children through attention to the decisions that affect children…[it] is intervention on behalf of children in relation to those services and institutions that impinge on their lives.”-Richard Tompkins, 1980

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Why should we be advocates?

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Why should we be advocates?Children cannot advocate for themselvesWe are in a unique position to see problems and understand their implicationsThe problems matterBecause of our scientific training, we have respect and credibility to make a difference

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Types of Advocacy

Legislative AdvocacyAdvocacy at the individual or family levelAdvocacy in the community

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Legislative Advocacy

ExamplesMandating window bars in apartments with children (city)Helmet laws (state)S-CHIP (federal)

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Legislative AdvocacyProcess is slow and idiosyncraticProcess varies for different legislative bodiesKnow when your voice will be heard and intervene!

Proposal of a billPublic Hearings on an issueLobbying individual legislators

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Advocacy for an IndividualExamples:

Filling out forms for SSI/disability benefitsAssisting patients in obtaining health insuranceWriting a letter to a landlord requesting that window guards be installedReferring a new mother to a breastfeeding consultant

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Advocacy for an IndividualUnderstand the problemInvolve the familyKnow the rulesCommunicate effectively—written or verballyMaster the appeals processKnow community resourcesFollow up!

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Advocacy in the Community

Examples:Post Partum Primary Care ProjectInjury and Violence Prevention CenterReach Out and ReadBest Beginnings

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Advocacy in the Community

Identify community concerns; find an issue that meets your interestsAssess community assets and needsIdentify your strengths and roleBuild and sustain partnershipsDevelop strategies for change

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Principles of AdvocacyDevelop a clear missionImplement a strategy of small winsIdentify friends and build coalitions, seeking as wide a base of support as possibleIdentify adversaries and attempt to neutralize the oppositionDon’t ever burn bridgesDevelop a good relationship with the media

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Principles of Advocacy (con’d)Use sound data; if no data exist, admit it.Be passionateBe pragmatic, willing to compromisePatience and persistence are imperativeMinimize looking self-serving, submerge the egoNever use scapegoats when things go wrong

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Designing an Effective Advocacy Project

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What do we mean by “project?”

“A mentored hands-on experience in community-linked endeavors to prepare residents to be lifelong active leaders in improving and advocating for child health in the community”

--Dyson Initiative working definition

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Designing an Effective Advocacy Project1. Define the problem2. Include a population perspective: how

important is problem in the community?• How many and which children are affected?• How severe are the effects?• How does this compare to other health

problems?

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Designing a Project (con’d)

3. Include a needs assessment• How do people in the community

perceive the problem?• What do community members believe are

the causes?• What do community members believe are

good solutions?

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Designing a Project (con’d)

4. Include a community resource assessment

• Who is already interested in the problem?• What is already being done to address

the problem?• What existing resources can be

mobilized?

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Designing a Project (con’d)

5. Apply academic expertise• Review the literature• Talk to those who have relevant

expertise; think interdisciplinary

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Designing a Project (con’d)

6. Consider the legislative perspective• Are there potential legislative solutions? • Are there politicians interested in the

problem (personally or politically)?

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Designing a Project (con’d)

7. Propose an intervention• Estimate anticipated effect of the

intervention

8. Include an evaluation plan• Assess the impact• Evidence that intervention is worth

funding or replicating

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What a Single Pediatrician Can AccomplishDr. Abraham Bergman was instrumental

in all of the following initiatives:Flammable Fabrics Act ’67Fluoridation of Seattle Water ’68Poison Prevention Packaging Act ’70National Health Service Corps ’71Consumer Product Safety Commission ’72Indian Health Care Improvement Act ‘76

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If I am not for myself, who am I?

But if I am only for myself, what am I?

And if not now, when?- Hillel