Health Advocacy is a core competency in Family Medicine. In their role as Health Advocates, family physicians are able to identify and respond to a range of issues that influence the health and well-being of individual patients, communities, and populations.
Through individual or collective action, family physicians work to promote health and prevent disease, address the social, economic, educational, and political factors that influence health outcomes, and direct their efforts at various levels to address the root causes of illnesses and inequities in health.
Resources
- Vancouver Coastal Health Population Health: Advocacy guidelines and Resources
- Community Tool Box – Principles of Advocacy
- Dr. Eugene Leduc – New Drafts for Survey and Case Report Guidelines
- Leadership in Public Health A guide to advocacy for public health associations
- Dharamsi S, Osei-Twum J, Shroff F, Mu L, Woollard R. (2010) The Health Advocate Role: Preparing future physicians for socially responsive practice.eBook Publication. Available electronically at UBC Faculty Development (Medicine)
- Dharamsi S, Ho A, Spadafora SM, Woollard R. The physician as health advocate: Translating the quest for social responsibility into medical education and practice.Acad Med 2011 Sep;86(9):1108-1113. 1
Method and Written Report Guidelines
(adapted from instructions for authors for Program Description, CFP July 2011)
Health Advocacy
Manuscripts must be prepared in accordance with the “Uniform Requirements for Manuscripts Submitted to Biomedical Journals” available on the International Committee of Medical Journal Editors (ICMJE) website.
Abstracts: Include Introduction (Issue/problem being addressed and objective of health advocacy initiative), Description of Initiative, Evaluation/Outcomes, and Conclusion and do not exceed 300 words. Up to 4 key words (MeSH headings) should be included.
Health Advocacy Essay should not exceed 2500 words, excluding abstract, tables, and references.
Introduction: Establish the issue/problem being addressed and why it is important to the healthcare community and the community/patient population. Specific objectives of the initiative should be described and the relevant primary literature reviewed and cited, summarizing the current knowledge of the problem being addressed. This section should answer the following questions such as:
- What is the issue and how was it identified?
- What does the current knowledge related to the issue indicate and where are the gaps in knowledge and/or initiatives taken?
- How will the undertaken initiative advance our knowledge and change current practices?
- Who is involved?
Selecting the Issue and type of advocacy
Advocacy efforts must have an assessable impact on the health and well-being of a population group or population at large to justify the efforts (see VCH Population Health: Advocacy Guideline and Resources) Residents must demonstrate collaboration/partnership with this population (the participants) in identifying the issue and plans for advocacy:
- Bottom-up approaches involve a process that actively engages the community. Community members are involved in identifying critical issues that affect their community.
- Top-down approaches are based on the identification of an issue by someone outside the community (e.g., healthcare professionals, civil society organizations, NGOs, etc.), nevertheless, the community would still need to be consulted for input around the objectives, design, scope and outcomes related to the issue of concern.
Approaches to solving the issue/problem must be identified and clearly defined, and evaluation plan outlined.
Description of Initiative: Explain in sufficient detail for someone else to reproduce it. The identified issue/problem should be addressed by the health advocacy initiative. To determine success or impact, a concise evaluation or approach to evaluation of the initiative should be described along with any data collected and analyzed.
Evaluation/Outcomes: Present in a concise manner. To determine if the health advocacy initiative was successful, qualitative and/or quantitative information is needed. An evidence-informed approach is required. Obtaining relevant and credible information to achieve these outcomes requires research. Research gives your advocacy credibility: new information is obtained and validated, enabling you to advocate in an informed and credible fashion.
Ethical approval will likely be required from the UBC Research Ethics Board (REB). Not all advocacy projects will require REB approval – if you believe your project does not require REB approval because you do not plan to collect data directly from people, then ask the REB for written confirmation that REB approval is not required. Document this in your report.
If your project requires REB approval, this will be necessary BEFORE starting your project. For more information read the section on Research Ethics.
Discussion: Highlight the outcomes of the initiative and compare the outcome with others in the field. Indicate if the initiative was successful and an improvement over previous initiatives to address the issue. Limitations of the advocacy project should be described.
Conclusion: Summarize the main outcomes of the advocacy initiative in relation to the problem addressed, and be justified by the information presented.
References: Must be current and complete. Check references for accuracy, completeness, and proper format. References should be numbered in the order they appear in the text and should be limited to works cited in the article. List all authors when there are 6 or fewer; when there are 7 or more, list the first 6, followed by et al. Reference management software (e.g., RefWorks, Mendeley, EndNote, etc.) are helpful in ensuring accurate referencing. These also provide a platform to save your article notes and annotations.
Authorship: Include a description in their written report of what each author contributed to their Resident Scholar Project. In addition, if several residents are involved in one Resident Scholar Project, residents should include a statement to describe the processes they underwent to decide the order of the authors on the Resident Scholar Project written report.
Acknowledgements: All people (e.g. faculty, professionals like statisticians and librarians, research assistants, etc.) who contributed to the work of the Resident Project who are not authors should be named in the Acknowledgements and what they did should be described. All financial support of the Resident Project should also be described in the acknowledgements section.
Guidelines for Authorship and Acknowledgements
Please follow the latest authorship definition provided by the Uniform Requirements for Manuscripts Submitted to Biomedical Journals listed below from the website: www.icmje.org as follows:
“All persons designated as authors should qualify for authorship, and all those who qualify should be listed. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. One or more authors should take responsibility for the integrity of the work as a whole, from inception to published article. Authorship credit should be based only on 1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; 2) drafting the article or revising it critically for important intellectual content; and 3) final approval of the version to be published. Conditions 1, 2, and 3 must all be met. Acquisition of funding, the collection of data, or general supervision of the research group, by themselves, do not justify authorship.”
In addition, all residents and faculty should refer to the Department of Family Practice Authorship and Collaboration that was approved by the Post-Graduate Education Committee in 2003. This policy guides the order of authors for faculty and residents who work together on a Resident Scholar Project.