12. Policy and Advocacy

Definition

A policy is a decision designed to address a given problem or interrelated set of problems that affect a large number of people. Advocacy consists of activities carried out on behalf of policies or constituencies; its purpose is to influence outcomes that affect peoples’ lives.

It is important for MCH leaders to possess policy and advocacy skills, because they often must defend and advocate for MCH resources in competitive economic and political environments.

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Knowledge Areas

Through participation in this program, a participant will know:

  • Public policy process at local, State, and national levels.
  • Current public-sector policies and private-sector initiatives that affect MCH population groups.
  • Appropriate methods for informing and educating policymakers about the needs of and impacts of current policies on MCH population groups.

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Skills

Basic. Through participation in this program, a participant will:

  1. Frame problems based on key data, including economic, political, and social trends that affect the MCH population.
  2. Use data, levels of evidence, and evaluative criteria in proposing policy change.
  3. Identify a wide range of stakeholders who influence changes in MCH policy.

Advanced. With more experience and building on the basic skills, MCH leaders will:

  1. Apply appropriate evaluative criteria to the analysis of alternative policies.
  2. Analyze the potential impact of policies on diverse population groups.
  3. Understand the roles and relationships of groups involved in the public policy development and implementation process, including the executive, legislative, and judicial branches of government at all levels and interest groups.
  4. Formulate strategies to balance the interests of diverse stakeholders, consistent with desired policy change.
  5. Present evidence and information to a legislative body, key decisionmakers, foundations, or the general public.

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Educational Experiences

  1. Write a policy brief about an emerging local MCH public health issue
  2. Attend a meeting of a local MCH stakeholder group, provide a written summary of their approach.
  3. Attend a professional association meeting and actively participate on a committee.
  4. Meet with a state legislator or staff member or member of Congress or staff member to discuss an MCH issue.
  5. Provide written and oral testimony to the state legislature.
  6. Write an OP/ED article on an MCH topic.
  7. Observe a legislative hearing on CSPAN, or if possible, attend a legislative hearing on an MCH topic.
  8. Track a bill over the Internet over the course of a legislative session.
  9. Interview an agency or organization-based MCH policy maker, administrator, or advocate and prepare a report and oral presentation. Present written and oral mock testimony from the perspective of the agency/association interviewed

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Resources/Assessment Tools – 12. Policy and Advocacy

Key Documents

Kingdon, J.  2003.  Agendas, Alternatives, and Public Policies, 2nd Edition, Longman Classics in Political Science Series.  Longman Publishing Group., ISBN-13: 9780321121851

U.S. Government, Senior Executive Service Leadership Competencies, http://www.opm.gov/ses/define.asp

McDonough, John E. 2000. Experiencing Politics:  A Legislator’s Stories of Government and Health Care. Regents of the University of California.

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Assessment Tools

Inclusion Criteria –

To be considered for initial inclusion in this web site, the materials had to meet several criteria:

  • the material needed to focus on one or more of the skills listed for a particular competency
  • the material needed to describe either a measurement instrument or theory that could support the creation of such an instrument
  • the material had to be publicly available, that is, where the item is not a commercial entity available for purchase
  • the material needed either psychometric information about its properties as a measure or, particularly in the case of material found only on the Web, a high degree of face validity

Copyright and Use Issues –

The materials initially described were identified for consideration by MCH interdisciplinary training programs. Many of these materials are copyrighted and thus, may not be copied, distributed, transmitted, or published without the express written permission of the copyright owner. It is the responsibility of each user to ascertain whether materials may be freely used or whether such permission is needed.

Case Studies

Frattaroli and Teret (2006) described a case study methodology that sought to understand the implementation of a new state policy. While this method is time-intensive and impractical for use as a teaching and assessment tool as described, the notion of understanding policy, including policy attributes and the people involved and impacted by a particular policy could serve as a small group or journal club type of activity. The topic lends itself to a variety of approaches, including learners’ taking the perspective of various stakeholders, such as policy-makers, consumers, health care professionals, etc.

Information at:
Frattaroli, S. & Teret, S. P. (2006). Understanding and informing policy implementation. Evaluation Review. 30(3): 347-60.

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Competency Grid

Bracy Kalb et al. (2006) described the pilot testing of a competency-based tool developed for use with public health nurses. The tool, used as part of regular performance appraisal, specifically addresses issues of policy development and program planning. The behaviors identified are developmentally sequenced for staff levels in the agency that developed the tool. Thus, they move from novice (individual RN) to advanced (nursing supervisor). Adaptation of the tool for use with MCH inter-disciplinary populations could provide a useful way to address issues of policy and advocacy in training programs.

Information at:
Bracy Kalb, K., Cherry, N. M., Kauzloric, J., Brender, A., Green, K., Miyagawa, L., Shinoda-Mettler, A., Kulbok, P., & Reed, J. (2006). A competency-based approach to public health nursing performance appraisal. Public Health Nursing, 23(2): 115-38.

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Community Education Competencies Grid

The Community Education Competencies Grid is a tool created by the Tri-College University Educational Leadership Program to assess learner portfolios on skills and knowledge related to community education. Many of these items are closely related to the MCH leadership competency of Working with Communities and Systems and could prove useful in designing and assessing learning plans that focus on specific components of this competency.

Information at:
www.ndsu.nodak.edu/ed_lead/documents/Community_Ed.doc

Directions for scoring the portfolios are also provided.

Information at:
Directions for SELF Scoring (DOC)

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Portfolios

Portfolios are collections of information that can be used to evaluate MCH knowledge in action.

Portfolios include materials prepared by a learner to demonstrate learning in response to a plan. There is increasing evidence of the utility of portfolios for assessment of learning and for competency assurance in health care.

For a portfolio to be effective, it should include:

  • a learning plan that contains specific goals and objectives
  • materials that demonstrate achievement relative to the learning plan
  • learner reflections
  • learner and faculty evaluations of the material

The ACGME, in its draft Toolbox of Assessment Methods, provides some information about the properties and uses of portfolios for assessment.

Information at:
http://www.acgme.org/outcome/assess/toolbox.asp

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