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Policy Advocacy A public health trainee’s guide Jason Cabaj, MD MSc PGY4 PHPM Resident May 28,...
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Transcript of Policy Advocacy A public health trainee’s guide Jason Cabaj, MD MSc PGY4 PHPM Resident May 28,...
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Policy AdvocacyA public health trainee’s guide
Jason Cabaj, MD MScPGY4 PHPM ResidentMay 28, 2014
Community Health Sciences
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Session Objectives
Illustrate the relevance of policy advocacy in public health practice
Outline the knowledge gap in PHPM residency training
Describe a potential solution for public health trainees:
Learning module incorporated into a wiki-based knowledge management platform
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Background
Policy Definite course of action selected from among alternatives to guide present and future decisions— Public health policy— Healthy public policy
AdvocacyIndividual and social action designed to gain political commitment or support for a health goal or program— Key method of achieving policy change and
protecting/improving health— Ottawa Charter strategy
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Successful Policy Advocacy?
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PHPM Competencies
RCPSC PHPM Objectives of Training — 1.2. Identify opportunities for advocacy— 2.1.1. Recognize situations where advocacy is required and define
strategies to effect the desired outcome— 3.3.3. Discuss mechanisms of policy development and methods of
implementation, including legislation, regulation, and incentives— 3.3.5. Conduct a policy analysis and policy evaluation— 3.7.1. Demonstrate competency in advocacy skills— 5.2.5. Contribute to the formulation of healthy public policy or
legislation at local, provincial or federal level Minimum Competencies for MOHs in Canada (2009)
— MOH competencies similar but more advanced— Highly required skills when working in a political environment
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PHPM Training
PHPM training requirements— CanMEDS
Knowledge, attitudes, skills— Broad and location dependent
Variation in academic curriculum Variation in opportunities for application
— Policy competencies Most residents have little background in political and social
sciences Focus on the Policy Cycle and on KT
o Valuable but limitedo Policy development is black box
Need to understand policy process itself to successfully engage and influence
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Proposed Solution
Development of single consolidated resource— Focus on informing public health practice
Learning module for PHPM residents Potential utility for other public health trainees
— Process Two month rotation guided by academic public health
physician preceptor (Dr. Lynn McIntyre) Targeted readings Environmental scan Policy briefs and analyses Policy scans Module development
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Learning Module
Learning module content— Policy science overview (i.e. policy 101)— Policy process theories— PHPM physician roles in policy advocacy— Advocacy methods, skills, tactics— Key policy concepts— Competency application opportunities
Policy briefs, policy analyses— Links to external resources
NCCHPP, NCCMT, PHPC, CPHA— Knowledge translation overview
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Policy Science
Theories of policy process— Policy Cycle
i.e. Stages Model/Heuristic “Textbook approach”
— Advocacy Coalition Framework Paul Sabatier
— Multiple Streams Framework John Kingdon
Policy Window
Problems
Proposals
Politics
Relatively Stable Parameters
External Subsystem Events
Long Term Coalition Opportunity Structures
Short Term Constraints and
Resources of Subsystem Actors
Policy Subsystem- Coalition A- Coalition B
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Physician Roles
Public health physicians have many potential roles— Decision maker/policy maker— Policy entrepreneur— Advisor— Coalition member— Honest broker— Medical doctor— Government employee— Expert— Private citizen— Association member
Key Policy Concepts
Valence
Rhetoric
AgendaSettingFraming
PolicyWindow
PolicyImplementation
PolicyImplications
Policy Entrepreneurs
Module
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Wiki
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Applications for Module
Two models for use— Stand alone resource
Self-learning module for PHPM resident policy and knowledge translation competency acquisition
— Elective rotation/directed study course guide Core or supplementary resource guidance document Recently used to good effect by CHS graduate student
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Summary
The world of policy is complex— Lack of existing practice focused learning resources— Custom learning module provides a concise entry point
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Thank you
Questions?
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References and Resources
Baumgartner, F.R. (2013). Ideas and policy change. Governance: An International Journal of Policy, Administration, and Institutions. 26:2, 239-258.
Canadian Public Health Association - Policy and Advocacy page Moloughny, B. (2012). The use of policy frameworks to understand public
health-related public policy processes: a literature review. Prepared for Peel Public Health. Learn about public policies and their effects on health. National Collaborating Centre for Healthy Public Policy
National Collaborating Centre for Healthy Public Policy National Collaborating Centre for Methods and Tools Public Health Physicians of Canada - Advocacy Documents Sabatier P. (ed) (2007). Theories of the policy process. Westview Press.
Cambridge. Scott, J.M, Rachlow, J.L., Lackey, R.T. (2008). The science-policy interface: What
is an appropriate role for professional societies. BioScience 58:9, 865-869.
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Key Policy Concepts
Agenda setting— Policy agenda is the issues/problems that decision makers are paying attention to
Framing — How actors seek to understand and act on complex situations
Policy entrepreneur — Individuals who may influence policy processes due to position, network, and
persistence Policy implementation
— The process of turning policy into practice Policy implications
— Social, legal, ethical, environmental, economic, political, and organization factors Policy window
— Critical period of time when policy streams converge to facilitate policy change Rhetoric
— The art of effective or persuasive speaking or writing used in policy debates Valence
— The emotional quality of an idea that makes it more or less attractive