Physician Assistant Involvement in Health Advocacy, Health Promotion and Disease Prevention: A Scoping Review

Abstract

OBJECTIVES:Physician Assistants (PAs) have been integrated into the Canadian healthcare system to improve patient access and clinical efficiency. The CanMEDS-PA framework describes the PA as a health advocate, but the current extent of PA involvement in health advocacy has not been delineated. A scoping review was conducted to investigate PA participation in health advocacy, health promotion and disease prevention initiatives.METHODS: An electronic literature search was conducted using Web of Science, PubMed, CINAHL, OVID (Embase and MEDLINE) and Cochrane databases. Broad eligibility criteria were used to include publications involving PAs or PA students who participated in health advocacy, health promotion and disease prevention initiatives globally.RESULTS:297 records were identified; 14 met the inclusion criteria.  Publications included cross-sectional studies, surveys, program evaluations, clinical framework development, and patient education handouts. Topics included cancer screening, chronic disease management, adolescent health promotion and stroke prevention.  All records were published in the United States. There was an overall positive contribution of PAs to health advocacy, health promotion and disease prevention. Several specific limitations were noted related to procedural techniques and continuity of practice.CONCLUSION:Global research on PA involvement in health advocacy, health promotion and disease prevention is limited and focuses on a small subset of medicine (cancer screening) in one geographical area (United States). Data show that PAs are effective health advocates but more reporting is needed to guide expansion of the PA role and to inform policy in Canada and globally.