Advocacy Efforts Research Articles

Understanding the what, how, and why in advocacy: Assessing the applicability of participatory process evaluation methodology in an advocacy context

While evaluations are critical for non-governmental organizations to strengthen their advocacy strategies, evaluators and advocates encounter many difficulties evaluating such efforts. This article discusses the contribution of the participatory process evaluation methodology to advocacy evaluation, using a Dutch global health advocacy program as a case study. As participatory process evaluation is a novel methodology in the field of advocacy, the article’s primary focus concerns the application and utility of the methodology. Findings suggest that participatory process evaluation in an advocacy context can provide insights into the implementation of advocacy tools and activities, encouraging reflection and leading to ideas and practical tools to strengthen advocacy efforts. While participatory process evaluation can help overcome some of the often-experienced barriers in advocacy evaluation, further research is needed to consolidate advocacy evaluation theory and practice.

R2 (Resident Advocacy Project) Reducing the Risk of ATV-related Harm in Saskatchewan Children

Abstract Rationale and Objectives All-terrain vehicles (ATVs) are the second highest cause of transport-related hospitalizations, emergency room visits, and disabilities in Saskatchewan citizens of all ages. Saskatchewan law restricts the use of ATVs by children aged 12-16 and bans the use of ATVs by children under the age of 12 on public land. Previous CPS status reports had found this level of legislation inadequate. Clinically, we certainly see many children enter Saskatchewan hospitals for ATV-related injuries, and previous attempts at education campaigns and government lobbying have not been successful. There is limited Saskatchewan information on this issue, so we first sought to gather data to identify where social and legislative advocacy efforts should be directed. Project Description We partnered with the Saskatchewan Prevention Institute, a non-profit organization working to prevent injuries in children, as they have worked on ATV safety over the years with community partners as well as government. We completed a retrospective chart review to describe the prevalence and outcomes of ATV accidents in children and youth (aged 20 and under) presenting to hospitals in Saskatoon from 2016 to 2021. Armed with this data, we will be able to improve education campaigns as well as share information with key stakeholders, and hopefully effect change. Outcomes During the study period, 354 children presented to hospital after an ATV accident (most aged 12-16 years). Over 90% of children using dirt-bikes were wearing a helmet compared to 48% of children using four-wheeled ATVs (quads, side-by-sides, and other ATVs). Accidents involving quads resulted in an average hospital stay of 10 days, compared to 2 days for cases involving dirt-bikes. Finally, the type of injury was significantly associated with the patient’s health region of residence. For example, children living in the North and Far North Saskatchewan accounted for the highest proportion of moderate/severe head injuries (76.19%) and polytraumas (50%). Discussion/Future Directions This data suggests that there is a potential knowledge gap in public knowledge regarding the risks of children using ATVs; that there may be barriers to helmet use; and, most strikingly, that there is a disproportionate number of severe injuries occurring in northern Saskatchewan. New public education initiatives are now in development based on these findings. There are many stakeholders to consider, and we are aiming to share our data so that evidence-based policy decisions can be made. We are currently drafting a letter to relevant ministries, and hope to have more progress to share in the near future.

“Is it Okay Not to be Okay?”: A Critical Literature Review of Barriers to Mental Health Treatment for Black Men

Black men reportedly have a high prevalence of mental illness with little to no counseling engagement. While there have been studies to determine potential influences on their lack of counseling utilization, the lack of impact toward progress and the scarcity of such literature in the counseling field proves the need for continued exploration. Many of these studies have been conducted by scholars in other social science disciplines with few done by counseling scholars. A review of research concerning Black men and counseling utilization is presented using BlackCrit as a theoretical framework. Racism and masculinity are highlighted as barriers to mental health treatment which require further exploration in counseling literature. Recommendations for improving future research and advocacy efforts are provided for counselors and other mental health professionals.

Coping with HIV/AIDS-Related Stigma and Discrimination: An Overview Based on a Personal Loss

Stigma and discrimination have a profound psychological and societal impact on individuals living with HIV/AIDS and their communities. This research offers an in-depth exploration of these challenges, drawing insights from a vast array of sources, such as articles, books, films, documentaries, websites, reports, resolutions, and famous stories. In order to provide valuable insights into building resilience and fostering supportive environments, the study simultaneously examines the coping mechanisms and strategies employed by the infected, as depicted in the literature used therein. The example of Miha, a young woman who faced societal biases despite her achievements, serves as a poignant reminder of the many sad narratives behind the statistics. This paper ultimately emphasizes the urgent need for continued efforts in awareness, education, and advocacy of combating HIV/AIDS-related stigma and discrimination, and culminates in a call for collective action, empathy, and a shared vision of an inclusive world.

Sexual and Reproductive Health Knowledge of In-school Adolescents: A Comparative Study of Visually Impaired and Non-visually Impaired Students

Adolescents’ Sexual and reproductive health (SRH) knowledge is important for preventing SRH problems and enabling young people to live a healthy sexual and reproductive life. This study assessed the differences in SRH knowledge between the visually impaired (VI) and non-visually impaired (N-VI) adolescents; and examined the factors contributing to the differences between the two groups. The study was conducted in Ondo State, Nigeria using a multi-stage sampling technique to select 394 visually impaired and non-visually impaired in-school adolescents aged 15-19 years. Quantitative data were collected using Open Data Kit (ODK). Models were fitted with Ordered Logistic Regression (OLR) using Stata 14. Results showed that 89% of N-VI compared with 66% of VI had good access to SRH information, while 63.4% of the VI and 40.3% of N-VI had poor SRH knowledge. Students with good access to information were more likely to have a better SRH knowledge, although the relationship is stronger for the N-VI than for the VI. The OLR results further showed that the respondents who had good access to information were about 116% more likely to have good SRH knowledge than their counterparts with poor access to information (OR = 2.163; C1:1.41–3.32). Also, the likelihood of the N-VI having good SRH knowledge more than doubled (138% more) that of the VI (OR = 2.377; C1:1.14 – 4.00). Extra-curricular activities also increased the likelihood of good SRH knowledge. The study therefore recommends advocacy efforts to provide adolescents with increased SRH knowledge with special focus on VI.

Gaining Ground: OER at 3 Health Sciences Institutions

Background: Open Educational Resources (OER) are rising in popularity at higher education institutions to help combat high textbook costs. To date, little research has been published discussing the impact of OER in the health sciences context. This comparative case study seeks to fill this gap. Experience: The article shares OER programs and advocacy efforts at three institutions, including a brief history of OER work, barriers and failures, current successes, and future directions at each institution. Discussion: All three institutions are making efforts in OER outreach and advocacy, informed and impacted by their institutional community. Two institutions have an OER grant with increasing submissions from health sciences faculty. OER work is completed by one librarian at two of the institutions, while the third completes the work through a committee of stakeholders from across the institution. All cases include OER advocacy and outreach through library workshops and working to establish faculty partnerships. Barriers at all three institutions include a lack of time and funds to dedicate to finding or developing OER. Unique barriers include a desire to work with for-profit companies, concerns over disadvantaging students on their qualifying exams, and the sustainability of institutional efforts in OER. Takeaways: Libraries are uniquely situated to support faculty and staff as they incorporate OER into their practices. While health sciences faculty are typically slower to adopt OER, once they do take this step, they become strong advocates for open practices, the librarian, and the library.

A Mixed Methods Analysis of Southern HIV Service Organizations' Implementation of Harm Reduction to Address the HIV and Opioid Syndemic.

Southern HIV Service Organizations (SHSOs) are promising sites for the adoption and implementation of harm reduction as a means for addressing the HIV and opioid syndemic. However, little research to date has examined exactly how harm reduction is operationalized within and among SHSOs. Using program evaluation data (i.e., organizational assessment dataand semi-structured qualitative group interviewdata with SHSO staff), this study aimed to characterize organizational implementation of harm reduction among SHSOs that sought harm reduction capacity-building assistance (i.e., training, coaching, funding) from the SUSTAIN Center. Authors utilized a convergent mixed methods design in which quantitative and qualitative approaches were employed in parallel to gain simultaneous insights into how harm reduction was operationalized in SHSOs and how the local context influenced implementation. Means and proportions of each organizational assessment domain were compared. Thematic analysis of group interview transcripts examined SHSO staff perceptions of harm reduction implementation in their respective communities. Quantitative results revealed that SHSOs most commonly operationalize harm reduction in the Outreach, Advocacy, and Principles domains but struggle to do so in terms of Services and Organizational Infrastructure. Qualitative results revealed that various factors in SHSOs' local context, such as the community's lack of knowledge and understanding of harm reduction, limited harm reduction services, and a challenging socio-political context, influence SHSOs implementation of harm reduction. Taken together, analyses reveal that (1) SHSOs expend significant effort conducting outreach activities because Southern communities are generally unaware of harm reduction, (2) SHSOs continually advocate for harm reduction in the midst of a challenging socio-political context, and (3) SHSOs offer fewer harm reduction services and integrate harm reduction into their organizational infrastructure to a lesser extent due to external, contextual factors. The combination of organizational-level data and SHSO staff insights provided by this mixed methods study have implications for policy advocacy, funding initiatives, and capacity-building efforts.

O.6.2-3 The Global Observatory for Physical Education (GoPE!): monitoring physical education and physical activity in children and adolescents worldwide

Abstract Purpose It is estimated that 80% of children and adolescents do not meet the 60 min of moderate-to-vigorous intensity physical activity (PA) per day to benefit their health.1,2 Strengthening the provision of quality physical education (PE) and PA experiences within schools is a highly recommended policy action.3 Furthermore, there is a gap in monitoring systems of PE&PA at schools, which would contribute to tracking progress and inform decision-making to drive PE&PA policy, action, and research in this population group.4 After 10 years of successful monitoring of adults’ PA by The Global Observatory of Physical Activity (GoPA!), there is an urgent need to complement and initiate high-quality monitoring in children and adolescents. The Global Observatory of Physical Education (GoPE!) will be launched in 2023, therefore, our purpose is to present the GoPE! to the HEPA network. Project description Placed within the GoPA!, GoPE!’s main mission is to monitor PE and PA in children and adolescents worldwide. The GoPE! monitoring system will use a set of surveillance, policy, and research standardized indicators to allow countries to initiate, determine and improve their current status and progress around PE and PA. Standardized indicators will be updated every 3-4 years, allowing comparability between countries and world regions. GoPE! will publish the country profiles [GoPE! Country Cards], which are going to be developed following the GoPA! stepwise approach, and will consolidate as an independent evidence and local representatives-based and global surveillance system including the best PE&PA and sports experts, researchers, practitioners, and policymakers. Conclusions GoPE! will demonstrate its critical role in facilitating periodic PE&PA surveillance, policy and research data, to inform promotion, advocacy, and agenda-setting efforts to achieve international goals and recommendations. GoPE! and GoPA! will continue to monitor progress to battle the global pandemic of physical inactivity across the life course. References 1 USDHHS. 2018 PA Guidelines Advisory Committee Scientific Report. Washington: USDHHSD;2018. 2 van Sluijs, E. et al. PA behaviours in adolescence: current evidence and opportunities for intervention. The Lancet. 2021;398(10298):429-442. 3 WHO. GAPPA 2018–2030: more active people for a healthier world. Geneva;2018. 4 WHO. Global status report on PA 2022. Geneva: WHO;2022.

The psychosocial impact of childhood dementia on children and their parents: a systematic review

BackgroundChildhood dementias are a group of rare and ultra-rare paediatric conditions clinically characterised by enduring global decline in central nervous system function, associated with a progressive loss of developmentally acquired skills, quality of life and shortened life expectancy. Traditional research, service development and advocacy efforts have been fragmented due to a focus on individual disorders, or groups classified by specific mechanisms or molecular pathogenesis. There are significant knowledge and clinician skill gaps regarding the shared psychosocial impacts of childhood dementia conditions. This systematic review integrates the existing international evidence of the collective psychosocial experiences of parents of children living with dementia.MethodsWe used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched four databases to identify original, peer-reviewed research reporting on the psychosocial impacts of childhood dementia, from the parent perspective. We synthesised the data into three thematic categories: parents’ healthcare experiences, psychosocial impacts, and information and support needs.ResultsNineteen articles met review criteria, representing 1856 parents. Parents highlighted extensive difficulties connecting with an engaged clinical team and navigating their child’s rare, life-limiting, and progressive condition. Psychosocial challenges were manifold and encompassed physical, economic, social, emotional and psychological implications. Access to coordinated healthcare and community-based psychosocial supports was associated with improved parent coping, psychological resilience and reduced psychological isolation. Analysis identified a critical need to prioritize access to integrated family-centred psychosocial supports throughout distinct stages of their child’s condition trajectory.ConclusionThis review will encourage and guide the development of evidence-based and integrated psychosocial resources to optimise quality of life outcomes for of children with dementia and their families.

System-Level Strategies to Improve Home Dialysis: Policy Levers and Quality Initiatives.

Advocacy and policy change are powerful levers to improve quality of care and better support patients on home dialysis. While the kidney community increasingly recognizes the value of home dialysis as an option for patients who prioritize independence and flexibility, only a minority of patients dialyze at home in the United States. Complex system-level factors have restricted further growth in home dialysis modalities, including limited infrastructure, insufficient staff for patient education and training, patient-specific barriers, and suboptimal physician expertise. In this article, we outline trends in home dialysis use, review our evolving understanding of what constitutes high-quality care for the home dialysis population (as well as how this can be measured), and discuss policy and advocacy efforts that continue to shape the care of US patients and compare them with experiences in other countries. We conclude by discussing future directions for quality and advocacy efforts.

Increased Mortality of Black Incarcerated and Hospitalized People: a Single State Cohort Analysis.

To quantify racial disparities in mortality and post-hospitalization outcomes among incarcerated individuals that were hospitalized during their incarceration period. We designed a retrospective cohort study using administrative and hospital data collected from a preferred healthcare referral center for all Massachusetts jails and prisons between January 2011 and December 2018 with linkage to Massachusetts Vital Records and Statistics. We identified 4260 incarcerated individuals with complete data on race/ethnicity that were hospitalized during the study period. The primary study indicators were age, race, ethnicity, length of hospital stay, Elixhauser comorbidity score, incarceration facility type, and number of hospital admissions. The primary outcome was time to death. Of the incarcerated individuals that were hospitalized, 2606 identified as White, 1214 identified as Black, and 411 people who identified as some other race. The hazard of death significantly increased by 3% (OR: 1.03; 95% CI: 1.02-1.03) for each additional yearly increase in age. After adjusting for the interaction between race and age, Black race was significantly associated with 3.01 increased hazard (95% CI: 1.75-5.19) of death for individuals hospitalized while incarcerated compared to White individuals hospitalized while incarcerated. Hispanic ethnicity and being incarcerated in a prison facility was not associated with time to mortality, while increased mean Elixhauser score (HR: 1.07; 95% CI: 1.06-1.08) and ≥ 3 hospital admissions (HR: 2.47; 95% CI: 2.07-2.95) increased the hazard of death. Our findings suggest disparities exist in the mortality outcomes among Black and White individuals who are hospitalized during incarceration, with an increased rate of death among Black individuals.Despite hypothesizedequal access to healthcare within correctional facilities, our findings suggest that incarcerated and hospitalizedBlack individuals may experience worse disparities than their White counterparts, which has not been previouslyexplored or reported in the literature. In addition to decarceration, advocacy, and political efforts, increasedefforts to support research access to datasets of healthcare outcomes, including hospitalization and death, forincarcerated people should be encouraged. Further research is needed to identify and address the implicit and explicit sources of these racial health disparities across the spectrum of healthcare provision.

Towards improving the utilisation of counselling centre services by Ghanaian university students: An exploratory study

This study sought to explore university students’ expectations from on-campus counselling centres in order to improve service utilisation. A total of 72 Ghanaian students attending a public university in Accra (64% females; 85% undergraduate; 90% in the 18–35 age range) provided written responses of their expectations from their counselling centre. Thematic analyses yielded two essential counselling centre needs: Enhanced counselling centre functions and the elimination of systems barriers. For enhanced counselling centre functions, students reported needing traditional and non-traditional services, as well as advocacy efforts on their behalf. Systems barriers students wanted eliminated were stigma, low awareness and inaccessibility. These findings indicate a need for a holistic approach to service delivery, and elimination of services-seeking barriers to improve counselling centre service utilisation at Ghanaian universities.

A fractional-order tuberculosis model with efficient and cost-effective optimal control interventions

This study is concerned with applying fractional calculus in modelling tuberculosis (TB) transmission dynamics. A new six-dimensional fractional-order mathematical model in the sense of the Caputo derivative operator is formulated to capture memory effects in the spread process of tuberculosis. Some key features such as vaccination, forces of TB infection, and exogenous re-infection by two actively infectious classes are considered. Banach fixed point theory is employed to prove the existence and uniqueness of a solution for the fractional-order model. Equilibrium points and effective reproduction number of the model are determined. Analysis reveals that the model exhibits backward bifurcation where stable TB-free and TB-present equilibrium points co-exist when the effective reproduction number is below unity. Some sensitive parameters of the model are identified to help design intervention measures against the disease. Hence, four time-dependent controls, namely advocacy effort against infection and re-infection, vaccination control, prophylaxis against latent infection, and treatment control, are considered to form a fractional-order optimal control model. The controls are characterized using Pontryagin’s maximum principle. Efficiency and cost-effectiveness assessments are conducted to quantify the most efficient and cost-effective intervention plan to minimize TB spread in the population. Behaviours of the fractional-order TB model at varying values of the order of the Caputo derivative are extensively explored to show memory effects in the transmission dynamics of the disease.

41766 Efficacy of a Virtual, State-Wide, Dermatology Advocacy Day in Promoting Advocacy Efforts amongst Medical Trainees

41766 Efficacy of a Virtual, State-Wide, Dermatology Advocacy Day in Promoting Advocacy Efforts amongst Medical Trainees

Music for All or Partisan Advocacy? Exploring Socialized Epistemologies

Abstract: When novice music educators abandon their expressed dedication to forward-looking ideas like equity, epistemological distinctions between belief and knowledge, or lack of such distinctions, may influence such action. Political philosopher Russell Hardin argued that it makes sense for people to hold false, conflicting, and even extreme beliefs. Drawing on his work, we consider how social influences may encourage music educators to adopt a view of knowledge as the acquisition of information that is useful rather than truthful in the sense of being falsifiable and supported by evidence. First, we examine how teachers’ everyday socialization may cause them to abandon practices associated with “music for all,” an ill-defined ideal—officially adopted by the (US) National Association for Music Education—that we problematize here. Second, we consider the effects of broader polarization on socialized epistemology, including amplifying effects of technology, which may contribute to an in-group versus out-group mentality. Third, we investigate how advocacy related endeavors as well as bounded social circles in both K-12 music education and collegiate music teacher education may further solidify extreme beliefs within the profession. Finally, we consider implications for practice, including providing tools for more inclusive and open-minded advocacy efforts and some version of profession-wide “music for all” that focuses on socialization and recognition.

Music for All or Partisan Advocacy? Exploring Socialized Epistemologies

Abstract: When novice music educators abandon their expressed dedication to forward-looking ideas like equity, epistemological distinctions between belief and knowledge, or lack of such distinctions, may influence such action. Political philosopher Russell Hardin argued that it makes sense for people to hold false, conflicting, and even extreme beliefs. Drawing on his work, we consider how social influences may encourage music educators to adopt a view of knowledge as the acquisition of information that is useful rather than truthful in the sense of being falsifiable and supported by evidence. First, we examine how teachers’ everyday socialization may cause them to abandon practices associated with “music for all,” an ill-defined ideal—officially adopted by the (US) National Association for Music Education—that we problematize here. Second, we consider the effects of broader polarization on socialized epistemology, including amplifying effects of technology, which may contribute to an in-group versus out-group mentality. Third, we investigate how advocacy related endeavors as well as bounded social circles in both K-12 music education and collegiate music teacher education may further solidify extreme beliefs within the profession. Finally, we consider implications for practice, including providing tools for more inclusive and open-minded advocacy efforts and some version of profession-wide “music for all” that focuses on socialization and recognition.

Exploring Caseload Data of Vision Professionals and Their Implications

Introduction: To determine the current and future needs for teachers of students of visual impairments (TVIs), orientation and mobility (O&M) specialists, and dually certified professionals, information about caseloads is needed. However, few current studies exist that provide this data. Methods: The purpose of the study was to analyze demographic and caseload data gathered from 834 professionals who took part in a larger study. Descriptive and inferential statistics compared caseload size averages based on employment status, role, service delivery model, and region. Results: Minimal caseload differences existed among the regions of the United States, based on mean. Average caseload sizes by role reflected past literature. Caseloads ranged between 0 and 107 students, once outliers were removed. Discussion: This study provides some new data that provide insight into current caseloads, but a more expansive study would further contribute to the understanding of service provision for students with visual impairments. Implications for Practitioners: The field of visual impairment should continue to work toward recruiting a more diverse workforce and continue advocacy efforts for reasonable workloads and equitable services for students with visual impairments.

Analyzing Twitter Data to Understand Stigmatization of Schizophrenia Before and After Elon Musk

Stigmatization of mental health has become an increasingly prevalent issue in recent years, particularly on social media. The perpetuation of online stigma has significant negative impact on those with schizophrenia, affecting their social lives, self-esteem, ability to succeed in treatment, and more. One major factor that may affect stigmatization on social media is how content moderation is perceived by the users of the platform, as well as the social norms surrounding acceptable discussions on said platform. This relationship has not yet been examined in the context of schizophrenia stigma on Twitter. Elon Musk’s recent acquisition of Twitter has provided an opportunity to do just this, as his public statements and goals for the platform have suggested increased “freedom of speech” and decreased restrictions on content posted, changing how Twitter users perceive allowed conversations. The current study analyzed discussions of schizophrenia on Twitter before and after Elon Musk’s acquisition, coding individual Tweets based on the extent to which they indicated a stigmatizing attitude towards schizophrenia. Main findings include a marginally significant positive association between schizophrenia stigmatization and Musk’s acquisition of Twitter, with an increase in stigmatizing attitudes. Further, in agreement with previous literature on this topic, this study reveals that the stigma of schizophrenia is widespread on Twitter both prior and following Musk’s acquisition. The results of the study may be useful in guiding social networking companies and advocacy efforts to create programs or restrictions that counters stigmatization and further protects those with schizophrenia.

Media for advocacy of mental health in the Ethiopian context. Current practice, gaps, and future directions.

Media plays a crucial role in reshaping societal attitudes and behaviors towards individuals with mental illness. It contributes to improved rights of people living with mental health conditions and access to care services. However, in Ethiopia, mental health advocacy faces obstacles such as deep-rooted misconceptions, fear, and discrimination about mental illness, as well limited engagement of stakeholders and language barriers. Both mainstream and social media play a large role in disseminating mental health topics in Ethiopia. However, they need organized initiatives and efforts in order to be successful in promoting mental health awareness to the public. Implementing a comprehensive strategy comprising public awareness campaigns, policy advocacy, community engagement, stakeholder collaboration, responsible reporting, and increased coverage of mental health topics is crucial. The World Health Organization also emphasizes the role of health ministries in supporting mental health advocacy efforts. By promoting education, challenging stigmas, and improving access to mental health services, media advocacy can contribute to creating a more informed and supportive society for individuals with mental illness in Ethiopia.

Sequelae of carbide-related thermo-chemical injury: A retrospective analysis.

To describe the outcomes of eyes with calcium carbide (CaC2)-related thermo-chemical injury. This study included 28 eyes of 23 patients who presented with calcium carbide-related ocular burns. Only patients with more than three months of follow-up were included. Group A included 16 eyes with Dua's Grade I-III burns, while Group B included 12 eyes with Grade IV-VI burns. Electronic medical records were reviewed to provide data on the etiology of burn, presenting clinical signs and visual acuity, sequelae, and surgical interventions performed, both in the acute and chronic phases. The overall mean age was 28.48 ± 11.8 years. Fifteen patients were injured while using carbide to create an explosion to scare away animals on farms. The median presenting BCVA (best-corrected visual acuity) in Group A (20/160) was significantly better than in Group B [(20/2000) (P = 0.002)]. Five eyes in Group A and one eye in Group B underwent medical management. There was no difference in the duration of follow-up for both groups (P = 0.24). The median final BCVA in Group A (20/32) was significantly better than in Group B [(20/200) (P = 0.02)]. Two eyes in Group A and nine eyes in Group B developed LSCD. Two eyes in Group B were phthisical at the last visit. Calcium carbide-related ocular injuries can result in significant visual morbidity in young adults. Early presentation and management may improve outcomes. Prevention of these injuries by increasing awareness and increasing advocacy efforts is necessary.