Legislative Advocacy Research Articles

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.

Roadblocks at every turn: What reproductive health experts say about barriers to legislative abortion advocacy

ObjectivesAdvocacy is an important part of the reproductive health care profession, but barriers to participating in the legislative process are not well understood. This study examines the barriers experts in reproductive health experience to testifying at state legislative committee hearings regarding abortion. Study designWe conducted in-depth semistructured interviews with 40 experts in reproductive health, including obstetrician gynecologists (OBGYNs), midwives, pediatricians, nurses, primary care providers, and professional advocates. We analyzed the interview transcripts using an inductive coding process. ResultsWe identified four barriers to testifying at state legislative committee hearings regarding abortion. First, our interviewees described a tension between claiming expertise and stigma: those without direct experience in abortion care often felt too unqualified to testify, but representing oneself as an abortion provider came with stigma that made communicating with legislators difficult. Second, issues of power and identity informed interactions in committee chambers, as well as the structure of advocacy work more broadly. Third, institutional constraints shaped what experts could say and whether they could rely on their professional affiliations for support. Finally, fear of harassment and violence kept many of our interviewees from testifying, especially those who were active abortion providers. ConclusionsThese barriers appear unique to testifying on abortion and represent a complex web of hurdles that experts in reproductive health must navigate to participate in this part of the policymaking process. ImplicationsOur findings suggest multiple strategies for improving the state of expert involvement in abortion policymaking, including expanding the pool of testifiers to include nonabortion providers and experts with a range of backgrounds, as well as supporting organizations that link experts to training and advocacy networks.

Partisipasi dan Agensi: Perempuan Muda selama Advokasi UU TPKS

Since a decade ago, the women’s movement in Indonesia has consolidated its power to advocate for policies aimed at eliminating sexual violence through legislative advocacy and public campaigns. These efforts were a response to the increasing cases of sexual violence and the absence of a legal framework to address the issue. In the process of policy advocacy, young women have played a crucial role by participating in formal and informal political processes, although their participation has often been overlooked and unrecognized. This research examines the dynamics of young women’s activism in various forms at the national level in the advocacy process for Sexual Violence Criminal Law (UU Tindak Pidana Kekerasan Seksual/UU TPKS). This research aims to demonstrate the role and forms of activism among young women in advocating policies related to sexual violence. The study utilizes a qualitative methodology through in-depth interviews with eight young women activists involved in the advocacy, lobbying, and campaigning to pass the bill. The research finds that young women face various barriers and challenges, but simultaneously demonstrate their agency in the policy advocacy process.

Legislative Advocacy on Capitol Hill: Experiential Learning for Nursing and Midwifery Students.

Policies, regulations, and laws influence all aspects of health care, including the education of health care professionals, independent practice, and patient access to care. Health equity and social justice are mediated through policy. While health policy knowledge and skills are recognized as essential competencies within nursing and midwifery curricula, most students graduate with limited or no experience engaging in advocacy efforts to advance legislation that would improve health systems and the delivery of care. An experiential learning activity is described that gives students authentic experience in federal legislative advocacy. Students report powerful, positive learning from interacting with their legislators. Support of a legislative advocacy experiential learning activity requires ongoing faculty initiative and can promote advancement of health policy bills into law. Opportunities to participate in legislative advocacy need to be expanded within nursing and midwifery education to cultivate leaders who can effect policy change.

Assessing the Impact of a Real-World Legislative Visit on Student Pharmacists’ Perceptions on Legislative Advocacy

Assessing the Impact of a Real-World Legislative Visit on Student Pharmacists’ Perceptions on Legislative Advocacy

Implementing front-of-pack nutrition warning labels in Mexico: important lessons for low- and middle-income countries.

To analyse the implementation of front-of-pack nutrition labelling (FOPNL) in Mexico. Review of publicly accessible documents, including legislative websites, news sources, and government, intergovernmental, and advocacy reports. Usage of the policy cycle model to analyse the implementation and evaluation stages of Mexico's General Health Law, amended with FOPNL (2019-2022). In October 2019, the government published a draft modification of the Norma Oficial Mexicana (Official Mexican Standard) to regulate and enforce a new FOPNL warning label system. A 60-d public consultation period followed (October-December 2019), and the regulation was published in March 2020 and implementation began in October 2020. An analysis of nine key provisions of the Standard revealed that the food and beverage industry and its allies weakened some original provisions including health claims, warnings for added sweeteners and display areas. On the other hand, local and international public health groups maintained key regulations including the ban on cartoon character advertisements, standardised portions and nutrient criteria following international best practices. Early implementation appears to have high compliance and helped contribute to reformulating unhealthy products. Continued barriers to implementation include industry efforts to create double fronts and market their cartoon characters on social media and through digitalised marketing. Early success in implementing the new FOPNL system in Mexico was the result of an inclusive and participatory regulatory process dedicated to maintaining public health advances, local and international health advocacy support, and continued monitoring. Other countries proposing and enacting FOPNL should learn from the Mexican experience to maintain scientifically proven best practices, counter industry barriers and minimise delays in implementation.

Speaking a Foreign Language: Our Executive Federal Agency and Legislative Advocacy Visit

Speaking a Foreign Language: Our Executive Federal Agency and Legislative Advocacy Visit

Even one voice: Teaching legislative advocacy as a core competency in family medicine.

Credentialing bodies increasingly focus on advocacy as a competency to be developed by physicians during residency. The skills of advocacy are especially important with the increased attention on social determinants of health, as restrictive state and federal health policy decisions gain widespread attention in the national news media. This movement is reflected in the ACGME's recently revised statement on the training mission of family medicine residencies with the most recent update of milestones, which identifies advocacy as a core competency. Additionally, the major family medicine organizations and governing bodies all similarly identify advocacy as an important professional responsibility for family physicians. Advocacy is a broad term that can be applied across a range of settings and scenarios. For the purposes of this paper we focus primarily on legislative advocacy as a specific area for growing curricular emphasis in family medicine residency programs.

Advocacy 101 for Interventional Cardiologists: A Society for Cardiovascular Angiography & Interventions Policy Statement.

Advocacy is a core mission of the Society for Cardiovascular Angiography & Interventions (SCAI). SCAI advocates on behalf of interventional cardiologists and our patients. This document provides foundational information and a toolkit for grassroots advocacy by interventional cardiologists. The first half of the document summarizes how health care laws are made, how medical devices are approved, and how procedure reimbursement is determined. The second half of the document is a playbook of advocacy strategies: legislative advocacy, judicial advocacy, advocacy with regulators and payors, advocacy in the media, and participation in SCAI advocacy initiatives, such as the Government Relations Committee and SCAI Political Action Committee. Equipped with this toolbox, interventional cardiologists must increase our advocacy activities with government, payors, and industry.

Peer Mentoring: A Case Study in Developing Legislative Advocacy Skills among Social Work Students

Peer mentoring in social work education can be beneficial in developing and promoting legislative advocacy skills among social work students taking foundational social welfare policy courses at both the undergraduate and graduate levels. A descriptive case study is presented of a student peer mentoring project within a social work educational program at a regional comprehensive state university. This study describes the incorporation of a peer mentoring program to assist in promoting legislative advocacy skills among social work students. The project encompasses annual state-level high-impact practice (HIP) legislative advocacy action events across 5 years before and during the global pandemic. This article also seeks to inspire social work educators to embrace peer mentoring as a means to enhance and promote the development of advocacy skills as students find their collective voice and speak up to educate lawmakers on contemporary social problems impacting vulnerable populations.

Bidirectional Medical Training: Legislative Advocacy and a Step Towards Equity in Global Health Education.

The authors report no conflicts of interest. [email protected] Supplemental Digital Content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal's website, www.annalsofsurgery.com.

It Has Been a Big Year for NASN's Advocacy Efforts!

Annually, the National Association of School Nurses (NASN) sets advocacy goals, including legislative priorities. This past January, the NASN Board of Directors resumed their in-person Hill Day, with over 100 appointments with Members of Congress and Senators. This article highlights NASN's 2022-2023 legislative priorities and advocacy efforts, along with briefly discussing the relationship of Bipartisan Safer Communities Act to Medicaid reimbursement for school nursing services.

Collaboration between pharmacists in community pharmacy and ambulatory clinic settings: Current state and future directions

AbstractPharmacists in the community and ambulatory settings are primed for collaboration that can optimize care. Now is the time to capitalize on the momentum and positive disruption of the COVID‐19 pandemic that propelled pharmacists and their organizations to respond with agility to deliver care in new ways, pivot to develop new partnerships, and leverage technology. The growth of collaborative practice agreements within ambulatory care settings, the enhancement of clinically integrated networks, and the growth in professional organization support create an environment ripe for implementation of pharmacist‐to‐pharmacist collaborations. The American College of Clinical Pharmacy 2022 Clinical Practice Affairs B Committee sought out literature, as well as prepublication contemporary examples, demonstrating models of intraprofessional collaboration among pharmacists in community and ambulatory settings. The committee formulated six key recommendations to optimize pharmacist collaborations in the community and ambulatory settings and formed a framework for practical implementation strategies at the levels of individual pharmacists, organizations, and educational institutions and for legislative advocacy.

Preparing School Counseling Trainees in Professional Legislative Advocacy

Professional legislative advocacy is a pathway to improve the field of education as it may lead to policy changes that impact schools and the profession directly. Higher education educators have the opportunity to infuse in their students the skills and confidence to become advocates for their respective disciplines. In this study on an approach to teaching, we developed a training intervention to teach and build school counseling trainees' confidence for engaging in professional legislative advocacy and evaluated its effectiveness in an initial study. Compared to pretest scores, the participants had significant gains in knowledge, skills, and attitudes related to professional legislative advocacy after the training intervention. Their posttest scores were also higher than a sample of school counselor trainees who did not participate in the training. We discuss the implications of these findings and suggested research directions.

It’s 10 O’clock: Do You Know Where Your State Legislature Is?

It’s 10 O’clock: Do You Know Where Your State Legislature Is?

The Need for Required Stock Epinephrine in All Schools: A Work Group Report of the AAAAI Adverse Reactions to Foods Committee

Epinephrine is the first line of treatment for anaphylaxis which can occur outside a medical setting in community environments like schools. Patients with diagnosed IgE-mediated food allergy at risk of anaphylaxis are prescribed self-injectable epinephrine and given an individualized anaphylaxis action plan. As students, such patients/families provide their school with completed medication forms, a copy of their anaphylaxis plan, and additional student-specific epinephrine. However, students approved to self-carry prescribed self-injectable epinephrine may forget to do so or have other reasons for lacking prescribed epinephrine such as familial inability to fill the prescription due to cost or other access barriers. Undiagnosed students lacking prescribed epinephrine may also experience anaphylaxis at school. The presence of non-student specific school stock epinephrine allows school nurses and other staff the ability to treat anaphylaxis on-site while awaiting emergency medical services. Notably, not all states legally mandate K-12 schools to stock epinephrine. In states with laws only voluntarily allowing schools to stock epinephrine, it provides the ability to opt-out. Herein, we present a comprehensive review of barriers to school stock epinephrine, related improvement strategies, and workgroup recommendations supporting the need for mandated stock epinephrine in all schools in every state. Proposed solutions include ensuring legal immunity from liability for prescribers; advocacy for legislation to stabilize cost of self-injectable epinephrine; educational initiatives to schools promoting merits and safety of epinephrine and related anaphylaxis training; and partnerships between patient advocacy groups, medical and nursing organizations, public health departments and other health professionals to promote laws and district policies addressing need for stock epinephrine and school nurses to train and supervise school staff.

Advocacy training tool for pediatric residents to strengthen firearm safety laws.

Firearm injury is the leading cause of death in children and adolescents in the US, surpassing motor vehicle crashes. There is a need for greater legislative advocacy around firearm injury prevention, specifically around safer storage of firearms. A national medical trainee-based program convened in 2021 with the goal of increasing advocacy efforts around common causes of pediatric injury. A focus was to create a set of advocacy training tools that could be utilized by a wide variety of stakeholders. The subgroup sought to design policy-based training tools; one focused on general firearm injury prevention principles and another specifically focused on Child Access Prevention (CAP) laws. We explicate the utility of these documents and the need for greater advocacy around pediatric firearm injuries.

Burnout: A Call to Action From the AUA Workforce Workgroup.

We hypothesize burnout has failed to improve and certain demographics may be disproportionately affected. The AUA Workforce Workgroup examined work from the annual AUA Census over the past several years. Particular to this study, relevant burnout-related data were examined from the past 5 years. In 2021, 36.7% of urologists reported burnout compared to 36.2% in 2016. Burnout in men decreased from 36.3% to 35.2%, but increased in women from 35.3% to 49.2%. When examined by age, the largest increases in burnout were seen in those <45 years old, increasing from 37.9% to 44.8%, followed by 45-54 years old, increasing from 43.4% to 44.6%. When asked about the effect of COVID-19 on burnout, 54% of urologists didn't feel COVID-19 impacted burnout. Beyond burnout, only 25.0% of men and 4.6% of women reported no conflict between work and personal responsibilities, while 25.7% of men and 44.7% of women resolved these conflicts in favor of work or were unable to resolve them. Of respondents, 22.5% of men and 37.1% of women were "dissatisfied" with work-life balance. Similarly, 33.6% of men reported their work schedule does not leave enough time for personal/family life, compared to 57.5% of women. Overall, urologists have higher burnout now when compared to 2016. The gender discrepancy has vastly widened with women experiencing burnout at an increased rate of 14% compared to 2016, while burnout in men decreased by 1%. Burnout has increased the most in those <45 years old. Further action is needed to substantiate the causes of burnout.

Incorporating Health Policy and Advocacy Curricula Into Undergraduate Medical Education in the United States.

Physicians serve as crucial advocates for their patients. Undergraduate medical education (UME) must move beyond the biomedical model, built upon the perception that health is defined purely in the absence of illness, to also incorporate population health through health policy, advocacy, and community engagement to account for structural and social determinants of health. Currently, the US guidelines for UME lack structured training in health policy or advocacy, leaving trainees ill-equipped to assume their role as physician-advocates or to engage with communities. There is an undeniable need to educate future physicians on legislative advocacy toward improving the social determinants of health through the creation of evidence-based health policy, in addition to training in effective techniques to engage in partnership with the communities in which physicians serve. The authors of this article also present curricular case studies around two programs at their institution that could be used to implement similar programs at other US medical schools.

A Student-Designed Multimodal Sex- and Gender-Based Women's Health Elective Program: Advocacy Curriculum for Medical Students.

The objective of this article is to describe the design and implementation of a multimodal, student-driven, sex- and gender-based women's health (SGBWH) elective with a curricular focus on patient and legislative advocacy. In this single arm, pre/post design, interventional study, we detail and evaluate the use of social media, newsletters, and round-table discussions in conjunction with a traditional lecture-based educational format to engage medical students in a virtual learning environment. We developed a 22-week SGBWH curriculum for pre-clinical and clinical medical students, which included a series of lectures on multi-specialty and gender-inclusive topics related to SGBWH, small group discussions with community leaders and legislators involved in women's health advocacy, and other self-directed resources such as social media, a website, and digital newsletters. Students were surveyed before and after completing the curriculum to assess for increases in self-reported confidence in advocating for their female and gender minority patients. One hundred and one students completed the anonymous pre- and post-elective surveys. There was statistically significant improvement in 8 of the 12 self-reported confidence measures. Eight (8%) participants identified their sex as male. Fifty-five (55%) participants stated future interest in primary care specialties (Internal Medicine, Family Medicine, Obstetrics and Gynecology, and Pediatrics). Our curriculum improved medical students' self-reported confidence in advocating for their female and gender minority patients when controlling for sex and specialty interest of participants. The success of our multimodal approach demonstrates the value in incorporating resources such as social media as tools for education and advocacy in the evolving landscape of medical education.