Advocacy Practice Research Articles

Context and practices of health advocacy role by nurses in Ghana: A qualitative study

Background & Aim: Nurses play a crucial role in health advocacy, which is both morally obligatory and has significant consequences for the clinician. However, there is a paucity of empirical evidence regarding its context and practices. The location, method, and rationale behind nurses fulfilling their health advocacy duties are crucial in hospital settings. This study explored and described where and under what circumstances nurses fulfill their health advocacy responsibilities in Ghana. Methods & Materials: The study employed an inductive qualitative exploratory descriptive design to gather and analyze data from 24 nurses and midwives. Using a semi-structured interview guide, participants were selected from three regional hospitals in the upper, middle, and southern zones of Ghana, and qualitative content analysis was performed. Results: Nurses and midwives carried out their health advocacy roles both inside and outside of healthcare institutions, using both proactive and reactive advocacy practices to initiate their role performance. Although reactive advocacy roles were reported more, the nurses and midwives identified unfair client treatment, health professionals' errors or omissions of procedure, and social injustice as the driving forces behind their advocacy. Conclusion: Although health advocacy is performed by both nurses and midwives in hospitals and outside the hospitals, they are mostly reacting to situations. Teaching biopsychosocial assessment techniques to students during training and providing them with coaching and mentoring during clinical practice may enhance their ability to assess clients for unmet advocacy needs, enabling them to be proactive in their role performance.

Barriers to advocacy for recovery and wellbeing: a mixed methods study of challenges faced by mental health hospital social workers in Ontario, Canada

ABSTRACT Although advocacy is a key process in social work practice, there is a dearth of research on the constraints experienced in engaging in this process. Drawing on a larger project on frontline social workers’ advocacy practices, this paper focuses on barriers hospital mental health social workers face as they advocate against systemic inequity and support recovery for clients with serious mental illness. Using descriptive statistics and reflexive thematic analyses of an online survey (n = 43) and in-depth interviews (n = 12), this article presents the intertwined macro, mezzo, and micro-level barriers social workers encounter as they advocate to promote client, family, and community wellbeing.

Advocacy in Practice: Who Advocates for the Advocates?

Advocacy has been defined as promoting social inclusion, equality and social justice to empower people - principles closely associated with social work’s professional values. However, in-depth literature on advocacy and the current challenges it faces is sparse. Little is known about the day-to-day realities faced by advocates and the pressures they currently experience. This raises the question of who might advocate for the advocates themselves? This article reports on findings from a larger study to explore local recruitment and retention issues in adult social care from the perspective of different populations of interest in the South of England. A mixed methods approach was undertaken. One group of participants were advocates drawn from LA contracted services (n = 7) who participated in a focus group. Comments relating to the challenges facing advocacy and knock-on impacts on advocates from the recruitment and retention issues currently being experienced in adult social care were themed together and are described. The findings highlight a number of challenges currently facing advocacy and advocates alongside an urgent need for more research to take place within this area. The authors also offer suggestions for consideration to help improve this picture.

Abstract B106: Empowering communities: Prostate cancer short training pilot program

Abstract The prostate cancer short training was designed to empower cancer survivors, their families, and advocates by providing comprehensive insights into prostate cancer research, prevention, and practical advocacy strategies. Participants were equipped with effective communication methodologies to disseminate information to their close circles and broader networks, thereby establishing a reputable source of information within their communities. The primary aim was to develop and evaluate a bilingual program focused on educating and empowering individuals within Hispanic/Latino communities to advocate for prostate cancer awareness. Sessions were conducted in both English and Spanish, and materials were culturally tailored to the Hispanic/Latino demographic. The overarching objectives included educating on risk factors, screening techniques and reinforcing advocacy for prostate cancer awareness. This training aspired to cultivate an inclusive community of informed advocates, advancing cancer awareness, support systems, and treatment accessibility. The Prostate Cancer Short Training served as an exclusive standalone session structured to provide participants with comprehensive knowledge regarding prostate cancer. It was delivered by the Florida California CaRE2 Health Equity Center, a partnership comprising three universities, the Florida A&M University, the University of Florida, and the University of Southern California. The training addresses prostate cancer and its disproportionate impact among thee Hispanic/Latino population. Pre- and post-tests were applied to assess participants' knowledge, self-efficacy, and intent to disseminate prostate cancer information. We present data from the 2024 Prostate Cancer Training pilot cohort (pre, N=11, post, N=11). The 11 participants were all of Hispanic/Latino ethnicity with 81.8% female participants and 18.2% male respectively. Participants demonstrated a notable increase in knowledge, with a 72% difference in correct responses between pre and post-assessment. No decline was observed in post-test scores. Our statistical analysis on knowledge, yielded p-values of 0.013, 0.13, 0.041, 0.074, >0.9, 0.041, and >0.9. Furthermore, there was an increase in self-efficacy and intention to disseminate cancer information among participants. In conclusion, we present findings from a Prostate Cancer Short Training pilot program designed for Hispanic/Latino adults, aimed at fostering advocacy within this demographic. Additionally, we underscore the significance of short training initiatives within the community to further support the overarching mission of eliminating cancer health disparities, particularly concerning Hispanic/Latino men, within the program's context. Citation Format: Ileana Guzman, Nazleen Del Rio, Brooke Hensel, Carolina Aristizabal, Eduardo Ibarra, Rosa Barahona, Lourdes Baezconde-Garbanati, Mariana C. Stern, Sandra Suther, John Luque, Fern J. Webb. Empowering communities: Prostate cancer short training pilot program [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B106.

‘Bridge-builders’ and ‘boundary spanners’: a qualitative study of youth workers’ perceptions of their roles and practices with vulnerable young people in school-based settings

ABSTRACT This paper presents a qualitative study of 22 youth workers’ perceptions of their roles and practices in seven school-based settings in a large post-industrial city in regional Australia. Youth workers are often engaged in school-based settings working with vulnerable young people, yet knowledge of how workers perceive and conceptualize their role and practice in these settings remains limited. Through focus group interviews, youth workers were asked how they engage, and work with vulnerable students, how they conceptualize their roles and the bodies of knowledge to which those practices and roles pertain. We find that youth work in school-based settings requires the dynamic and non-linear application of the practices of youth accompaniment, family support and youth-centred advocacy, underpinned by respect for the dignity, autonomy and agency of the young person. We argue that the complex application of these practices positions youth workers as ‘bridge-builders’ and ‘boundary-spanners’. Bridge-builders assist young people to connect and engage with support services. Boundary-spanners build relationships across service providers to network different organizations and professionals for better collaboration and support of young people. These findings have implications for youth policy and practice in the area of youth work with vulnerable young people in school-based settings.

The Social Work Code of Ethics: Supporting Reproductive Justice for Women

ABSTRACT The 2022 U.S. Supreme Court decision in Dobbs v. Jackson Women’s Health Organization overturned reproductive, health, and abortion rights for women. Using the NASW Code of Ethics, a course assignment is offered for students to examine the professional, ethical commitment and responsibility of social workers to advocate for these rights and reproductive justice for women. Practical ideas for incorporating content examining ethics into coursework in higher education are examined. An advocacy practice and policy model is provided and examined for consideration and use for advocacy when promoting reproductive rights and justice for women. The course assignment centers on the work of Freire (1970), as students work in small groups to identify generative themes in relationship to the NASW Code of Ethics and reproductive and health rights and justice for women. Practical and useful follow-up considerations, assignments, and takeaways are offered for assessing student learning in relationship to the course assignment.

Social work with Irish Travellers: Findings from a national evaluation

Summary This article reports on the findings from a national evaluation of a specialist, Irish, social work service for Traveller families and communities. It begins with an historical overview of the service which was established in the 1960s but which has evolved and developed over the past few decades at a time of changing patterns of Traveller lives and social and economic conditions. It was also a period when the role of social work was changing, most notably with the introduction of state regulation of the profession. The article then critically analyses national and international literature on the role of social workers with Travellers. It then describes the mixed research method used to evaluate the service. Findings The findings highlight various, sometimes competing perspectives on the social work role, drawn from administrative data, a survey of social workers interviews with social workers and Traveller representatives. These include views about how the social work role was viewed by social workers and Traveller representatives, informed by theories on anti-oppressive practice, systems approaches and forms of advocacy. Applications The article concludes with a discussion of ways in which the lessons learned from the evaluation can be used to further develop the social work service in ways that can enhance the lives of Travellers, through forms of continuous professional development and the created of a national policy and practice framework.

Counselors as Social Justice Advocates: Experiences Addressing Systemic Marginalization

A phenomenological study was conducted to determine how counselors are experiencing engagement in social justice advocacy. Participants included seven (N = 7) licensed clinical counselors in the United States. Several themes emerged from the data: social justice advocacy as part of counselor professional identity, experiences of emotional discomfort and gratification, advocacy in action on a micro-, mezzo-, and macro-level, skills utilized to be effective advocates, identity impacting advocacy efforts, challenges faced, and advocacy successes. Results highlighted advocacy action steps that counselors can take to support clients. Skills needed to effective advocates included gaining a knowledge of systems, self-awareness of bias and privilege, intentionality and strategy with advocacy actions, and use of common counseling skills such as compassion and managing challenging responses. Four main elements are identified for potential training implications: (1) establishing a clear professional identity/role around social justice advocacy, (2) teaching advocacy competencies, (3) education about what advocacy practice looks like, and (4) building skills frequently utilized in advocacy practice.

ESSA ADVOCACY NETWORK

INTRODUCTION AND AIMS Advocacy is an important and effective way to influence policy changes to improve outcomes. Best practice advocacy is when efforts are coordinated, multifaceted, structured, and collective. The ESSA Advocacy Network was piloted in 2021, to improve engagement with members, and strengthen ESSA advocacy efforts, whilst simultaneously building members capacity and confidence, to engage in activities for positive change. METHOD ESSA advocacy priorities are broad and diverse, aiming to enhance workforce opportunities to benefit all member groups. These areas include chronic conditions, mental health, rural and remote health, disability, aged care, physical activity, primary healthcare, public health, sport, and, workplace and personal injury. These priorities are affected by enablers including technology and innovation, data and evidence and funding mechanisms such as GST and fee schedules in compensable scheme. All advocacy efforts aim to reduce barriers, enhance enablers and increase access to the exercise and sports science workforce. The advocacy network self-identify interest in priorities and are engaged when opportunities arise to share knowledge, experience and their expertise to inform and shape advocacy. RESULTS In 2023, members were engaged in the development of over 300 submissions and letters. Advocacy efforts resulted in member engagement in meetings with Members of Parliament, Senators, Parliamentary advisors, and senior government officials plus representation on advisory groups for the development of clinical guidelines, strategic plans and resources for allied health. CONCLUSION As the advocacy network emerges from its infancy into the next stage of maturity as an integral part of advocacy for exercise physiology, exercise science, and sport science, a professional and streamlined approach is required. ESSA will grow the network in terms of members engaged and the output.

MATERNAL VACCINATION BEHAVIORS, ATTITUDES, AND KNOWLEDGE ASSESSMENT: A CROSS-SECTIONAL RESEARCH CONDUCTED IN KARACHI, PAKISTAN

Objective: to evaluate mothers’ vaccination habits, attitudes, and knowledge about immunizing a one-year-old childat Department of Pediatrics, Peoples university of Medical Health Sciences Nawab Shah KarachiStudy Design: A Cross-sectional StudyPlace and Duration of Study: This study was conducted at the Department of Pediatrics, Peoples university ofMedical Health Sciences NawabShah from 05- July 2022 to 05- Dec- 2022Materials and Methods: Using a semi-structured questionnaire, all mothers of children under a year old werequestioned about their vaccination practices, attitudes, and knowledge. Version 21 of the SPSS programme was usedto enter and analyse the data obtained through a questionnaire.Results: The study found significant differences in maternal knowledge of EPIs, particularly in low-income andilliterate communities. 80% initiated their child’s vaccination program and 30.4% had inadequate vaccination. Higherlevels of education are associated with socioeconomic status and better advocacy practices. Common reasons for lateattendance included difficulty understanding policies and the absence of physicians. Medical professionals served as theprimary source of information, and parents generally expressed positive attitudes towards vaccinations, although someconsidered vaccinations unnecessary for minor illnesses meaning no exposure in focused efforts to address knowledgegaps and increase vaccine coverage, potentially reducing vaccine-preventable diseases.Conclusion: Our mothers’ strong positive attitudes and sparse vaccination practices were found to be associated withpoor vaccination knowledge.Keywords: Vaccination practices, Mothers ,Attitudes, Immunization

Gustavo Gutierrez and the Economic Realities of Africa: An African Theological Reflection

The purpose of this study is to find out how Gustavo Gutierrez used theological reflection and praxis to effectively impact the economic and social life of his home country, Peru and Latin America at large and to establish the lessons African theologians can imbibe from him. The methodology used was a secondary qualitative analysis of literature. In this regard the works of Gutierrez were reviewed. Key strands of African theological reflection were reviewed. The analysis of various perspectives was done to establish their respective impact on the socio-economic life of their people. The key findings are that African theologians were preoccupied with theological phenomenon at seminar and conference levels in coming up with various strands of African theological reflections. On the other hand, Gutierrez did his theological reflection from the point of view of the suffering poor thereby reflecting on what type of theology was needed to permanently change the narratives of the poor. The concluding lessons for African Theologians include a preferential option for the poor, social ministries in the Church should demonstrate incarnation, divine spirituality should entail a commitment to the poor and oppressed, and the establishment of concrete corrective actions. The importance of the Church Community in the divine enterprise for taking ample notice of the presence of the poor and working without fail to change their story. This is a scholarly contribution to harnessing the synergy among strands of African theology towards effective and practical advocacy and activities towards the eradication of abject poverty from Africa and the development of the continent. The paper contributes to the search for practical steps to reduce or end the abject poverty and poor development trajectory in Africa. Keywords: Theology, Economic, poverty, oppressed poor, incarnational ministry

Is there space for a ‘care-oriented’ advocacy in social work practice with people who have substance use problems?

Although advocacy is a valuable concept, it has received little attention in social work practice with people who have substance use problems. The tendencies of medicalisation and responsibilisation, as well as criminalisation and the War on Drugs ideology, create an unfavourable environment for the emergence of an advocacy discourse. Within the neoliberal context, advocacy in social work practice in the field of addiction is not only an overlooked but also an under-theorised issue. Using Tronto’s political ethics of care theory, the article argues that a perspective on advocacy that places care at the centre of its analysis might provide an illuminating framework for working with people who have substance use problems. Each of Tronto’s ethical elements of care, which are attentiveness, responsibility, competence, responsiveness and trust, can offer useful directions for advocacy practice in the field of substance use and addiction.

Fooled by Diversity? When Diversity Initiatives Exacerbate Rather Than Mitigate Bias and Inequality

To advance the discussion on Diversity, Equity, and Inclusion (DEI) initiatives, we analyze the management literature and examples of advocacy practices inspired by the three DEI logics of moral justice, business case, and power activism. By emerging litigation, self-interest and coercion as the mechanisms driving change within these logics, we show how the concept of diversity is approached differently in the three logics. Based on this discussion we explain why diversity has taken precedence over equity and inclusion in both research and practice. We further show how the tensions between DEI logics inform diversity initiatives and exacerbate rather than mitigate bias and inequality. To rejuvenate scholarly and managerial debates around DEI initiatives and address managerial biases to focus on the wrong things, we discuss what could be learned from the rationales of such initiatives, including how one can be fooled into focusing on diversity at the expense of equity and inclusion.

Reconceptualizing Advocacy through the Women, Peace and Security Agenda: Embodiment, Relationality, and Power

Abstract This article critically examines the embodied and relational politics of networked advocacy in the case of the Women, Peace and Security (WPS) agenda in the United Kingdom. Moving beyond liberal framings that position WPS advocacy as an attempt to overcome gender exclusion from peace and security policymaking, this article is concerned instead with the gendered, racialized, and classed logics and hierarchies (re)produced through the practice of WPS advocacy. Toward this end, this article conceptualizes advocacy as an embodied, relational practice where WPS meanings are shaped, power is negotiated, and individuals are interpolated into subject positions. This conceptual claim is substantiated through an initial, exploratory analysis of interviews conducted with UK NGO professionals and government officials. Examining the figures of the “critical friends” and the “shouty NGOs,” I demonstrate how modes of advocating for WPS are ascribed and inscribed to certain bodies, which, in turn, reproduce power relations that affect the possibilities of the agenda. By reconceptualizing advocacy, the article contributes not only to WPS scholarship on civil society and advocacy but to wider debates within international political sociology around embodiment, relationality, and power. Additionally, it contributes empirically by highlighting how NGOs advocate for the WPS agenda.

Law practice in ukraine in the aspect of implementation of general european standards of the organization of legal activities (theoretical and legal aspect)

The article examines the development directions of the advocacy institute based on the analysis of the content of the special legislation of Ukraine. In the aspect of intensifying the processes of European integration of Ukraine, as a candidate state for joining the European Union, the main factors of reforming the institution of advocacy of the self-governing bodies of the advocates are analyzed, the priorities of the reform of the legislation on advocacy are outlined, taking into account the problems of the practice of advocacy. On the basis of a systematic analysis of international and bilateral documents, the latest amendments to the Law of Ukraine "On the Bar of Ukraine" and laws on the implementation of the rights and freedoms of a person and a citizen of Ukraine provided for by the Constitution, aspects of the practical implementation of the principles of the rule of law, strict adherence to the constitutional provisions of the law, democracy, social expediency, principles of scientific validity, systematicity and coherence, interconnection and interaction of legislative acts, priority of generally recognized norms and principles of international law in relation to national legislation. The conclusion that the main task in the process of practicing law is to highlight the processes of reforming the institution of advocacy and the mechanisms for ensuring the development of special legislation is substantiated. Special emphasis is placed on improving the self-government of lawyers, guarantees for the protection of the professional rights of lawyers, and strengthening the qualification requirements for persons who must gain access to the profession of lawyer.

Art and movement as catalysts for insight into the human condition of depression.

Despite arts advancement and advocacy in education, research, and clinical practice, the arts, including music, dance, theater, and visual art, continue to be largely viewed as stimulating and not necessarily scientifically sound disciplines. This article describes the intentional and methodical use of artistic inquiry to expand the grasp of the mental health condition of depression and suggest ways to engage with it. Different art forms, dance/movement, collage, sculpting, photography, and watercolor were utilized in separate artistic inquiries to explore and better understand the phenomenon of depression, specifically the elements emptiness, hopelessness, and uncertainty. The engagement with art revealed that darkness promotes the germination of something new and valuable. Another discovery was that change is constant in life and can be a comforting fact considering that depression may feel interminable. Last, connection was found to be crucial. When two colors were blended, they yielded another hue and thus a novel outlook on life. Artistic inquiry is not only an intuitive and freely accessible tool, but it also offers a unique understanding of the human condition that is rich in meaning and personally relevant. By methodically engaging with art during uncertainties or when facing a clinical or personal challenge, practitioners can increase their insight and develop exceptional and creative solutions that may contribute to psychiatric rehabilitation and recovery. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Agency, co-creation and environmental advocacy in lens-based practice.

Tahāroa is a tiny settlement to the South-West of the Kawhia harbor, in the North Island of Aotearoa-New Zealand. N.Z Steel first brokered an agreement with local tribe Ngāti Mahuta ki-te-Hauāuru in the 1970’s to extract the titanomagnetite from the sands and ship it offshore for use in the construction of steel. This film asks what prolonged mineral extraction and the re-introduction of that material into the global manufacturing chain might mean for the mauri (or spirit) of the land, and for our planetary relationships.

Deconstructing Social Work Exam Bias: Advocacy Practice Guidelines to Close the Gap

ABSTRACT Introduction The social work profession is in a precarious situation regarding licensure. Test takers of color are struggling to pass social work licensure exams at rates comparable to their White counterparts, per data released by the Association of Social Work Boards (ASWB). As a nation, we are required to meet the needs of our increasingly diverse population. Yet the recruitment and retention of a diverse body of social workers is unlikely to be actualized if disparities persist in these exams. Given ASWB’s monopoly on social work exams and the likelihood that many states will continue to require the exams for licensure, we sought to explore public responses to the data released, using the National Association of Social Work (NASW) as our starting point. As the nation’s largest association of social workers, having local chapters within each state, NASW serves as an area of connection between social workers nationwide. Methods We utilized content analysis to explore emerging themes and conduct a review of the state chapter’s public responses to exam pass rate data. Results A variety of state chapter’s responses, with few states engaging in advocacy efforts or taking action to facilitate change. Discussion Advocacy efforts play a pivotal role in the restructuring of fragmented systems. This study revisits seemingly ignored disparities diverse test takers may face, while also serving as a call-to-action in advocacy engagement. We conclude with a set of advocacy practice guidelines for use in the promotion of equitable licensing opportunities for all test takers.

Wild Horse Roundups and Removals

Epistemological contestation about what – and whose – knowledge counts is central to the struggle about the future of wild horses on US public lands. In the politics of wild horse management, the construction of knowledge claims about wild horses as well as the formation of beliefs about their credibility is shaped by interspecies affective relations; relations that, we contend, are strikingly gendered. We seek to understand how these affective relations – the intermingling of facts and values – shape knowledge claims concerning wild horse roundups and removals carried out on federal lands managed by the Bureau of Land Management (BLM). Using data collected from 28 roundups and removals conducted between 2020 and 2022, in 7 states, we show that BLM’s disavowal of emotion in wild horse management places both wild horses and wild horse advocates in the same subaltern category of being destructive, disruptive, and out of place – in short, “feral.” The wild horse advocacy practices of witnessing roundups and removals of free-roaming horses from a position of “entangled empathy” discussed in this article reject this double-feralization of wild horses and the humans who care for them by establishing that wild horses are grievable, have ecological value, and are capable of participating in relations of interspecies kinship. We elaborate on these claims in terms of four major themes found in our data: protecting ecological integrity, regulating horses’ numbers, listening to nonhuman others, and debating advocacy strategies. Improved understanding of the political function of emotion helps identify a path toward managing wild horses more compassionately.

Use of Shackles on Incarcerated Pregnant Women

The United States has the largest population of prisoners worldwide, and profound racial and structural inequities exist within this population. Qualitative and quantitative data suggest that shackling incarcerated pregnant women occurs in the United States despite anti-shackling legislation and recommendations from professional organizations against shackling. Incarcerated women are vulnerable to adverse health outcomes when shackled during labor, birth, and the postpartum period. Because anti-shackling legislation is often nonexistent or not comprehensive, nurses play a critical patient advocacy role. The purpose of this article is to increase awareness of state anti-shackling legislation and deficiencies. We also aim to promote effective state advocacy and meaningful change in clinical practice to improve patient safety and health care quality for incarcerated pregnant women.