Advocacy Practice Research Articles

Power and the International Human Rights Imaginary: A Critique of Practice

Abstract The international human rights movement is undergoing an internal reckoning. The legitimacy of the human rights project is being questioned within the movement. These internal critiques render more visible and contestable the influence of human rights movement actors in the Global North over the international human rights agenda. Yet these critiques are incomplete. Grounded in decades of experience as an international human rights practitioner, this article uses the concept of the international human rights imaginary to explain why and how the technologies of traditional international human rights practice (practice forms) embed colonizing tendencies to supplant local knowledge and priorities. It argues that the harms of practice forms can be mitigated if international practitioners incorporate a principle of solidarity with local human rights struggles. The common understandings of what human rights are and how they should be defended are advanced by international nongovernmental organizations based in western Europe and the United States with access to international decision makers, institutions, and funding. These are the actors who exercise power to set the priorities for the international human rights movement. The human rights practice forms commonly used by dominant NGOs are integral to the political economy of the international human rights movement. These dynamics are illustrated through the three quintessential practices of statement advocacy, human rights reporting, and standard setting advocacy. Their study exposes how the imaginary operates in practice. North-based human rights actors need to reimagine human rights to be relevant to a multi-polar, pluralistic, and global—rather than to a merely North-based, western, and international—human rights movement.

Politics of International Advocacy Against the Death Penalty: Governments as Anti–Death Penalty Crusaders

Two-thirds of the countries worldwide have moved away from the death penalty in law or in practice, with global and regional organisations as well as individual governments working towards universal abolition. This article critically examines the narratives of these abolitionist governments that have abolished the death penalty in their country and have adopted the role of ‘moral crusaders’ (Becker 1963) in pursuit of global abolition. In 2018, the Australian Government, while being surrounded by retentionist states in Asia, joined the anti–death penalty enterprise along with the European Union, the United Kingdom and Norway. Using the concepts of ‘moral crusader’ (Becker 1963) and ‘performativity’ (Butler 1993), this article argues that advocacy must be acted on repeatedly for governments to be anti–death penalty advocates. Otherwise, these government efforts serve political ends in appearance but are simply a self-serving form of advocacy in practice.

Enhancing Student Learning and Engagement Using Digital Stories

ABSTRACT To prepare students for competent practice in increasingly technology-enabled settings, social work curricula must provide ample opportunities for developing digital literacy. Incorporating digital stories as course assignments offer educators one promising approach. Despite the fact that digital stories can provide a powerful teaching strategy and meaningful learning experience for students, they have received little attention in the social work education literature. This study explored implementation of a digital story assignment in three social work courses and examined undergraduate and graduate students’ appraisals of the assignment and learning outcomes. Qualitative findings indicated high satisfaction and learning associated with key social work competencies such as digital literacy, group work, and advocacy. Students valued the novel opportunity for creativity and collaboration, and were challenged in positive ways to produce high quality work that could be shared with a public audience. Key challenges identified by students included a steep technology learning curve, some technology resistance, and limitations associated with group projects (e.g., group dynamics). Overall, however, these exploratory findings suggest that digital story assignments can offer a timely and useful tool for social work educators to enhance engagement and learning, foster advocacy practice skills, and build digital literacies needed in the 21st century practice landscape.

Review: Queer Public History: Essays on Scholarly Activism, by Marc Stein

Review: <i>Queer Public History: Essays on Scholarly Activism</i>, by Marc Stein

Are Australian junior doctors failing to act as health advocates? A qualitative analysis

ObjectiveTo explore junior doctors’ attitudes towards and experiences of health advocacy practice and teaching in Australia. MethodsSemi‐structured interviews were conducted with 15 junior doctors across Australia. Data were thematically analysed. ResultsThree themes were identified: i) participants inconsistently understood and practised health advocacy, with many failing to conduct any advocacy work; ii) distinct factors motivated and enabled participants to undertake health advocacy; however, these were largely unrelated to any formal medical education; iii) the current medical workplace and education system is non‐conducive to health advocacy practice given the numerous barriers faced by junior doctors when engaging with health advocacy. ConclusionsHealth advocacy is generally poorly taught, weakly understood, and rarely performed despite being one of the four core graduate competencies of the Australian Medical Council (AMC). The AMC must clearly define health advocacy and its scope in their outcome statements, and this must be translated into medical education curricula and advocacy opportunities in the workplace. Implications for public healthDoctors are well‐placed to act as public health advocates, yet they are denied the encouragement and training to do so. With the growing burden of complex and sensitive public health issues, junior doctors should be trained and encouraged in health advocacy.

Shifting Sands: The Institutional Embeddedness of the Sydney Nonprofit Sector and its Relation to the State, Market, and Civil Society

In this essay, we explore the institutional embeddedness of the Sydney nonprofit sector via its changing relations with the state, market, and civil society. We explore the historical development of these relations and how these durable relations have shifted in recent years, putting pressures on the sector. The federal government’s effort to constrain advocacy practices has resulted in a tense relationship between the sector and the state. The push to introduce market mechanisms to generate resources for the sector and the rise of impact investing have pushed nonprofit organizations to explore financial innovations and into the now locally labeled “social economy.” These developments directly impinge on how nonprofits perform their roles by circumscribing the scope for advocacy and by putting nonprofits on a different path for financial sustainability. Compounding these shifts are the COVID-19 pandemic and the sector’s relationship with civil society. The pandemic underscored the importance of the work carried out by nonprofits and saw a resurgence in the sector’s relationship to civil society, while revealing the sector’s chronic fragility. By examining the institutional embeddedness of the nonprofit sector in this way, we provide a common framework for understanding a local nonprofit sector in the context of global changes, fostering future comparative work.

Tracking the trajectory of feminist advocacy in Uganda: How has theory informed the practice of advocacy?

abstract Since Uganda’s independence in 1962, feminist advocacy in Africa and Uganda, in particular, has experienced waves and critical agendas that have shaped the direction of movements and women’s rights organisations. How can we map the trajectory of feminist advocacy to understand the influence of theory, in particular African feminism(s) in Uganda? This is the central focus of this article. Literature shows how women activists in Africa took centre stage, questioned women's conspicuous absence in social economic and political history and assertively challenged patriarchal oppression against women in public and private spheres. Activists in the Ugandan feminist movement formulated advocacy strategies to resist colonial gender oppression, mobilised women to respond to the review of the constitutional provisions on women’s rights, to organise even when confronted with state silencing, and to form critical alliances to meet male resistance to their political representation in Parliament head on, among others, since independence. The article draws on findings from an empirical study conducted in 2019-2021, Kampala, Uganda, on selected historical junctures and interrogates theoretical origins and motivations that could be read as having informed feminist advocacy - the feminist agenda, strategies and tactics, framing and language. I am particularly interested in how African feminists’ theoretical frames critically inform shifting advocacy positions in Uganda over time to advance gender transformation, and thereby advance the theorisation of an African centred-feminist advocacy.

Mediating Pain: Navigating Endometriosis on Social Media.

With the rise of social media, many people with endometriosis have turned to platforms such as Facebook and Instagram in the face of lacking care. This qualitative study focuses on why and how people with endometriosis use these platforms. Despite the risks of misinformation and conflict on social media, the results of this research show that many people with endometriosis find these spaces beneficial, particularly for information sharing, social support, representation, and advocacy practices around endometriosis. Using data collected from surveys and interviews, this study reveals that people with endometriosis often use social media to understand, experiment with, and navigate their symptoms and that these efforts deserve recognition by endometriosis researchers and practitioners. This article proposes that, in order to improve future patient-practitioner and patient-researcher relationships for endometriosis, we must understand, not dismiss, the social media practices of those with endometriosis. By understanding how and why patients turn to social media, clinicians and researchers can build toward more patient-oriented futures.

The role of advocacy and empowerment in shaping service development for families raising children with developmental disabilities.

IntroductionEmpowerment of families raising children with developmental disabilities (DDs) is essential to achieving rights‐based service development.MethodsIn this qualitative study, we investigated stakeholder perceptions on the role of advocacy and empowerment in developing caregiver interventions for families of children with DDs in a global context. Participants had experience with at least one intervention, namely the Caregiver Skills Training developed by the World Health Organization (WHO). Participants were clinicians, caregivers and researchers representing five continents, and representatives of WHO and Autism Speaks. Two focus group discussions and 25 individual interviews were conducted. Data were analysed thematically.ResultsThree themes were developed: empowerment as independence and as a right; the role and practices of advocacy; and using evidence to drive advocacy. Many professional participants defined empowerment within the realms of their expertise, focusing on caregivers' individual skills and self‐confidence. Caregivers expressed that this expert‐oriented view fails to acknowledge their intuitive knowledge and the need for community‐level empowerment. Participants discussed the challenges of advocacy in light of competing health priorities. The gap between the rights of caregivers and the availability of services, for example, evidence‐based interventions, was highlighted as problematic. Scientific evidence was identified as a key for advocacy.ConclusionRights‐orientated empowerment of caregivers and advocacy may make vital contributions to service development for children with DDs in contexts worldwide.Patient and Public ContributionResearch questions were revised based on views presented during focus group discussions. Participant feedback on preliminary themes informed the development of the interview guides.

Virtual Performance as Social Activism

Performance that exists in the virtual world has potential for tremendous social activism. Using a medium familiar to students in the digital age, dance educators can promote agency through student-centered pedagogy and collaborative dance-making while promoting digital literacy and civic responsibility. Guiding a dance performance in the virtual realm offers opportunities for students to explore sociopolitical content while experiencing the practice of advocacy.

COVID-19 and Latinx Disparities: Highlighting the Need for Medical Schools to Consider Accepting DACA Recipients.

COVID-19 revealed and magnified the preexisting health inequities faced by many vulnerable groups. The Latinx community is one of these groups and has borne the brunt of disparate rates of infection, hospitalization, and mortality associated with COVID-19. These disparities are rooted in social inequities, such as poverty and lack of access to health care, as well as health inequities associated with disparate disease and condition burdens. Moreover, the lack of an adequate Latinx physician workforce contributes to and exacerbates these inequities. The COVID-19 pandemic has intersected with the U.S. Supreme Court’s decision in the Department of Homeland Security v. Regents of the University of California case. The court’s decision in this case struck down the attempted ending of the Deferred Action for Childhood Arrivals (DACA) program, although it was settled that the government could end the program if it was done lawfully. Even though this constitutes a win for DACA recipients, the decision is a stopgap as the future of DACA recipients remains vulnerable and subject to other legal challenges and political vagaries. In a time when the need to ameliorate health inequities for the Latinx community is so pronounced, DACA recipient medical trainees could provide much-needed relief. Since the implementation of DACA, some medical schools have decided to accept DACA recipient students, but many do not. This access-limiting practice stymies a group of potential trainees who could help to increase the Latinx physician workforce, as the majority of DACA recipients are Latinx. This article argues that all medical schools should take steps to consider accepting DACA recipient applicants in line with the principles of health equity and suggests 5 recommendations for medical school admissions, support, and advocacy practices.

Using Toolkits to Improve Students' Skills in Advocacy.

Advocacy is widely recognized as a nursing responsibility. Speaking up, a form of advocacy, is known to benefit patient safety and quality of care yet research shows that nurses are hesitant to speak up and face multiple barriers when deciding to do so. A toolkit that included web-based learning modules and simulation experience with a standardized patient was developed to enhance advocacy skills in baccalaureate nursing students. Student perceptions of the efficacy of this approach were used to revise and improve toolkit materials. There were 131 participants over four semesters. Students reported the toolkit helped them understand how to use advocacy skills (87%), allowed them to use critical thinking (97%), and practice advocacy (94%). Educational experiences like this promote development of students' advocacy skills in a safe environment and can be used to bridge the gap between expectation and practice. [J Nurs Educ. 2022;61(10):599-602.].

Systemic Advocacy for BIPOC LGBTQIA + Clients and Their Families

Systemic advocacy involves various aspects, such as inclusive leadership and clinical practice. The Socially Just and Culturally Responsive Counseling Leadership Model (SJCRCLM) will be described as a way for counselors to continue to help BIPOC LGBTQIA + individuals and families. This model has been used to discuss professional advocacy, but less to discuss client advocacy in practice. Ways to apply the SJCRCLM to BIPOC and LGBTQIA + clients, families, and communities, will be included. Understanding the advocacy needs of clients who intersect among the BIPOC and LGBTQIA + communities is crucial.

Implementation of a Process Approach to the Quality of Expert Legal Assistance in the face of Digitalization

Digital transformation of legal profession and advocacy involves finding, selecting, and developing approaches that ensure the translation of data about objects, connections, and processes of the real (analog) world related to the relevant subject area into a virtual (digital) format. Therefore, it is very important that the description of the properties of objects, connections and processes subject to digitalization should be machine-readable, and the «pre-digital» (analog) image of such should fit into the paradigm of information technology (Information Technology, IT) for the subsequent transformation of this image into digital form.The digital transformation of legal profession and advocacy is not an end in itself. The key issue is the quality of expert legal assistance. The issue of the quality of expert legal assistance must be addressed on a systematic basis, taking into account such quality management functions as quality planning, quality assurance, quality control, and quality improvement. The development of the topic of quality (proper quality) of expert legal assistance involves the formation of a certain theoretical model on an appropriate methodological basis, followed by its implementation in the regulatory (regulatory) framework of the ecosystem of advocacy and implementation in corporate practice. The author offers one of these models. The model is based on the so-called process approach. The paper describes the essence of the process approach, the process model of the quality of the expert legal assistance itself and gives a general description of its elements. The process model allows you to look at the provision of expert legal assistance through the prism of the process approach used in IT: it makes it possible to plan the provision, provide and analyze the results of the rendered expert legal assistance in the paradigm of this approach. The author notes the high analytical potential of the process model of the quality of qualified legal aid and its practical usefulness.

Nursing and advocacy in health: An integrative review.

The practice of health advocacy in nursing has been defined as a process aimed at promoting the independence and autonomy of users of health services, in addition to providing information on healthcare decision-making and offering support for decisions taken. Ethics approval was not required to conduct this review. This integrative review aims to synthesize evidence in the literature on health advocacy in professional nursing practice. An integrative review methodology guided by Whittemore and Knalf was used. Studies were identified by conducting searches on PubMed, Scopus, Web of Science, CINAHL, and LILACS databases. Of 2179 records, 34 studies matched the inclusion criteria. The main aspects involved in the practice of health advocacy by professional nurses are related to the ethical principles of the nursing profession, such as protecting patients seeking autonomy and care. Furthermore, the practice of health advocacy by nurses requires an empathetic attitude, responsibility, and assertive communication. The diverse possibilities for the practice of advocacy synthesized in this study allow nurses to approach and become familiarized with the topic, being able to acquire and complement knowledge that will reflect on their professional practice in different work environments such as the educational field, in hospital practice, or basic health care.

School Counsellors’ Perceptions of School Justice and Awareness of Advocacy Duties

The purpose of this study is to examine school counsellors' awareness of their advocacy responsibilities in relation to distributive, procedural, and interactional justice. The participants in this case study were 14 school counsellors working in secondary schools. They were selected using criterion sampling and maximum variation. Research data were collected using a semi-structured interview form and analyzed using content analysis. According to the findings, school counsellors described their school environments as fair considering the democratic attitudes of principals and teachers. Participating counsellors reported that students complain about various issues regarding favoritism, discriminatory attitudes, problematic communication, and unfair grading. They also reported that when students experience injustice at school, they show emotional reactions such as anger, unhappiness, and helplessness, in addition to aggression towards teachers, school objects, or themselves. School counsellors stated that they encourage such students to share their feelings, claim their rights, and talk to their teachers. However, school counsellors who encouraged students to claim their rights rarely talked to teachers to solve such problems. It can be said that school counsellors who strive to prevent student victimization have played a mediating role rather than being an advocate. Future studies can explore the advocacy practices at private and public schools.

Perspectives of Stakeholders of Equitable Access to Community Naloxone Programs: A Literature Review.

The purpose of this review is to examine the existing literature about facilitators and barriers influencing equitable access to naloxone programs by individuals who use opioids. A total of 49 published articles were examined, which generated four overarching themes:(1) Stigma as a barrier to access; (2) Lack of a wide range of stakeholder perspectives; (3) Need for a comprehensive understanding of factors affecting equitable access to naloxone programs; (4) Facilitators to increase the access of community naloxone programs. Our review highlighted the importance of advocacy in practice, education, administration, and policy to address the health inequities that exist in naloxone distribution programs. Advocacy activities involve the need for health care professionals to engage in social justice practice through evidence-based informed research about the facts of opioid use; challenging the stigma toward victim-blaming against naloxone users; as well as promoting program development and health policy to bring about equitable access to naloxone programs by marginalized and socially disadvantaged populations.

ENFERMAGEM E A ADVOCACIA EM SAÚDE: PROCESSO DE ELABORAÇÃO DE CARTILHA EDUCATIVA

ABSTRACT Objective: to describe the development and validation of an educational manual for nurses on the practice of health advocacy in their professional experience. Method the method used to develop the manual was composed of three stages carried out from 2018 to 2020: an integrative review of studies published from 2010 to 2018, development of the content, and validation of the educational manual by experts. Results: based on the integrative literature review, 91 final articles related to the theme of advocacy in health and nursing were selected, which subsidized the definition of four themes: The meaning and fundamental elements for the practice of advocacy in nursing; Advocacy in teaching and the involvement of other care actors; Advocacy as a professional, moral, and ethical obligation; Advocacy about specific population groups. The themes contributed to the development of the educational manual content. After submission and validation by specialists, it was possible to define the layout, size, number of pages, and final design of the educational manual, which will be printed and handed out to nursing professionals and students, and made available online. Conclusions: the elaboration and validation of the manual help to build knowledge related to the professional practice of the nursing team and the exercise of advocacy in health.

How CARE Tools Are Being Used to Address Brain Injury and Mental Health Struggles With Survivors of Domestic Violence.

CARE (Connect, Acknowledge, Respond, and Evaluate) is an advocacy framework developed for domestic violence service organization (DVSO) providers to address and accommodate domestic violence (DV) survivors with brain injury and mental health struggles. The CARE tools were designed for use by advocates and include the Just Breathe booklet, the Head Injury education card, and the Invisible Injuries booklet. The purpose of this study was to report findings on how CARE tools are being used by DVSO providers as well as their impact on DVSO advocacy practice. Post-CARE retrospective process evaluation online surveys (n = 60) and focus groups (n = 10 groups; 57 advocates) were conducted with consenting staff at 5 DVSOs in Ohio who partnered with the state coalition to develop and evaluate CARE, overseen by a university research partner. Rigorous, iterative coding qualitative analysis methods, endorsed by the Centers for Disease Control and Prevention, were used (Cohen's κ = 0.903 [stage 1] and 0.810 [stage 2]). The use of CARE tools has been integral to DVSO providers' implementation of the CARE advocacy framework. DVSO advocates are using CARE tools to Connect with self, survivors, and other systems; to Acknowledge that head trauma and mental health struggles are common among survivors and that ongoing education and self-care are necessary for advocates. Advocates have been able to provide a more holistic Response through accommodation within DVSOs and referral to other providers, often by using the CARE tools, including the Head Injury education card. CARE tools were designed for lay use to address head trauma, strangulation, and mental health struggles with DV survivors and are free for download at the Center on Partner Inflicted Brain Injury website: https://www.odvn.org/brain-injury. More widespread use of these tools by advocates has the potential to improve services for DV survivors and address what have historically been invisible injuries and mental health struggles in the population.

Healthcare Provider Advocacy for Primary Health Care Strengthening: A Call for Action.

Primary Health Care (PHC) is the backbone of health systems and a cornerstone of Universal Health Coverage. In 2018, political commitment to PHC, including a comprehensive approach based on essential care throughout the lifespan, integrated public health functions, and community empowerment was reaffirmed by international stakeholders in Astana. As recent events exposed weaknesses of health care systems worldwide, growing attention has been paid to strengthening PHC. While the role of care providers as health advocates has been recognized, they may lack skills, opportunities, and resources to actively engage in advocacy. Particularly for PHC providers, guidance and tools on how to advocate to strengthen PHC are scarce. In this article, we review priority policy areas for PHC strengthening with relevance for several settings and health care systems and propose approaches to empower PHC providers—physician, non-physician, or informal PHC providers—to advocate for strengthening PHC in their countries by individual or collective action. We provide initial ideas for a stepwise advocacy strategy and recommendations for practical advocacy activities. Our aim is to initiate further discussion on how to strengthen health care provider driven advocacy for PHC and to encourage advocates in the field to reflect on their opportunities for local, national, and global action.