Policy Advocacy

1. Community Health Sciences Policy Advocacy Jason Cabaj, MD MSc PGY4 PHPM ResidentMay 28, 2014 A public health trainee’s guide

2. Session Objectives • Illustrate the relevance of policy advocacy in public health practice • Outline the knowledge gapin PHPM residency training • Describe apotential solutionfor public health trainees: Learning module incorporated into a wiki-based knowledge management platform

3. Background • Policy Definite course of action selected from among alternatives to guide present and future decisions • Public health policy • Healthy public policy • Advocacy Individual and social action designed to gain political commitment or support for a health goal or program • Key method of achieving policy change and protecting/improving health • Ottawa Charter strategy

4. Successful Policy Advocacy?

5. PHPM Competencies • RCPSC PHPM Objectives of Training • 1.2. Identify opportunities for advocacy • 2.1.1. Recognize situations where advocacy is required and define strategies to effect the desired outcome • 3.3.3. Discuss mechanisms of policy development and methods of implementation, including legislation, regulation, and incentives • 3.3.5. Conduct a policy analysis and policy evaluation • 3.7.1. Demonstrate competency in advocacyskills • 5.2.5. Contribute to the formulation of healthy public policy or legislation at local, provincial or federal level • Minimum Competencies for MOHs in Canada (2009) • MOH competencies similar but more advanced • Highly required skills when working in a political environment

6. PHPM Training • PHPM training requirements • CanMEDS • Knowledge, attitudes, skills • Broad and location dependent • Variation in academic curriculum • Variation in opportunities for application • Policy competencies • Most residents have little background in political and social sciences • Focus on the Policy Cycle and on KT • Valuable but limited • Policy development is black box • Need to understand policy process itself to successfully engage and influence

7. Proposed Solution • Development of single consolidated resource • Focus on informing public health practice • Learning module for PHPM residents • Potential utility for other public health trainees • Process • Two month rotation guided by academic public health physician preceptor (Dr. Lynn McIntyre) • Targeted readings • Environmental scan • Policy briefs and analyses • Policy scans • Module development

8. Learning Module • Learning module content • Policy science overview (i.e. policy 101) • Policy process theories • PHPM physician roles in policy advocacy • Advocacy methods,skills, tactics • Key policy concepts • Competency application opportunities • Policy briefs, policy analyses • Links to external resources • NCCHPP, NCCMT, PHPC, CPHA • Knowledge translation overview

9. Policy Science • Theories of policy process • Policy Cycle • i.e. Stages Model/Heuristic • “Textbook approach” • Advocacy Coalition Framework • Paul Sabatier • Multiple Streams Framework • John Kingdon

10. Physician Roles • Public health physicians have many potential roles • Decision maker/policy maker • Policy entrepreneur • Advisor • Coalition member • Honest broker • Medical doctor • Government employee • Expert • Private citizen • Association member

11. Key Policy Concepts Framing Agenda Setting Policy Implementation Valence Policy Entrepreneurs Policy Implications Rhetoric Policy Window

12. Module

13. Wiki

14. Applications for Module • Two models for use • Stand alone resource • Self-learning module for PHPM resident policy and knowledge translation competency acquisition • Elective rotation/directed study course guide • Core or supplementary resource guidance document • Recently used to good effect by CHS graduate student

15. Summary • The world of policy is complex • Lack of existing practice focused learning resources • Custom learning module provides a concise entry point

16. Thank you Questions?

17. References and Resources • Baumgartner, F.R. (2013). Ideas and policy change. Governance: An International Journal of Policy, Administration, and Institutions. 26:2, 239-258. • Canadian Public Health Association - Policy and Advocacy page • Moloughny, B. (2012). The use of policy frameworks to understand public health-related public policy processes: a literature review. Prepared for Peel Public Health. Learn about public policies and their effects on health. National Collaborating Centre for Healthy Public Policy • National Collaborating Centre for Healthy Public Policy • National Collaborating Centre for Methods and Tools • Public Health Physicians of Canada - Advocacy Documents • Sabatier P. (ed) (2007). Theories of the policy process. Westview Press. Cambridge. • Scott, J.M, Rachlow, J.L., Lackey, R.T. (2008). The science-policy interface: What is an appropriate role for professional societies. BioScience 58:9, 865-869.

19. Key Policy Concepts • Agenda setting • Policy agenda is the issues/problems that decision makers are paying attention to • Framing • How actors seek to understand and act on complex situations • Policy entrepreneur • Individuals who may influence policy processes due to position, network, and persistence • Policy implementation • The process of turning policy into practice • Policy implications • Social, legal, ethical, environmental, economic, political, and organization factors • Policy window • Critical period of time when policy streams converge to facilitate policy change • Rhetoric • The art of effective or persuasive speaking or writing used in policy debates • Valence • The emotional quality of an idea that makes it more or less attractive