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Developing an Advocacy Curriculum: Sample Syllabus

Background

To best serve their patients, physicians operate across a variety of interpersonal relationships and systems. Physicians advocate in the health care institutions where they work, the communities (broadly defined) where they live, the professional and research entities to which they belong, and finally, the political and media systems that broadly play a role in supporting or inhibiting a physician’s work. 

Overview

The following readings are recommended as a brief introduction to the field of advocacy, with a focus on abortion, family planning, and reproductive health, to spark critical thought. This field is constantly evolving, and these readings are a starting point to shape, supplement, or bolster, your advocacy syllabus or curriculum. They can also be applied to informal learning settings such as a journal group. Do you have advocacy curriculum materials you’d like to share with us? Contact [email protected]. 

What is Advocacy and Why Should We Advocate?

  • ACOG video: “Why We Advocate” 
  • Gruen RL, Pearson SD, and Brennan TA. “Physician-Citizens—Public roles and professional obligations.” Journal of the American Medical Association 2004;291(1):94-98. 
  • Earnest MA, Wong SL, and Federico SG. “Perspective: Physician advocacy: What is it and how do we do it?” Academic Medicine 2010;85(1):63-67. 
  • Dharamsi S, Ho A, Spadafora SM, and Woollard R. “The physician as health advocate: translating the quest for social responsibility into medical education and practice.” Academic Medicine 2011;86(9):1108-13. 
  • Huddle TS. Perspective: Medical professionalism and medical education should not involve commitments to political advocacy. Academic Medicine 2011;86(3):378-383. 

Advocating at All Levels: A Social-Ecological Approach to Physician Advocacy

  1. Advocating for individual patients
    • Schwartz L. “Is there an advocate in the house? The role of health care professionals in patient advocacy.” Journal of Medical Ethics 2002;28(1):37-40. 
    • Brockman J. “Patient advocacy for beginners.” American Medical Association Journal of Ethics 2011;13(8):530-533. 
  2. Advocating within health care institutions
    • Okoroh EM, Kane DJ, Gee RE, Kieltyka L, Frederiksen BN, Baca KM, Rankin KM, Goodman DA, Kroelinger CD, and Barfield WD. “Policy change is not enough: engaging provider champions on immediate postpartum contraception.” American Journal of Obstetrics & Gynecology 2018;218(6): 590.e1-590.e7.
    • Eisenberg, DE and Leslie, VC. “Threats to reproductive health care: time for obstetrician-gynecologists to get involved.” American Journal of Obstetrics & Gynecology 2017;216(3):256.e1-256.e4.
    • Stulberg DB, Dude AM, Dahlquist I, and Curlin FA. “Obstetrician-gynecologists, religious institutions, and conflicts regarding patient-care policies.” American Journal of Obstetrics & Gynecology 2012;207(1):73.e1-73.e5. 
    • ACOG resources on practice management
  3. Community advocacy
    • Committee on Health Care for Underserved Women. ACOG Committee Opinion No. 437: “Community involvement and volunteerism.” Obstetrics & Gynecology 2009;114(1):203-204.
    • Dobson S, Voyer S, Hubinette M, and Regehr G. “From the clinic to the community: The activities and abilities of effective health advocates.” Academic Medicine 2015;90(2):214-220. 
    • Gadon M. “Revisiting the social contract: physicians as community health promoters.” Preventing Chronic Disease [serial online] 2007;4(3).
  4. Advocating within professional bodies
    • Espey E, Dennis A, and Landy U. “The importance of access to comprehensive reproductive health care, including abortion: a statement from women’s health professional organizations.” American Journal of Obstetrics & Gynecology 2019;220(1): 67-70.
  5. Advocacy through coalition-building 
    • Gupta M, Donovan EF, and Henderson Z. “State-based perinatal quality collaboratives: Pursuing improvements in perinatal health outcomes for all mothers and newborns.” Seminars in Perinatology 2017;41(3): 195-203. 
    • McGovern, T. “Building coalitions to support women's health and rights in the United States: South Carolina and Florida.” Reproductive Health Matters 2007, 15(29): 119-129.
  6. Advocating through research
    • Hofler LG, Cordes S, Cwiak CA, Goedken P, Jamieson DJ, and Kottke M. “Implementing immediate postpartum long-acting reversible contraception programs.” Obstetrics & Gynecology 2017;129(1):3-9.
    • Cottingham J. “Historical note: How bringing women’s health advocacy groups to WHO helped change the research agenda.” Reproductive Health Matters 2015;23(45):12-20. 
    • Grossman, D. “The Use of Public Health Evidence in Whole Woman’s Health v Hellerstedt.” JAMA 2017;177(2):155-156. 
    • Jones L and Wells K. “Strategies for Academic and Clinician Engagement in Community-Participatory Partnered Research.” Journal of the American Medical Association 2007;297(5):407-410. doi:10.1001/jama.297.4.407 
  7. Regulatory and legislative advocacy
    • Committee on Health Care for Underserved Women. “ACOG Committee Opinion No. 815: Increasing access to abortion.” Obstetrics & Gynecology 2020;136:e107–15.
    • Aksel S, Evans ML, and Gellhaus TM. “Training physicians in advocacy: Why it matters.” Obstetrics & Gynecology 2017;130(6):1334-1337.
    • Weinberger SE, Lawrence HC, Henley DE, Alden ER, and Hoyt DB. “Legislative interference with the patient-physician relationship.” New England Journal of Medicine 2012;367(16):1557-59.
    • Mallampati D, Simon MA, Janiak E. “Evolving state-based contraceptive and abortion policies.” Journal of the American Medical Association 2017;317(24):2481-2482.
    • ACOG’s approach to legislative advocacy 
  8. Advocating through the media
    • Cahill E and Conti JA. “Abortion in the media.” Current Opinion in Obstetrics and Gynecology 2017;29(6):427–430.
    • Patton EW, Moniz MH, Hughes LS, Buis L, Howell, J. “National network television news coverage of contraception - a content analysis.” Contraception 2017;95(1):98-104.
    • DeNicola N, Good M, and Newton L. “Back to the future: a history of ACOG in social media’s golden age.” Current Opinion in Obstetrics & Gynecology 2014;26(6):495-502. 
    • Woodruff K. “Coverage of abortion in select U.S. newspapers.” Women’s Health Issues 2019;29(1):80-86. 

Acknowledgements

This document and framework is modelled after a resource generated by ACOG’s Strategies for Health Equity Department.