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The American Nephrology Nurses Association (ANNA) and American Society of Nephrology (ASN) have joined forces with the goal of advancing improvements in kidney care through transformative change. Through the integration of expertise, resources, and networks from both organizations, these collaborations have the potential to improve patient outcomes, advance clinical practice, and shape policy initiatives. In this article, we describe our focus on three areas: strengthening the nephrology and nephrology nursing workforce, championing health care equity, and advocating for kidney health.

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BACKGROUND: Health Advocacy is considered one of the most difficult skills to teach. Many medical learners feel ill-equipped in social competencies and identify it as a significant gap in their medical training. Experiential learning has recently been emerging as a more effective method to teach health advocacy. The Post Graduate Medical Education (PGME) Health Advocacy Day is a new experiential learning curriculum designed to teach important competencies of health advocacy and social accountability to post-graduate medical residents at the University of Ottawa in Ottawa, Canada. The objective of this mixed-methods study was to assess resident experiences. METHODS: Second-year trainees from all adult residency programs attended the Advocacy Day as part of a mandatory academic day. All participants completed a mandatory pre-and post-session quiz to assess knowledge of key topics before and after the course. We also distributed a voluntary survey to all participants and invited residents to participate in semi-structured interviews to provide feedback on the course. We used descriptive statistics to analyze quiz scores and survey results and conducted a paired t-test of pre and post-test quiz scores. We also performed a thematic analysis of qualitative feedback, specifically survey comments and semi-structured interviews. RESULTS: One hundred and eighty-three residents participated in the Advocacy Day and 112 (61.2%) completed the post-course survey. Ten residents volunteered to be interviewed. Respondents were generally satisfied by the session and felt it was of good quality. Most residents felt the course enhanced their ability to advocate for individual patients or communities (N = 80; 71.5%) and understand patients and families' lived experience with illness (N = 87; 77.5%). Most residents also felt the course improved their knowledge of the impact of social determinants of health (N = 91; 81.2%) and increased their awareness of local resources that can support patients and their families (N = 88; 78.3%). Visiting community sites in-person and meeting persons with lived experiences were highlighted as the most valuable components of the course. CONCLUSION: Experiential learning can be integrated within post-graduate medical curricula to teach health advocacy competencies. Future studies should examine the longitudinal impact of the curricula, to determine whether shifts in perspectives persist over time.

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This study examines the concept of health advocacy and explores related scholarly material to understand its evolution from 1977 to 2021. The bibliometric analysis investigates the publication trends, most relevant authors, keywords-based clusters, research trends, author productivity, and future research areas in health advocacy. The relevant articles were extracted from the Scopus database and analyzed to identify and explore the most active authors, author-wise contribution to the sources, sub-research topics, core sources, top authors' production over time, global cited documents, thematic maps, word cloud, country-wise collaboration network and map, author keywords-based network, historiograph, and spectroscope. The study finds that health advocacy as a concept is under-explored and thus warrants a need for future research work. Limited authors have contributed to this theme, and the continuity of publication needs to be improved. The study highlights that there needs to be a robust framework to assess, evaluate, and implement health advocacy. The researchers are limited to only a few authors who have published in limited journals. The current study brings out the need for research and publications on health advocacy to develop a framework for assessing and implementing health advocacy. Also, the study highlights emerging themes of Coronavirus pandemic and emergency and disaster preparation. The niche themes that emerged during the survey highlight keywords such as agenda-setting and maternal health.

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BACKGROUND: Health advocacy (HA) involves purposeful actions to inform, mobilise, and organise activities to address social determinants of health affecting individuals or communities. It is a fundamental component of medical practice, deemed mandatory by professional and educational bodies. Therefore, including health advocacy training in pre- and post-graduate medical education is crucial. OBJECTIVES: In this study, we aimed to determine the need for HA training for family physicians (FPs) based on expert opinions. METHODS: We conducted a modified Delphi study with 105 academic experts and active FPs to explore HA training needs. Using a three-round technique, experts first answered five open-ended questions on HA competencies, teaching and assessment methods, learning environments, and integration in residency training. In the second round, statements from the responses were rated on a 5-point Likert scale, in the third round, statements below the 85% consensus level were revised and re-evaluated. RESULTS: The panel consisted of 41 experts (33 academicians, 8 practitioners) who accepted the invitation and completed the study. At the end of the three rounds, consensus was reached on 38 statements for HA competencies, 15 for teaching methods, 8 for assessment methods, and 20 for integration for HA training. CONCLUSION: Competencies for the HA role are very broad in perspective and show commonalities with the FPs' 'professional', 'expert' and 'leader' roles. Longitudinally integration of the HA training into the national 'Family Medicine Residency Training Core Curriculum' through participatory processes and training of FM trainers in HA is strongly recommended.

The competencies expected for the health advocacy role of the family physicians show commonalities with the family physicians' 'professional', 'expert' and 'leader' roles.It is important to longitudinally integrate health advocacy training into the family medicine residency training core curriculum at the national level.

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BACKGROUND: The aim of this study was to document how Mexico adopted a WHO Framework Convention on Tobacco Control (FCTC)-based national tobacco control law. METHODS: We analyzed publicly available documents and interviewed 14 key stakeholders. We applied the Multiple Streams Framework (MSF) to analyze these findings. RESULTS: Previous attempts to approve comprehensive FCTC-based initiatives failed due to a lack of political will, the tobacco industry's close connections to policymakers, and a lack of health advocacy coordination. Applying the MSF reveals increased attention towards collecting and sharing data to frame the severity of the problem (problem stream). The expansion of a coordinated health advocacy coalition and activities led to increased support for desired FCTC policy solutions (policy stream). The election of President López Obrador and legislative changes led to a deep renewed focus on tobacco control (politics stream). These three streams converged to create a policy window to secure a strong FCTC-based initiative on the political agenda that was ultimately passed. CONCLUSIONS: The Mexican experience illustrates the importance of continued health advocacy and political will in adopting FCTC-based policies. Other countries should follow Mexico's lead by collecting and sharing data through coordinating efforts in order to be prepared to seize political opportunity windows when strong political will is present.

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Loneliness has emerged as a significant public health concern, with profound implications for health outcomes, which can manifest in physical, psychological, and social affliction. Working alongside Fulham Medical Centre, I sought out to create a range of both offline and online resources (YouTube video, ten-episode Spotify podcast, online website, GP practice brochure and poster) designed to provide base learning, practical strategies, community connections and a sense of support to those grappling with loneliness. These resources were well-received by the practice and were implemented on a practice basis, to provide support to the local community. Reflection on this project, highlights the need for student projects, and emphasises the tangible impact that we can have on community support and care for individuals tackling feelings of loneliness.

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Addressing patient adherence is a key element in ensuring positive health outcomes and improving health-related quality of life for patients with atopic and immunologic disorders. Understanding the complex etiologies of patient nonadherence and identifying real-world solutions is important for clinicians, patients, and systems to design and effect change. This review serves as an important resource for defining key issues related to patient nonadherence and outlines solutions, resources, knowledge gaps, and advocacy areas across five domains: health care access, financial considerations, socioenvironmental factors, health literacy, and psychosocial factors. To allow for more easily digestible and usable content, we describe solutions based on three macrolevels of focus: patient, clinician, and system. This review and interactive tool kit serve as an educational resource and call to action to improve equitable distribution of resources, institutional policies, patient-centered care, and practice guidelines for improving health outcomes for all patients with atopic and immunologic disorders.

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Facets of well-being for cardiothoracic surgeons include interconnectivity, or a sense of belonging within a community, and social relatedness. Striving for health equity achieves a sense of belonging and meaning to one's work. In "Elevating Health Equity: The Synergy of Community Engagement and Advocacy," the imperative for mentorship and diversification within health care is expounded, establishing a multitiered blueprint for equity. Integral to this framework is the nurturing of a heterogeneous health care workforce, ameliorating racial and gender disparities in patient care. This article puts forth an intricate, empirically substantiated roadmap toward a more empathic and efficacious health care system.

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This article reviews the existing literature related to medical training in public advocacy and provides the reader with several training examples to consider in a child and adolescent psychiatry fellowship or in combined training programs. Advocacy training embedded within community, forensic, integrated care, school, and many other experiences throughout training provides the skills and tools that the trainee will use in the future when they practice in any setting. This comprehensive training approach aligns with the evolving landscape of child and adolescent mental health where a deep commitment to public health and advocacy is increasingly essential.

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OBJECTIVE: This case study describes how an All of Us engagement project returned value to community by strengthening high school students' capacity to serve as health advocates. MATERIALS AND METHODS: Project activities included health literacy education and research projects on the influence of environmental, societal, and lifestyle factors on community health disparities. The research project involved use of the Photovoice method and All of Us data. At project's end, students presented their research to the community. RESULTS: The project's success was measured by students' participation in the research poster session and comparison of pre- and post-project scores from the Health Literacy Assessment Scale for Adolescent. Data analysis suggests the project succeeded in meeting its goal of increasing students' health literacy. DISCUSSION AND CONCLUSION: Through education and research activities, students learned about community health issues and the importance of participation in medical research programs, like All of Us, to address issues.

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Background: The Nigerian mental health law titled the Lunacy Act of 1958 has been under scrutiny for violating the human rights of people with mental illness. The call to reform the obsolete Lunacy Act has garnered attention from the government, as the law has been unamended for over 60 years. Aim: This study presents the challenges and implications of the new mental health law to the mental health services of Nigeria. Methods: ScienceDirect, PubMed, and Google Scholar were used to find pertinent material. The implications and difficulties facing the new mental health law examined from the literature were discussed. Recommendations were made following an exploratory search for literature on mental health legislation in Nigeria. Results: The new Law in Section 5(6) saw the introduction of mental health services in primary and secondary healthcare. It also addresses critical issues such as non-discrimination, fundamental human rights, standards of treatment, access to information, confidentiality and autonomy, and the employment rights of persons with mental health and substance abuse-related disorders. The Law failed to include mental health services in the country's health insurance system. Conclusion: There is a need for legislation to meet people's mental health needs and encourage them to seek treatments, such as regulations that protect against discrimination and harsh treatment of people with mental illness. Contribution: Nigerian mental health services would benefit from the new mental health law if the key issues raised in this review are addressed.

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Introduction: While community health workers (CHWs) are well-positioned as health advocates, they frequently lack support and feel undervalued. Advocacy training may prepare CHWs to support communities better. Methods: This study uses a design-based research approach to (1) explore how participation in curriculum-development workshops for a digital advocacy course influenced CHWs' (n = 25) perceptions of advocacy and (2) describe how CHW involvement shaped course development. Data were collected via five discussion groups and seven surveys over six months. Results: Initially, the CHWs perceived themselves as community-advocates but not as self-advocates. They increasingly reflected on the merits of advocating for better working conditions and aspired to greater involvement in decision-making. CHWs reflected positively on their advisory role in shaping the course to improve content acceptability and validity. Discussion: Training efforts to engage CHWs in advocacy must overcome systemic barriers and norms internalized by CHWs that deter them from reaching their full potential as advocates.

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BACKGROUND: Systematic ways to teach health advocacy, an educational outcome for pharmacy graduates, is lacking. We developed a workshop to facilitate understanding and application of a novel structured framework for health advocacy and explored how pharmacy students enacted opportunities for health advocacy during subsequent outpatient experiential training. EDUCATIONAL ACTIVITY AND SETTING: A two-hour workshop was introduced for year 2 students in 2019. Its content was organized around a health advocacy framework. With patient and faculty facilitators, students worked through examples characterized into the framework's four quadrants: 1) shared advocacy "with patients" at the individual- or 2) systems-level and 3) directed advocacy "for patients" at the individual-or 4) systems-level. We then conducted a longitudinal diary study asking pharmacy students (N = 23) to reflect on opportunities to practice health advocacy skills in community pharmacy practice. A systematic, multi-coder reflexive thematic analysis of diary entries was employed. FINDINGS: Pharmacy students did not express a fulsome view of patient health advocacy and mischaracterized self-reported practice examples into inappropriate categories of the health advocacy framework. Most overemphasized usual pharmacist care as acts of health advocacy. No systems-level activities were undertaken, although isolated episodes of shared advocacy with patients were identified. SUMMARY: Lasting impacts of a health advocacy workshop in our pharmacy curriculum were not widely apparent. While longer training periods in community pharmacy practice may yield more opportunities to develop and enact this role, gaps in student conceptualization of health advocacy and inabilities to practically observe and exercise system-level advocacy are ultimately problematic for patient care.

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OBJECTIVE: The objective of this study was to document how Ethiopia adopted a WHO Framework Convention on Tobacco Control (FCTC)-based tobacco control law. METHODS: We analyzed publicly available documents, including news media articles, advocacy reports, and government documents. We triangulated these findings by interviewing nine key stakeholders. Data were analyzed to construct a historical and thematic narrative and analyzed through a retrospective policy analysis. RESULTS: Local and international health advocacy efforts helped introduce and support WHO FCTC-based legislation by (1) educating policymakers about the WHO FCTC, (2) providing legal assistance in drafting legislation, (3) generating local data to counter industry claims, and (4) producing media advocacy to expose industry activity. Health advocates worked closely with government officials to create a multi-sectoral tobacco committee to institutionalize efforts and insulate tobacco companies from the policymaking process. Japan Tobacco International bought majority shares of the government-owned tobacco company and attempted to participate in the process, using standard industry tactics to undermine legislative efforts. However, with health advocacy assistance, government officials were able to reject these attempts and adopt a WHO FCTC-based law in 2019 that included 100% smoke-free indoor places, a comprehensive ban on tobacco advertising, and large pictorial health warning labels, among other provisions. CONCLUSION: Sustained local health advocacy efforts supported by international technical and financial assistance can help establish WHO FCTC-based tobacco control laws. Applying a standardized multi-sectoral approach can establish coordinating mechanisms to further institutionalize the WHO FCTC as a legal tool to build support with other government sectors and insulate the tobacco industry from the policymaking process.

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Despite a great need for healthcare, unhoused individuals encounter significant barriers to utilizing public healthcare systems. Given the inequities in access to healthcare, accompanied by disabilities and health risks associated with homelessness, self-efficacy for self-care is particularly critical. As a primary purpose of this article, we describe a self-care intervention (Health Advocacy Behavioral Activation), which was implemented within a long-standing participatory community action research project for homeless shelters, and report evidence of the intervention's effectiveness in enhancing self-efficacy for self-care. Participants included 62 residents of the St. Vincent de Paul Gateway Shelter for Men (Dayton, Ohio). Shelter residents with disabilities and those without disability benefited approximately equally from the intervention and both showed statistically significant pre- to post-intervention improvements in self-efficacy for self-care. Recommendations for future research examining the effectiveness of the intervention are provided. As a secondary (supplementary) purpose, we report preliminary evidence of psychometric validation for a new instrument (Scale of Self-Efficacy for Self-Care), which was developed in service of our primary purpose (i.e., to examine the effects of intervention on self-efficacy for self-care) because a literature search did not identify an appropriate measure. Because this new instrument fills a void in the literature, we anticipate that it will be useful in practice and research, and so we delineate research recommendations for additional psychometric validation of this measure. Because of the barriers that unhoused people encounter with regard to access to healthcare in the community, self-care interventions provided (and evaluated) on-site (e.g., in homeless shelters) are necessary.

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Exploring the landscape of intracranial aneurysms in South America unravels a complex interplay of epidemiological factors, clinical manifestations, and therapeutic challenges. The study methodically conducts a comprehensive literature review spanning the years 2003 to 2023, focusing on English-language articles obtained from diverse databases to elucidate the multifaceted nature of intracranial aneurysms in the region. Results and discussions categorize outcomes into positive domains, emphasizing successful treatments, favorable recoveries, and high survival rates, while also shedding light on negative aspects such as residual aneurysms and complications. The research illuminates significant gaps in pathological typing of intracranial aneurysms and exposes challenges in healthcare accessibility, notably the disparities in neurosurgical resources. Management challenges, including constrained infrastructure access, a neurosurgeon shortage, and gender disparities, are underscored. Transitioning to future prospects, the study advocates for strategic interventions, proposing expanded neurosurgical training, multidisciplinary approaches, improved funding, enhanced access to care, and fostering international collaborations. The study concludes by emphasizing the pivotal role of collaborative efforts, intensified training programs, and global partnerships in propelling intracranial aneurysm management forward in South America, ultimately contributing to enhanced patient outcomes across the region.

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ABSTRACT Objective: To describe the process of implementing a cancer surveillance technical group based on the health advocacy framework. Method: Convergent Care Research addressing 11 representatives of the support and governance system of the healthcare network in a town in Santa Catarina, Brazil. Data were collected from June 2020 to July 2021 in online meetings called convergence groups. The analysis followed the apprehension, synthesis, theorization, and transference steps. Results: The motivations for creating the group included the town's cancer epidemiological context, the need to meet the annual health program, and the professionals' duties in this context. Based on the advocacy framework, the group associated the implementation process with concepts such as integrality, humanization, and professional practice in health. Along this path, strategies were acknowledged and supported the group, such as the establishment and appropriation of philosophical and theoretical bases, in addition to actions such as creating a statute, planning activities, developing instruments, and identifying priorities to implement tasks effectively. Conclusion: Knowledge was exchanged, and a process for providing integral and equitable healthcare in cancer surveillance was developed collectively. Hence, advocacy proved to be a theoretical pillar for the political action of the technical group's members, translating practice into patient rights advocacy.

RESUMEN Objetivo: describir el proceso de implementación de un grupo técnico de vigilancia del cáncer, fundamentado en el referencial de advocacy en salud. Métodos: Investigación Convergente Asistencial realizada con 11 profesionales, representantes de puntos de atención y del sistema de apoyo y gobernanza de la red de atención a la salud de un municipio de Santa Catarina, en Brasil. La recolección fue desarrollada de junio/2020 a julio/2021 en reuniones online denominadas grupos de convergencia. El análisis siguió las etapas de comprensión, síntesis, teorización y transferencia. Resultados: el grupo evidenció como motivaciones para su creación el escenario epidemiológico del cáncer en el municipio, la necesidad de atender la programación anual de salud, y los compromisos profesionales en este contexto. En su proceso de implementación, y a partir del referencial de advocacy en salud, el grupo lo asoció a otros conceptos como la integralidad, la humanización, y el ejercicio profesional en el área de la salud. En este recorrido, fueron reconocidas estrategias iniciales, como la definición y la apropiación de bases filosóficas y teóricas para anclar el grupo, así como estrategias de acciones desde la elaboración de un regimiento, planificación de actividades del grupo, construcción de instrumentos, e identificación de prioridades para implementación efectiva de los trabajos. Conclusión: hubo promoción e intercambio de conocimientos y, colectivamente, se estructuró un proceso para atención integral y ecuánime en la vigilancia del cáncer. Se confirmó el advocacy como pilar teórico para acción política de los profesionales en el grupo técnico, y sus prácticas se traducen en acciones de defesa de los derechos de los usuarios.

RESUMO Objetivo: descrever o processo de implementação de um grupo técnico de vigilância do câncer fundamentado no referencial de advocacy em saúde. Métodos: Pesquisa Convergente Assistencial realizada com 11 profissionais representantes de pontos de atenção e do sistema de apoio e governança da rede de atenção à saúde de um município de Santa Catarina, Brasil. A coleta foi desenvolvida de junho/2020 a julho/2021 em reuniões online denominadas grupos de convergência. A análise seguiu as etapas de apreensão, síntese, teorização e transferência. Resultados: o grupo evidenciou como motivações para sua criação o cenário epidemiológico do câncer no município, a necessidade de atender a programação anual de saúde, e os compromissos profissionais neste contexto. Em seu processo de implementação, e a partir do referencial do advocacy em saúde, o grupo o associou a outros conceitos como a integralidade, a humanização, e o exercício profissional na área da saúde. Neste percurso, foram reconhecidas estratégias iniciais como a definição e a apropriação de bases filosóficas e teóricas para ancorar o grupo, bem como estratégias de ações desde a elaboração de um regimento, planejamento de atividade do grupo, construção de instrumentos, e identificação de prioridades para implementação efetiva dos trabalhos. Conclusão: houve promoção e compartilhamentos de conhecimentos e, coletivamente, estruturou-se um processo para atenção integral e equânime na vigilância do câncer. Confirmou-se o advocacy como pilar teórico para ação política dos profissionais no grupo técnico, e suas práticas traduzem-se em ações de defesa dos direitos dos usuários.

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Resumo Enquadramento: No campo da enfermagem a advocacy procura contribuir no direito à saúde, que se insere no campo dos direitos humanos, pois está intrinsecamente relacionado ao direito de todos a uma vida saudável. Objetivo: Analisar a perceção de docentes sobre a advocacy na enfermagem e discutir as estratégias de promoção de advocacy para o trabalhador docente universitário de enfermagem. Metodologia: Estudo descritivo e exploratório, de abordagem qualitativa realizado em duas universidades públicas situadas no município do Rio de Janeiro, Brasil. Os participantes foram 14 docentes de enfermagem. Utilizou-se o grupo focal e os dados foram analisados à luz da técnica de análise de conteúdo. Resultados: Destaca-se a advocacy como atividade imperativa para alcançar a defesa dos interesses da categoria profissional, bem como a utilização das mídias como estratégia de divulgação do trabalho da enfermagem, incluindo os docentes de enfermagem. Conclusão: A advocacy é uma estratégia de promoção e valorização dos docentes de enfermagem em universidades sendo necessário o investimento nessa estratégia como importante recurso para a promoção da valorização profissional.

Abstract Background: In nursing, advocacy seeks to contribute to the right to health, which is intrinsically related to the human right to a healthy life. Objective: To analyze university teachers' perceptions of advocacy in nursing and discuss strategies to promote advocacy for university nursing teachers. Methodology: A descriptive and exploratory study with a qualitative approach was carried out in two public universities in Rio de Janeiro, Brazil. The participants were 14 nursing teachers. A focus group was conducted, and data were analyzed using the content analysis technique. Results: Advocacy stands out as a crucial activity to defend the professional category's interests, using the media as a strategy for disseminating nursing work, including nursing teachers. Conclusion: An investment in advocacy is needed as it is a strategy for valuing university nursing teachers and promoting their professional development.

Resumen Marco contextual: En el ámbito de la enfermería, la advocacy pretende contribuir al derecho a la salud, que se enmarca en el ámbito de los derechos humanos, ya que está intrínsecamente relacionado con el derecho de todos a una vida sana. Objetivo: Analizar la percepción de los profesores sobre la advocacy en la enfermería y debatir estrategias para promover la advocacy para el trabajador docente universitario de enfermería. Metodología: Estudio descriptivo y exploratorio de enfoque cualitativo realizado en dos universidades públicas localizadas en el municipio de Río de Janeiro, Brasil. Los participantes fueron 14 profesores de enfermería. Se utilizó el grupo focal y los datos fueron analizados con la técnica de análisis de contenido. Resultados: Se destaca la advocacy como actividad imprescindible para lograr la defensa de los intereses de la categoría profesional, así como la utilización de los medios de comunicación como estrategia de difusión del trabajo de enfermería, incluidos los docentes de enfermería. Conclusión: La advocacy es una estrategia de promoción y valoración del profesorado de enfermería en las universidades y es necesario invertir en esta estrategia como recurso fundamental para la promoción de la valoración profesional.