RESUMO
The need for effective advocacy on the part of health professionals has never been greater. The recent COVID-19 pandemic has made the connection between human health and social conditions clear, while highlighting the limitations of biomedical interventions to address those conditions. Efforts to increase the frequency and effectiveness of advocacy activities by health professionals have been hampered by the lack of a practical framework to define and develop advocacy competencies among trainees as well as to plan and execute advocacy activities. The authors of this article propose a framework which defines advocacy as occurring across three domains of influence (practice, community, and government) using three categories of advocacy skills (policy, communication, and relationships). When these skills are successfully applied in the appropriate domains of influence, the resulting change falls into three levels: individual, adjacent, and structural. The authors assert that this framework is immediately applicable to a broad variety of health professionals, educators, researchers, organizations, and professional societies as they individually and collectively seek to improve the health and well-being of those they care for.
Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias , Pessoal de Saúde , Defesa do PacienteAssuntos
Pesquisa Biomédica/tendências , Censos , Saúde da Criança , Pediatria/organização & administração , Pré-Escolar , Emigrantes e Imigrantes , Financiamento Governamental , Hospitais Pediátricos/economia , Humanos , Lactente , Recém-Nascido , Internet , Medicaid , Serviço Social , Estados Unidos , Populações VulneráveisAssuntos
Ética Médica , Política de Saúde , Consentimento Livre e Esclarecido , Pediatria/ética , Adolescente , Adulto , Criança , Pré-Escolar , Ensaios Clínicos como Assunto/ética , Ensaios Clínicos como Assunto/legislação & jurisprudência , Tomada de Decisões , Letramento em Saúde , Humanos , Lactente , Recém-Nascido , Pais , Participação do Paciente , Pediatria/legislação & jurisprudênciaAssuntos
Cotinina , Política de Saúde , Exposição Ambiental/análise , Humanos , Lactente , Saliva , FumarAssuntos
Expectativa de Vida , Adolescente , Adulto , Criança , Previsões , Política de Saúde , Humanos , Adulto JovemAssuntos
Idade Gestacional , Recém-Nascido Prematuro , Humanos , Lactente , Recém-Nascido , Política PúblicaRESUMO
Behavioral health problems are ubiquitous in today's society. Social, environmental, and physical stressors impact our daily activities and wellness, contributing to mental health conditions, both diagnosed and undiagnosed, as well as substance use. We know that populations and identities are not equally impacted. Populations who experience greater stressors suffer more. Structures and systems cause and reinforce inequities in health, inclusive of behavioral health. Still, there is insufficient understanding of the existing disparities in behavioral health. Right now, what do we know? And perhaps more importantly, what do we know that we do not know? Behavioral health itself is an inequity in health care. Predominantly isolated from physical health, we still have not achieved parity in preventive measures, access, management, or reimbursement for care. We cannot let what we do not know prevent us from advocating for adequate resource allocation and prioritizing community driven solutions for populations with the greatest needs. These efforts must shift from programmatic interventions to full-scale paradigm shifts in public policy and adoption of disaggregated racial data to effectively narrow the gaps in equality and help us address behavioral health with the respect deserved to balance inequities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Psiquiatria , Transtornos Relacionados ao Uso de Substâncias , Humanos , Grupos RaciaisRESUMO
In this editorial we describe the clinician/administrator/researcher experience of frustration or confusion around how to effectively advocate for policy change in health care. By the end of the piece the reader will (a) understand the importance of health professionals' advocacy; (b) know how to use policy papers to advocate; and (c) understand how policy organizations use policy papers. We also discuss the National Academies of Medicine, Science, & Engineering High Quality Primary Care report as an example of a policy paper, introduce our new coeditors for the Policy and Management Department, and describe the Collaborative Family Health Care Association's new policy principles. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Assuntos
Atenção à Saúde , Política de Saúde , Pessoal de Saúde , Humanos , Atenção Primária à SaúdeRESUMO
Barriers to the spread of integrated behavioral health and primary care continue to limit progress on meeting critical needs for mental health and substance use disorder services. The recent Bipartisan Policy Center Report (2021) provides key policy recommendations to address these barriers and accelerate the adoption of integrated behavioral health in Medicaid and Medicare. Having bipartisan support presents a policy window of opportunity to advance integrated behavioral health through advocacy for implementation of these recommendations, parallel changes to occur in employer-based and other commercial insurance plans, and development of operationalized standards for core service delivery elements. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Assuntos
Medicare , Psiquiatria , Idoso , Humanos , Medicaid , Saúde Mental , Atenção Primária à Saúde , Estados UnidosRESUMO
Integrated care is recognized as a promising approach to comprehensive health care and reductions in health care costs. However, the integration of behavioral health and primary care is complex and often difficult to implement. Successful and sustainable integration efforts require coordination and alignment both within health care organizations and across multiple sectors. Furthermore, implementation progress and outcomes are shaped by the readiness of stakeholders to work together toward integrated care. In the context of a Colorado State Innovation Model (SIM) effort, we examined stakeholder readiness to advance and sustain partnerships for behavioral health integration beyond the period of grant funding. Partnership readiness was assessed using the Readiness for Cross-sector Partnerships Questionnaire (RCP) in spring 2019. Participants from 67 organizations represented seven sectors: government, health care, academic, practice transformation, advocacy, payer, and other. RCP analyses indicated a moderate level of readiness among Colorado stakeholders for partnering to continue the work of behavioral health integration initiated by SIM. Stakeholders indicated their highest readiness levels for general capacity and lowest for innovation-specific capacity. Five thematic categories emerged from the open-ended questions pertaining to partnership experiences: (a) collaboration and relationships, (b) capacity and leadership, (c) measurement and outcomes, (d) financing integrated care, and (e) sustainability of the cross-sector partnership. Partnering across sectors to advance integrated behavioral health and create more equitable access to services is inherently complex and nonlinear in nature. The RCP usefully identifies opportunities to strengthen the sustainability of integrated care efforts.
Assuntos
Atenção à Saúde , Atenção Primária à Saúde , Governo , HumanosRESUMO
Recent changes in health care delivery systems and in medical training have primed academia for a paradigm shift, with strengthened support for an expanded definition of scholarship. Physicians who consider advocacy to be relevant to their scholarly endeavors need a standardized format to display activities and measure the value of health outcomes to which their work can be attributed. Similar to the Educator Portfolio, the authors here propose the Advocacy Portfolio (AP) to document a scholarly approach to advocacy.Despite common challenges faced in the arguments for both education and advocacy to be viewed as scholarship, the authors highlight inherent differences between the two fields. On the basis of prior literature, the authors propose a broad yet comprehensive set of domains to categorize advocacy activities, including advocacy engagement, knowledge dissemination, community outreach, advocacy teaching/mentoring, and advocacy leadership/administration. Documenting quality, quantity, and a scholarly approach to advocacy within each domain is the first of many steps to establish congruence between advocacy and scholarship for physicians using the AP format.This standardized format can be applied in a variety of settings, from medical training to academic promotion. Such documentation will encourage institutional buy-in by aligning measured outcomes with institutional missions. The AP will also provide physician-advocates with a method to display the impact of advocacy projects on health outcomes for patients and populations. Future challenges to broad application include establishing institutional support and developing consensus regarding criteria by which to evaluate the contributions of advocacy activities to scholarship.
Assuntos
Defesa do Consumidor , Documentação/métodos , Docentes de Medicina/normas , Médicos/normas , Documentação/normas , HumanosRESUMO
Although many health care professionals are interested in health policy, relatively few have training in how to utilize their clinical experience and scientific knowledge to impact policy. Developing a policy brief is one approach that health professionals may use to draw attention to important evidence that relates to policy. This article offers guidance on how to write a policy brief by outlining 4 steps: (a) define the problem, (b) state the policy, (c) make your case, and (d) discuss the impact. The steps and tips offer a starting point for health care professionals interested in health policy and translating research or clinical experience to impact policy. (PsycINFO Database Record
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Política de Saúde/tendências , Formulação de Políticas , Redação , HumanosRESUMO
Comments on the article "Please break the silence: Parents' views on communication between pediatric primary care and mental health providers" by Greene et al. (see record 2015-14521-001). The article highlights the need to improve communication between primary care and mental health care providers to better serve children and families. The report reaffirms that parents understand the value and necessity of collaborative care, as evidenced by the identification of gaps in consistency of bidirectional communication between providers in traditional and separate practice settings and the desire for improved care coordination.
Assuntos
Comunicação , Pais/psicologia , Médicos de Atenção Primária , Psicologia da Criança , Feminino , Humanos , MasculinoAssuntos
Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/prevenção & controle , Anamnese/métodos , Papel do Médico , Criança , Transtornos do Comportamento Infantil/psicologia , Feminino , Humanos , Masculino , Anamnese/normas , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/prevenção & controle , Transtornos do Neurodesenvolvimento/psicologiaRESUMO
Many medical authors and organizations have called for physician advocacy as a core component of medical professionalism. Despite widespread acceptance of advocacy as a professional obligation, the concept remains problematic within the profession of medicine because it remains undefined in concept, scope, and practice. If advocacy is to be a professional imperative, then medical schools and graduate education programs must deliberately train physicians as advocates. Accrediting bodies must clearly define advocacy competencies, and all physicians must meet them at some basic level. Sustaining and fostering physician advocacy will require modest changes to both undergraduate and graduate medical education. Developing advocacy training and practice opportunities for practicing physicians will also be necessary. In this article, as first steps toward building a model for competency-based physician advocacy training and delineating physician advocacy in common practice, the authors propose a definition and, using the biographies of actual physician advocates, describe the spectrum of physician advocacy.