D025 Final Exam: Advocacy for Policy Change in Community Health

D025 Final Exam: Advocacy for Policy Change in Community Health

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 Western Governors University

D025 Essentials of Advanced Nursing Roles and Interprofessional Practice

Prof. Name

Date

Advocating for Policy Change to Improve Community Health Outcomes

Advocacy in nursing involves utilizing education, professional expertise, and one’s role to champion the rights and needs of others. This foundational nursing skill begins during early education and remains integral throughout a nurse’s professional journey. Nurses commonly advocate for individual patients within clinical environments by ensuring they receive appropriate care. However, the broader role of advocating for community health—especially in preventive care through policy change—is often overlooked. Advanced professional nurses (APNs) hold a distinctive responsibility to influence systemic policy reforms that can improve health outcomes at the community level.

Advanced Professional Nurse as Advocate

How does advocacy differ between community populations and individual patients in clinical practice?

Advocacy by APNs varies significantly when addressing community populations versus individual patients. The key differences are outlined below:

Aspect	Community Advocacy	Clinical Practice Advocacy
Level of Care Focus	Preventive care through policy change	Secondary and tertiary care for acute illness
Collaborative Partners	Local leaders and policymakers	Interprofessional healthcare teams (doctors, nurses, pharmacists, therapists)
Scope of Impact	Indirect impact on community health outcomes	Direct impact on individual patient outcomes

Community advocacy focuses on prevention by shaping policies affecting population health, collaborating with legislators and stakeholders. Clinical advocacy, by contrast, concentrates on treating individual health conditions, typically within a healthcare team (Nickitas et al., 2018; Bondurant & Armstrong, 2016). APNs thus must balance these roles to ensure both individual and public health needs are met.

Interprofessional Collaboration

What strategies promote effective teamwork in community advocacy?

Successful community advocacy depends on coordinated efforts by an Advocacy Action Team (AAT), comprising professionals committed to supporting marginalized populations. Two evidence-based strategies enhance interprofessional collaboration:

• Establishing Guidelines and a Shared Purpose: Clearly defining roles, responsibilities, and common goals helps team members understand their contributions and work cohesively toward shared objectives (Sims, Hewitt, & Harris, 2015).
• Critical Reflection on Progress: Regular, unbiased evaluations of team efforts identify successes and barriers, encouraging adaptability, innovation, and efficient resource use (Sims et al., 2015).

These approaches foster team cohesion and sustain momentum despite challenges or opposition.

Data-Driven Health Issue: Smoking in Winnebago County

According to the 2021 County Health Rankings, Winnebago County ranks poorly in Illinois health metrics, largely due to a high adult smoking rate of 21%, exceeding both state and national averages of 16%. This smoking prevalence constitutes a significant public health concern requiring targeted intervention.

Characteristics of the At-Risk Population

Who comprises the population most vulnerable to smoking in Winnebago County, and how do they compare nationally?

The population most susceptible to smoking in Winnebago County primarily includes adults with lower educational attainment—a factor strongly associated with childhood socioeconomic conditions. The table below compares key educational and poverty indicators between Winnebago County and the U.S. national averages:

Characteristic	Winnebago County Data	U.S. National Data
High School Diploma Rate	88% of adults	94% of adults
Some College Completion Rate	59% of adults	73% of adults
Childhood Poverty Rate	27% of children	10% of children

Lower education levels and higher childhood poverty rates contribute to increased adult smoking rates, consistent with findings by Gagne, Frohlich, and Quesnel-Vallee (2020).

Social Determinant of Health (SDOH)

Limited childhood access to education, particularly for children in poverty, stands out as a critical social determinant influencing smoking prevalence in Winnebago County. Healthy People 2030 (n.d.) reports that children raised in impoverished environments are more likely to drop out of school, which correlates strongly with adult smoking initiation. Therefore, improving early educational opportunities is vital to disrupting this negative health trajectory.

Current Policy and Its Limitations

Winnebago County enforces a Tobacco Free and Smoke Free Environment Policy (2014), which restricts tobacco use indoors and near public buildings in line with Illinois state laws. While this policy reduces secondhand smoke exposure, it does not address root causes such as educational disparities linked to poverty that contribute to smoking initiation.

Policy Proposal: Extended Early Childhood Program

What policy intervention is proposed to address the root causes of smoking?

To combat limited educational access, the proposed policy advocates for an Extended Early Childhood Program designed to support the socioeconomic and educational needs of children living in poverty. Research highlights that children from low socioeconomic backgrounds often require additional support to succeed academically and graduate (Healthy People 2020, n.d.). Early educational interventions can increase graduation rates and ultimately lower adult smoking rates.

Impact of the Policy on Health Outcomes

Implementing this Extended Early Childhood Program is projected to achieve multiple positive outcomes:

• Improved educational access for children in impoverished areas.
• Reduction in high school dropout rates.
• Long-term decrease in adult smoking prevalence.

Evidence from programs such as the Carolina Abecedarian Project supports the link between early childhood education and better physical and mental health outcomes, including reduced smoking likelihood (Healthy People 2020, n.d.).

Ensuring Equitable Distribution of Resources

To promote fairness, the policy includes a diversity clause prohibiting discrimination based on race, color, religion, sexual orientation, gender identity, or disability. A diversity board will monitor admissions to ensure equitable access based on genuine need. Unused reserved spaces for specific groups will be reallocated to those with the highest needs to maximize impact.

Ethical Considerations

This initiative aligns with the American Nurses Association (ANA) Code of Ethics provisions, which guide nursing advocacy efforts:

Provision	Description
Provision 7.3	Nurses have an obligation to engage in community advocacy and policy development (ANA, 2015).
Provision 8.2	Nurses must address social determinants of health through collaboration with leaders and policymakers.

By championing policies that expand educational access, APNs fulfill their ethical responsibility to promote health equity within communities (ANA, 2015).

Potential Barriers

What challenges might hinder policy implementation?

Several obstacles could impede the success of the proposed policy:

• Financial Constraints: Limited county budgets necessitate securing grants or external funding sources.
• Stakeholder Resistance: Divergent priorities among decision-makers may delay or block policy adoption.

Overcoming these barriers requires strategic communication and coalition-building with key stakeholders.

Policy Maker Identification

Jude Makulec, President of the Winnebago County School Board, emerges as a crucial policymaker in advancing the Extended Early Childhood Program. Their authority over educational policy and connections with local leaders position them to influence policy adoption significantly.

Strategic Next Steps for Advocacy

To maximize advocacy effectiveness, APNs should:

• Join professional nursing advocacy organizations such as the National League for Nursing or the American Association of Colleges of Nursing to stay informed on policy developments.
• Engage actively with community leaders and stakeholders to remain aware of social determinants and health priorities.
• Develop interprofessional collaboration skills, including effective communication, active listening, and reflective practice.

Conclusion

Advanced professional nurses play an essential role beyond individual patient care by engaging in community and policy advocacy to promote health equity. Through partnerships and targeted initiatives like the Extended Early Childhood Program, APNs can influence social determinants of health and enhance broad community health outcomes. Advocacy, as emphasized in the ANA Code of Ethics, remains a fundamental nursing responsibility critical to building healthier communities.

References

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/coe-view-only

Bondurant, P. G., & Armstrong, L. (2016). Nurses: Leading change and transforming care – expert opinion. Newborn & Infant Nursing Reviews, 16(3), 155–160. https://doi.org/10.1053/j.nainr.2016.07.004

County Health Rankings & Roadmaps. (2021). Winnebago (WB). https://www.countyhealthrankings.org/app/illinois/2021/rankings/winnebago/county/outcomes/overall/snapshot

Gagne, T., Frohlich, K. L., & Quesnel-Vallee, A. (2020). The role of education and other transition milestones in the progression of social inequalities in cigarette smoking between the ages of 18 and 25: Evidence from the Canadian national population health survey. Addictive Behaviors, 109. https://doi.org/10.1016/j.addbeh.2020.106476

D025 Final Exam: Advocacy for Policy Change in Community Health

Healthy People 2020. (n.d.). Early childhood development and education. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/early-childhood-development-and-education

Healthy People 2030. Education access and quality. https://health.gov/healthypeople/objectives-and-data/browse-objectives/education-access-and-quality

Nickitas, D. M., Middaugh, D. J., & Feeg, V. (2018). Policy and politics for nurses and other health professionals: Advocacy and action (3rd ed.). Jones & Bartlett Learning. https://ebookcentral.proquest.com/lib/westerngovernors-ebooks/reader.action?docID=5504726&ppg=25

Sims, S., Hewitt, G., & Harris, R. (2015). Evidence of a shared purpose, critical reflection, innovation and leadership in interprofessional healthcare teams: A realist synthesis. Journal of Interprofessional Care, 29(3), 209–215. https://doi.org/10.3109/13561820.2014.941459

Winnebago County. (2014). Tobacco free and smoke free environment policy. https://wincoil.us/media/90326/winnebago_county_tobacco_use_policy_revised_3_2014.pdf

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