D025 Final Exam: Advocacy for Policy Change in Community Health

D025 Final Exam: Advocacy for Policy Change in Community Health

Student Name

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 using education, expertise, and professional roles to support and protect the needs and rights of others. This important skill is introduced early during nursing education and remains a key responsibility throughout a nurse’s career. While nurses frequently advocate for individual patients within clinical settings—ensuring they receive the best possible care—the broader role of advocating for community health, particularly preventive care, is less emphasized. Advanced Professional Nurses (APNs) hold a unique position with a vital responsibility to push for systemic policy changes that improve health outcomes for entire communities.

Advanced Professional Nurse as Advocate

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

The advocacy role of APNs differs notably when focusing on community populations versus individual patients. The distinctions can be organized as follows:

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 team (doctors, nurses, pharmacists, therapists)
Scope of Impact	Indirect impact on community health outcomes	Direct impact on individual patient outcomes

In community advocacy, APNs emphasize prevention by influencing policies that shape population health. In clinical practice, the focus is on managing and treating individual health issues. Community advocacy requires cooperation with policymakers and local stakeholders, whereas clinical advocacy involves collaboration within healthcare teams (Nickitas, Middaugh, & Feeg, 2018; Bondurant & Armstrong, 2016).

Interprofessional Collaboration

What strategies promote effective teamwork in community advocacy?

Effective community advocacy relies on well-coordinated efforts within an Advocacy Action Team (AAT) composed of professionals committed to supporting vulnerable populations. Two key strategies to enhance collaboration include:

• Establishing Guidelines and a Shared Purpose: Clearly defined roles, responsibilities, and shared objectives help team members understand their contributions and work together efficiently toward common goals (Sims, Hewitt, & Harris, 2015).

• Critical Reflection on Progress: Regular, unbiased evaluations of team efforts allow identification of successes and challenges, promoting flexibility, innovation, and optimal resource use (Sims et al., 2015).

These approaches foster team cohesion and maintain momentum despite potential opposition or obstacles.

Data-Driven Health Issue: Smoking in Winnebago County

Winnebago County ranks among the least healthy counties in Illinois due to elevated adult smoking rates. According to the 2021 County Health Rankings and Roadmaps, 21% of adults smoke in Winnebago County—significantly higher than the Illinois and U.S. averages of 16%. This issue demands focused interventions to improve health outcomes.

Characteristics of the At-Risk Population

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

The most vulnerable group mainly includes adults with lower educational attainment, a factor closely related to childhood socioeconomic disadvantages. The following comparison highlights key differences between Winnebago County and national data:

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 correlate strongly with increased adult smoking prevalence (Gagne, Frohlich, & Quesnel-Vallee, 2020).

Social Determinant of Health (SDOH)

Limited childhood access to quality education, particularly for children living in poverty, is a major social determinant influencing smoking rates in Winnebago County. Healthy People 2030 (n.d.) highlights that children raised in impoverished households face higher dropout rates, which increase the risk of adult smoking. Therefore, improving early educational opportunities is essential to break this cycle and promote better long-term health outcomes.

Current Policy and Its Limitations

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

Policy Proposal: Extended Early Childhood Program

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

To tackle limited educational access, a policy is proposed for an Extended Early Childhood Program focused on meeting the socioeconomic and educational needs of children living in poverty. Research indicates that children from low socioeconomic backgrounds require additional support to succeed academically and complete graduation (Healthy People 2020, n.d.). This early intervention aims to increase graduation rates, thereby reducing adult smoking rates over time.

Impact of the Policy on Health Outcomes

Implementing the Extended Early Childhood Program is expected to provide several benefits:

• Improved access to education for children in impoverished communities.

• Decreased high school dropout rates.

• Long-term reduction in adult smoking prevalence.

Evidence from initiatives such as the Carolina Abecedarian Project supports that early childhood education positively influences physical and mental health into adulthood and lowers smoking likelihood (Healthy People 2020, n.d.).

Ensuring Equitable Distribution of Resources

To ensure fairness, the policy will include a diversity clause preventing discrimination based on race, color, religion, sexual orientation, gender identity, or disability. A diversity board will oversee admissions, ensuring access is based on genuine need. If reserved spaces for specific groups remain unused, they will be reallocated to those demonstrating the highest need.

Ethical Considerations

This policy aligns with provisions of the American Nurses Association (ANA) Code of Ethics:

Provision	Description
Provision 7.3	Nurses are responsible for community advocacy and policy development (ANA, 2015).
Provision 8.2	Nurses must address social determinants of health through collaboration with leaders and policymakers.

By advocating for educational reforms, APNs uphold their ethical obligation to promote health equity within communities (ANA, 2015).

Potential Barriers

What challenges might hinder policy implementation?

Key challenges include:

• Financial Constraints: Winnebago County’s limited budget necessitates securing grants or external funding.

• Stakeholder Resistance: Differing priorities among decision-makers may delay or obstruct progress.

Overcoming these barriers will require strategic communication and partnership-building with key stakeholders.

Policy Maker Identification

Jude Makulec, President of the Winnebago County School Board, is a crucial policymaker for advancing the Extended Early Childhood Program. Given their influence over education policy and local connections, Makulec plays a vital role in facilitating policy adoption.

Strategic Next Steps for Advocacy

To strengthen advocacy efforts, APNs should:

• Join nursing advocacy organizations such as the National League for Nursing or the American Association of Colleges of Nursing to stay informed about national policy developments.

• Engage actively with local leaders and stakeholders to remain aware of social determinants and community health priorities.

• Develop interprofessional collaboration skills, including effective communication, active listening, and reflective practice.

Conclusion

Advanced professional nurses extend their impact beyond individual patient care by engaging in community and policy advocacy to promote health equity. Through collaborative partnerships and targeted initiatives like the Extended Early Childhood Program, APNs can influence social determinants and improve broad health outcomes. Advocacy, emphasized in the ANA Code of Ethics, is fundamental to nursing practice and essential to fostering healthier communities.

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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

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