Advocacy

Nurses are accustomed to advocating for individual clients yet may not realize the impact they can have at a population level. Health care professionals should know who our elected officials are and seize opportunities to advocate for policy change, given our evidence-based knowledge and practice. What specifically identified public health issue to be changed/improved at the state or federal level? What would you change? Why? Who in your community would you contact?

In order to apply public health advocacy skills, students may choose from 1 of 3 three activities to fulfill the assignment: 1) write an individual letter about an issue of interest to the student and of importance to public health, 2) write a group letter about an issue of interest to the clinical site and of importance to population served, OR 3) direct advocacy experience and fact sheet: individual students may create an advocacy fact sheet and talk with an elected official or other pertinent decision-maker (i.e. a Chief Nursing Officer [CNO] of an organization providing health care) in a live face-to-face meeting.

SELECTION – Option A- Individual Advocacy Letter:

Write a letter to the appropriate elected official or other leader, identify yourself as a student registered nurse in the body of the letter and include high level evidence supporting your issue. Also include all your credentials after your signature. The Advocacy Letter should not exceed one typed page single spaced, 11-point font. Submit your letter via Blackboard.

Grading Rubric – weighted 10% of semester grade

Description

Points

Letter is correctly addressed in formal business letter format, with correct titles and salutations.

5

Letter identifies a specific public health issue or piece of legislation of interest. Make a detailed request from the decision-maker in the 1st paragraph.

10

Argument for or against the issue or legislation is explicitly identified and presented clearly and concisely.

20

Relevance of the action to public health nursing/ public health nursing is indicated.

10

Letter provides an example demonstrating why the requested course of action is important.

10

High level evidence supporting the policy or legislation is provided. At least 2 evidence-based references and supportive data should be discussed. Citations to be included on a second page.

25

Reflection of the decision-makers past history on the subject is noted, and a response is requested.

5

Appropriate closing and signature, including professional credentials are included.

5

APA- Correct spelling, grammar, punctuation, capitalization, format and citations. All original wording; no direct quotes from source material.

10

Total Possible

100

NOT FOR NURS 421 COURSE – DO NOT USE

Option B- Clinical Group Advocacy Letter:

Write a letter to the appropriate elected official or other leader, identify yourself as student registered nurse working in a community clinical site in the body of the letter. Describe why this issue is of high priority for your target population, and how granting the request would impact the community.

Include high level evidence supporting your issue. Also include all your credentials after your signature. The Advocacy Letter should not exceed one typed page single spaced, 11-point font. Submit your letter via Blackboard. Review bills considered by the Maryland General Assembly at http://mgaleg.maryland.gov/webmga/frm1st.aspx?tab=home for examples.

Grading Rubric – weighted 10% of semester grade

Description

Points

Letter is correctly addressed in formal business letter format, with correct titles and salutations.

5

Letter identifies a specific public health issue or piece of legislation of interest. Make a detailed request from the decision-maker in the 1st paragraph.

10

Argument for or against the issue or legislation is explicitly identified and presented clearly and concisely.

20

Relevance of the action to public health nursing/ public health nursing is indicated.

10

Letter provides an example demonstrating why the requested course of action is important.

10

High level evidence supporting the policy or legislation is provided. At least 2 evidence-based references and supportive data should be discussed. Citations to be included on a second page.

25

Reflection of the decision-makers past history on the subject is noted, and a response is requested.

5

Appropriate closing and signature, including professional credentials are included.

5

APA- Correct spelling, grammar, punctuation, capitalization, format and citations. All original wording; no direct quotes from source material.

10

Total Possible

100

* The following template may be used of either individual or clinical group advocacy letters. *

ADVOCACY LETTER TEMPLATE

[K. Fornili – Jan. 2008]

Your Name

Your Street Address

Your City, St, Zip

Your Phone

Your Email

Date

Recipient Name

Title

Agency Name

Street Address

City, St, Zip

Re: YOUR ISSUE OR PROBLEM

Dear Senator/Congressman LAST NAME: (or Dear Dr./Mr./Ms. Last Name):

FIRST PARAGRAPH: Succinct Statement of Request

(Who You Are and What You Are Asking)

Example:

I am a 4th year nursing student at the University of Maryland School of Nursing, and I am writing à to express my concerns about _______________ OR à to ask that you do this ________________. Make your specific request in the first paragraph. If you also reside in that person’s district (if that person is your legislator), say so. Also, if applicable, explain your unique perspective or expertise in this matter (for example, you are performing a clinical rotation with clients at an inner-city homeless shelter in Baltimore, or you have particular training and experience in critical care nursing, etc.).

NEXT ONE OR TWO PARAGRAPH(S): Justification & Rationale for the Request (Include literature citations, data to support your request). (2 points)

Example:

According to_____Source/Authority__________, in YEAR, there were

___Numbers for Your Problem/Issue_______….____State why this is a serious problem_________….________Include Cost Figures if available___________

NEXT PARAGRAPH: Explain briefly how granting your request is expected to impact the issue. Include measureable outcomes. (2 points)

Example:

It is estimated that ___whatever you want them to fix or do______ will result in a ##% reduction of ___your problem (teen births, HIV infections, etc.) OR a

##% increase in ___whatever you’re asking for (# cases of diseases prevented, # bed days reduced, # of people able to access treatment, find jobs, etc.). According to (YOUR SOURCE) estimates, this could result in reduction/savings of $ XXX, XXX in terms of ______________ (Ex. reduced healthcare or other financial costs). You can include reduction of other types of costs to society (unemployment, morbidity/mortality, domestic violence, etc.) or some kind of improvements (increase in # people with meaningful employment, increase in vaccination coverage rates, etc.)

FINAL PARAGRAPH: Let him/her know that you appreciate his/her work on ________________________ (committee or some other work that is aligned with your request, or the person’s efforts with your population of interest, etc .) à It makes them feel good to know you appreciate their work). Thank the person for his/her consideration of this particular request, and let the person know that you are looking forward to his/her response.

Sincerely,

3 spaces (returns) between Sincerely and Your Name

Your Full Name (Typed)

Your credentials (BSN candidate)

For additional information, see Addressing Correspondence to U.S. Policymakers:

http://ctb.ku.edu/en/table-of-contents/advocacy/direct-action/letters-to-elected-officials/main

REFERENCE LIST

(A cover page is not needed for the advocacy letter.)

Option C- Direct Advocacy Experience and Fact Sheet

During a clinical day’s experience, or on your own with permission from the instructor, visit your legislator in the Maryland General Assembly, or on Capitol Hill. Create a short fact sheet to refer to when talking with your elected official or other leader. Include high level evidence supporting your issue.

* Fact sheet and statements must be reviewed by the Course Director before the advocacy visit takes place. *

Grading Rubric – weighted 10% of semester grade

Description

Points

Professional dress, speech, and demeanor when meeting with the decision-maker.

5

Identify yourself as student nurse working in a community clinical site at the beginning of the meeting.

5

Describe why this issue is of high priority for your target population, and how granting the request would impact the community.

10

Identifies a specific public health issue or piece of legislation of interest. Make an explicit request from the decision-maker in the 1st section of the fact sheet.

20

Argument for or against the issue or legislation presented clearly and concisely.

10

Fact sheet provides an example demonstrating why the requested course of action is important.

10

High level evidence supporting the policy or legislation is provided. At least 2 evidence-based references and supportive data should be discussed. Citations to be included on a second page.

25

Reflection of the decision-makers past history on the subject is noted, and a response is requested.

10

Thank the decision maker, shake hands, and leave a way to get in touch in the future

5

Total Possible

100

An example of an advocacy fact sheet is found on the following pages. Fact sheets should be limited to one-two pages of content, with citations on the second page. A cover letter is not needed for the advocacy fact sheet.

Examples of Fact Sheets: Basic-

Eliminating coal tar sealcoat will protect Maryland’s citizens, waterways and wildlife

· Coal-based sealcoat is hazardous to human health and wildlife

· Polyaromatic hydrocarbons (PAHs) in coal tar based products are carcinogenic.

· High levels of PAHs are tracked into homes near coal tar seal coated pavement.

· PAHs have been linked to increased risks of lung, skin, bladder, and respiratory cancers.

· Runoff from coal tar sealcoat remains toxic for months, killing fish and harming wildlife.

https://lh5.googleusercontent.com/PrcU24sBpmb2tQYZhVp_PDePh2YYvLx4GeTtoCYIuc3Jj4tBis7pyxCouhpW6v-EI7P__IvHI7ZFqtj__cu9rM9pqKQr-Nz64hwASIkjzjGHNKx6hSYLd7_wlrzNnJjMpNscBemC (USGS, 2016)

· Safer alternatives are readily available and already widely used

· Many retailers and distributors, (including Ace Hardware, Lowe’s, Home Depot, True Value, Agway, Menards, and United Hardware), have stopped selling coal tar sealants.

· Most state Departments of Transportation no longer use coal tar-based sealants, saying they reduce asphalt life in the long run.

· Many places have restrictions on coal tar sealcoat to protect health

· 3 State bans: Washington, Minnesota and Maine (effective 10/2024)

· 5 County bans: Dane, WI; Montgomery, MD; Prince George’s, MD; Anne Arundel, MD and Suffolk, NY

· A total of 16 states/districts have restrictions or bans within their boundaries: (CA, CT, Washington DC, IL, KS, ME, MD, MI, MN, MO, NY, NC, SC, WA, WI, TX)

HB ___ Prohibition on the Sale and Application of Coal Tar Pavement Products

This bill will put an end to the harmful and unnecessary use of coal tar pavement sealcoat, in order to protect public health, water quality, and wildlife, and elevate Maryland to the ranks of many jurisdictions banning coal tar sealant products.