INTRODUCTION
According to the Bylaws of the American Association of Colleges of Pharmacy (AACP), the Advocacy Committee: “will advise the Board of Directors on the formation of positions on matters of public policy and on strategies to advance those positions to the public and private sectors on behalf of academic pharmacy.”
PRESIDENTIAL CHARGE
President Cynthia J. Boyle presented the committee with the following charge: Building on advocacy tools from previous committee work, the Advocacy Committee will consider how to empower us as citizens -- within our institutions, communities, and governments. Can we take our needs to actions by 1) preparing to answer ‘why now?’ 2) offering a plan, and 3) characterizing benefits or ‘what is in it for them’? This skill set is necessary for student pharmacists, but also for our faculty and professional staff members. Too often Legislative Day has become the equivalent of ‘dropping off the kids at the mall’ without the sufficient support and mentoring of faculty and practitioners. The 2015-16 Advocacy Committee will:
1. Identify and recognize citizen exemplars among faculty, practicing pharmacists, and students.
2. Identify the key characteristics and development opportunities to expand and empower the pool of pharmacy education advocates.
PROCESS
AACP members are annually requested to submit their interest in serving on AACP governance and standing committees. Staff, along with the President, determine the best fit of those interested in the Advocacy Committee with the given charge. Selected participants received a follow-up email asking them to verify both their interest and their expertise relative to the charge. Staff also reviewed the member profile of the interested participant for inclusion of content-expertise.
In November 2015, the selected committee members met during a face-to-face meeting in Toronto, Canada. During this meeting the Chair and staff reviewed the committee charge and led the group through in a wide-ranging discussion of that charge. Using a draft report outline, committee members determined who would be responsible for specific portions of the report, what that portion would include, and a timeline for committee work. The committee workgroups worked toward completion of their specified report portions sharing information and resources via email, google docs and phone calls. The committee, as a whole, held monthly conference calls to provide status updates, seek input from the entire group related to challenges, and review and modify accountabilities as needed. The outcome is a final committee report published in the American Journal of Pharmaceutical Education, the highlights of which are presented at the AACP 2016 annual meeting.
The committee discussed the work of recent Advocacy Committees in applying concepts and frameworks from implementation science to improve AACP’s advocacy efforts. These advocacy efforts recognize that public policy is an intervention and greater utility can be realized if public policy is evidence-based. As individuals and institutions increase the use of evidence-based interventions, these concepts and frameworks allow for the identification and implementation of successful interventions [1,2].
A CONSISTENT APPROACH TO ADVOCACY
Based on the presidential charge, the committee identified the characteristics of an engaged citizen, utilizing the following elements of the previously described approach:
1. Placing the issue in context- Committee members reviewed a variety of documents to better understand and appreciate the role of students and faculty as engaged citizens.
2. Defining the issues- To evaluate the progress of the academy, the committee discussed the need to find an existing definition for or define the term citizen engagement. This essential first step would provide the committee and readers with a clear statement of what it is we are attempting to address.
3. Describing core characteristics- Agreeing to a set of core characteristics that are commonly observed in engaged citizens was a next step. To keep the committee’s work evidence-based, committee members reviewed the literature for evidence supporting individual core characteristics.
CONTEXT
The Shelter: A Parable
A young boy learned about the importance of giving very early in life because his family had an annual tradition of volunteering at The Shelter to feed the homeless. The boy’s family was not wealthy, but they were rich beyond measure in their commitment to others on this very special day of the year. He noticed other familiar faces; men and women he saw every year who came together as a team to assist in the preparation and delivery of food for those who were less fortunate. Even though this ritual only happened once a year, it was as if their efforts were carefully scripted because everyone knew what had to be done. At the end of the day everyone was so tired, and yet so fulfilled because they knew their efforts had resulted in feeding over one hundred homeless and needy families. As they left and were returning home in their car the young boy asked, “Papa, what happens tomorrow when it is dinner time for the homeless?” His papa answered, “I suppose there are more families who will come to help the homeless.” “But papa”, the boy said, “it must be hard for so many people to come to the shelter for dinner every night.” His father responded, “Yes, it’s not a life I would want and it’s not a life I would want for you mijo.” “And what about breakfast and lunch papa?” the boy asked. “You ask very good questions son. Perhaps we should let others worry about tomorrow. We can be proud of what we did today.”
This story illustrates two important facets of providing assistance to those in need. There is a social service component that comes from the desire to help others, and there is a community engagement component that brings people together to work in teams to accomplish a common goal. What is missing in this scenario is a discussion about the causes and possible solutions to the homelessness that brought people to the shelter in the first place. Moving beyond responding to things as they are, to taking action to change an undesirable situation is at the heart of citizen engagement and advocating for improvements in our society.
Defining citizen engagement
The committee was unable to find an “official” or consensus-based definition for the phrase “citizen engagement”. For the purposes of this report and in attempting to demystify advocacy, the committee has broadly defined citizen engagement as: a person belonging to a community (e.g., sharing geography, characteristics, attitudes, interests, or goals) who through their active participation is informed and invested in promoting the goals and priorities of that community. While advocacy and citizen engagement are often thought of within the lens of the legislative process, it is recommended that the lens be broadened to include individual volunteerism and organizational involvement. For those in pharmacy or pharmacy education, preparing one’s self for citizen engagement requires the active, conscious development and maintenance of personal and professional relationships that allow one to effectively channel knowledge, skills, and passion toward improvements in the community or health care environments.
Examples of engaged citizens
To help readers identify with the above definition, the committee reflected on individuals who exemplify the engaged citizen. The exemplars included in the report are actual individuals whose identities have been concealed by using two, non-specific, initials. For consistency in describing an engaged citizen exemplar the committee members were asked to include the following information:
• Initials
• Gender
• Role in pharmacy- student, faculty, resident, practicing pharmacist
• Practice area
• Description of area of engagement
• Characteristics expressed by this individual
Example 1
BC is an independent pharmacy owner with three locations, an active member and former president of a regional pharmacy association, and a member of a local medical center governing board. He also serves on the state board of pharmacy. BC has been a highly effective advocate for pharmacy because he has created meaningful, collaborative and supportive relationships with people who have aspired to public office. He has contributed to political campaigns, he has hosted fundraising events for those seeking public office, and he has partnered with legislators in supporting important initiatives. In return for his loyalty and commitment, he is able to contact legislators directly when the need arises. He is also on their “speed dial” when they are looking for input on pending legislation. Even at the state level, legislators are asked to vote on between 600 and 800 bills each year. Having trusted professionals who are able to provide advice and counsel on bills related to health care becomes a great legislative resource. BC demonstrates passion for the profession of pharmacy in his interactions with legislators and others in public office. He has strong interpersonal skills and strengthens relationships through participation in campaigns, fundraising events, and social interactions. His strong communication skills are important for his very public support of issues that are vital to pharmacy.
Example 2
PD has demonstrated and continues to demonstrate significant advocacy for the profession of pharmacy through multiple venues. She was a pharmacist in an ambulatory care / physician office setting who always advocated for her patients. She believed that her advocacy for her patients manifested through her advocacy of the profession. She volunteered to serve on state professional association committees, which eventually resulted in eventually becoming president of the state pharmacy association and ultimately a dean for a college of pharmacy. Throughout her professional career, she has engaged legislators, the public and various health professionals to advocate on behalf of her patients through the profession. She takes the time educate herself about important bills, key constituents, and the impact of legislation. As needed, she attempts to educate her colleagues about key issues, including those individuals who are not engaged in advocacy. PD contributes to her community and the profession in a voluntary and significant manner. Her success as an advocate is a result of her passion, compassion, engagement and strong communication skills.
Example 3
DB has been a hospital pharmacy manager for over twenty-seven years having served as director of pharmacy in large and small institutions including metropolitan and rural/medically underserved areas of the state. Her commitment to patient care is multi-faceted as she has worked tirelessly to develop and implement systems to enhance patient safety as well as maximizing the role of the pharmacist in patient care. Her mantra is “We have to take what we are doing at the bedside and educate those who are in the position to make decisions that impact our patients and our practice.” To DB, advocacy is a core element of the professional responsibility. She has served on the board of pharmacy in her state including serving as president as well as serving on the state’s Medicaid pharmaceutical and therapeutics committee. She actively participates in election campaigns hosting legislators and staffers at her practice site and home. As a current member of the faculty at a college of pharmacy, she has expanded her sphere of influence by instilling the importance of active engagement in advocacy for student pharmacists. She is an exceptional role model for current and future practitioners.
Example 4
AP is a second year student pharmacist who currently serves as president of the APhA-ASP chapter and as regional delegate to APhA. He is also very involved through a local pharmacy association grassroots committee that has met with numerous legislators to gain support for state and national bills that are important to pharmacy and patients. AP recently introduced a new business item at the state pharmacy association House of Delegates meeting that focuses on pharmacy robberies and the importance of safety and security for pharmacy staff and patients. The business item was unanimously approved and forwarded to the reference committee. He attributes his successful involvement to his enthusiasm, passion, and interpersonal skills. His recent success at the House of Delegates also demonstrates that he is a consensus builder. AP credits his leadership development to twenty-one years of participation in Boy Scouts of America.
CORE COMPONENTS
Characteristics of engaged citizens
During their face-to-face meeting, the members of the committee discussed how they would describe an engaged citizen. The committee developed a list of nearly twenty characteristics. The complete list of characteristics was refined through the application of a survey tool that asked members to prioritize the characteristics into a “top ten” list. The prioritization of the initial list of characteristics resulted in the following characteristics being selected as the “top ten:” A second “List of evidence-informed characteristics” was developed through a review of the literature.
Evidence that supports these characteristics
During the meeting of the committee in November, a list of twenty characteristics were identified as key characteristics associated with advocacy and individual involvement in advocacy efforts. The committee used Survey Monkey to select the ten characteristics they associate with an engaged citizen. A literature search was then conducted to determine if evidence existed to support the characteristics identified by the committee. Based on the literature search, a key article from the nursing profession was identified and additional references were located based on this article. [5] Search terms used were as follows: pharmacist, pharmacy, legislative advocacy, political involvement. Each article was reviewed to determine if the literature endorsed the characteristics identified above. Five characteristics were endorsed by 3 or more articles: consensus builder/coalition building [6,7,8], community focused [9,10,11,12,13,14,15,16], strong communicator [17,18,19], engagement as a priority [20,21,22,23,24,25]. Two characteristics were not identified (passion, persistent); however, the committee felt that these were key traits of individuals involved in political advocacy. Two additional characteristics, education and understanding of political process [26,27], and family influence [28,29] were identified in the literature as key elements for engaged citizenship.
Identification of partners and development of partnerships to assist in advocacy efforts
When advocating for change it is important to both identify potential supporters and those who may be opposed to the change. As health care providers, we should not overlook the patients or populations we serve as potential allies. By tapping into existing health-related advocacy groups or alliances there is a tremendous opportunity for influence and support. Examples:
Diabetes Advocacy Alliance @DiabAdvAlliance (twitter): a coalition of 20 member organizations representing patient advocacy, professional societies, trade associations, nonprofit organizations and corporations that are committed to changing the way diabetes is viewed and treated in America. Their priorities are diabetes prevention programs, screening for type 2 diabetes, and diabetes treatment and care. Pharmacy members include NACDS and NCPA. http://www.diabetesadvocacyalliance.org/pdf/DAA_Fact_Sheet_April_2015.pdf
Million Hearts @MillionHeartsUS (twitter): a coalition of over 80 state, federal, local and private sector organizations committed to reducing by 1 million the number of heart attacks and strokes by 2017. Pharmacy members include National Alliance of State Pharmacy Organizations, APhA, NCPA, ACCP, NACDS, and Walgreens http://millionhearts.hhs.gov/
Kaiser Family Foundation @kaiserfamfound (twitter): Filling the need for trusted information on national health issues. A health policy analysis, journalism and polling non-profit organization with 62,000 followers. http://www.kff.org
The impact of social media is great and it has the potential of reaching a specific target audience. https://www.searchenginejournal.com/25-social-media-facts-end-2015/142206/ and https://about.twitter.com/company
• 320 million monthly active users
• 1 billion monthly visits to sites with embedded tweets
• 500 million tweets sent per day
• 88% of active users are on mobile devices
• Increasingly used for breaking news, events, commentary
• 1.39 billion monthly active users
• 136,000 photos are uploaded every minute
• 23% of users check their accounts at least 5 times per day
• 400 million users
• 100 million monthly active users
• 1.5 million groups
• 50% of users have bachelor or graduate degrees
• Only 20% of users are under age 30
YouTube
• 1 billion users
• 4 billion video views per day
• 40 minutes is average time spent per mobile session
Actions AACP can take to assist in the development of successful engaged citizens Recommended Actions:
Propose that the Academic Leadership Fellows Program take on the challenge of writing advocacy position papers on topics relevant to pharmacy practice, research or education. Team projects would recognize the importance of advocacy as an asset to effective leadership. Papers could be compiled as “ALFP Advocacy Positions Papers 2017” etc. These could then serve as training resources for schools and colleges of pharmacy.
CONCLUSION
The committee identified characteristics of an engaged citizen, based on reflection of their personal engagement and also reflected in individuals that the committee members identified as engaged citizens. The committee identified characteristics align well with those identified in the literature related to citizen engagement and political involvement, It is important that these characteristics be considered by the reader as indicative of his or her ability to be an engaged citizen.
Our nation was created based on the premise that individual awareness of and participation in community activities was essential to ensuring our nation would grow and flourish. No one is bereft of all the characteristics identified by the committee and supported by the literature. Neither should the reader think that the large number of nursing-related citations listed at the end of the report only reflect characteristics ascribed to nurses. From the literature review, it appears simply that the nursing profession is more likely to write about their engagement than other health professions.
At a time when the need for the pharmacist to be integrated into the healthcare team to improve the quality of care patients receive, an engaged profession and academy are essential to build the partnerships to make this integration a reality. Based on this report, you can’t ignore that it is important to be engaged and that you express one or more of the characteristics that make you a successful engaged citizen.
- © 2016 American Association of Colleges of Pharmacy
REFERENCES
In this issue
Jump to section
Similar AJPE Articles
Cited By...
- No citing articles found.