The Middle–Out Perspective — an approach to formalise 'normal practice' in public health advocacy

Background: The Middle–Out Perspective (MOP) provides a lens to examine how actors positioned between government (top) and individuals (bottom) act to promote broader societal changes from the middle–out (rather than the top–down or bottom–up). The MOP has been used in recent years in the fields of energy, climate change, and development studies. Public health practitioners involved with advocacy activities and creating alliances to amplify health promotion actions will be familiar with the general MOP concept if not the formal name. Methods: This paper introduces the MOP conceptual framework and customises it for a public health audience by positioning it among existing concepts and theories for actions within public health. Using two UK case studies (increasing signalised crossing times for pedestrians and the campaign for smoke–free legislation), we illustrate who middle actors are and what they can do to result in better public health outcomes. Results: These cases studies show that involving a wider range of middle actors, including those not traditionally involved in improving the public's health, can broaden the range and reach of organisations and individuals involving in advocating for public health measures. They also demonstrate that middle actors are not neutral. They can be recruited to improve public health outcomes, but they may also be exploited by commercial interests to block healthy policies or even promote a health-diminishing agenda. Conclusions: Using the MOP as a formal approach can help public health organisations and practitioners consider potential 'allies' from outside traditional health-related bodies or professions. Formal mapping can expand the range of who are considered potential middle actors for a particular public health issue. By applying the MOP, public health organisations and staff can enlist the additional leverage that is brought to bear by involving additional middle actors in improving the public's health.

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Building Advocacy Capacity and Skills Through a Statehouse Advocacy Day: Indiana SOPHE Experience

Health Promotion Practice ◽

10.1177/1524839918792239 ◽

2018 ◽

Vol 19 (6) ◽

pp. 803-806 ◽

Cited By ~ 3

Author(s):

Any’e Carson ◽

Heidi L. Hancher-Rauch ◽

Yordanos Gebru

Keyword(s):

Public Health ◽

Health Outcomes ◽

Real Life ◽

Sustainable Change ◽

Health Organizations ◽

Life Event ◽

Public Health Organizations ◽

Health Practitioners ◽

Public Health Practitioners ◽

Further Development

The purpose of this article is to provide public health organizations and practitioners a guide for organizing an advocacy summit to develop and practice advocacy skills. Further development of advocacy skills in current and prospective public health practitioners is vital in improving health outcomes among communities creating sustainable change. Though many approaches are available to help students and professionals acquire advocacy skills, an engaging real-life event such as the advocacy summit described within this commentary can be highly beneficial for both novice and seasoned advocates. The feedback obtained from summit participants showed that participants are interested in similar opportunities and believe that such events help further hone their advocacy skills. The essential steps to plan a successful advocacy summit are provided in the article, as well as a sample planning timeline, making it easier for public health advocates in other states to successfully plan similar events.

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Human Rights Treaty Bodies

10.1093/oso/9780190672676.003.0024 ◽

2018 ◽

Author(s):

Benjamin Mason Meier ◽

Virgínia Brás Gomes

Keyword(s):

Public Health ◽

Human Rights ◽

Global Health ◽

International Institutions ◽

Health Issues ◽

Health Practitioners ◽

Treaty Body ◽

Health Related ◽

Public Health Practitioners

This chapter assesses the role of human rights treaty bodies in monitoring, interpreting, and adjudicating health-related human rights obligations, facilitating accountability for the realization of human rights in health policy. With each core human rights treaty having its own corresponding human rights treaty body, these international institutions influence states and galvanize advocates to take action to realize human rights across a range of global health issues. Describing treaty body efforts to monitor state implementation, interpret human rights, and adjudicate individual complaints, this chapter examines the evolving composition and functions of these treaty bodies and analyzes their effectiveness in facilitating the implementation of human rights as a basis for global health. Given recent United Nations efforts to strengthen treaty body functions and streamline monitoring processes, treaty bodies provide complementary approaches for public health practitioners to support accountability for the implementation of health-related human rights.

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Health-Related Education for Sustainability: Public Health Workforce Needs and the Role of Higher Education

Australian Journal of Environmental Education ◽

10.1017/aee.2016.11 ◽

2016 ◽

Vol 32 (2) ◽

pp. 192-205 ◽

Cited By ~ 4

Author(s):

Rebecca Patrick ◽

Jonathan Kingsley ◽

Teresa Capetola

Keyword(s):

Public Health ◽

Workforce Development ◽

Environmental Sustainability ◽

Knowledge Exchange ◽

Education For Sustainability ◽

Public Health Workforce ◽

Health Practitioners ◽

Health Related ◽

Public Health Practitioners

AbstractPublic health practitioners have important roles to play in addressing environmental sustainability imperatives that have an impact on human health. Yet, to date, the extent to which practitioners are willing and able to address these issues is an understudied subject. This article draws on the findings of two qualitative studies involving 49 interviews with public health and/or sustainability practitioners and academics from Australia to highlight the capacity-building needs of the sector within the ‘health and sustainability’ space. The findings of this study raise several issues for workforce development and partnership building, contending that content on environmental sustainability should be integrated into all university courses. Underscoring gaps and opportunities, the article also reflects themes in the literature in relation to health-related education for sustainability; in particular, requirements for generic and transferable professional competencies and the role of universities in knowledge exchange and creation.

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Putting skills into practice: Readiness for change among public health practitioners

PsycEXTRA Dataset ◽

10.1037/e508992013-078 ◽

2005 ◽

Author(s):

Ann Casebeer ◽

Gail MacKean ◽

Carla Troy ◽

Jennifer Sealy

Keyword(s):

Public Health ◽

Readiness For Change ◽

Health Practitioners ◽

Practice Readiness ◽

Public Health Practitioners

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Postpartum depression guidelines for public health practitioners: Putting primary health care into action

PsycEXTRA Dataset ◽

10.1037/e508992013-191 ◽

2005 ◽

Author(s):

Peggy Strass

Keyword(s):

Public Health ◽

Health Care ◽

Primary Health Care ◽

Postpartum Depression ◽

Primary Health ◽

Health Practitioners ◽

Public Health Practitioners

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What makes a ‘successful’ collaborative research project between public health practitioners and academics? A mixed-methods review of funding applications submitted to a local intervention evaluation scheme

Health Research Policy and Systems ◽

10.1186/s12961-020-00671-0 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Peter van der Graaf ◽

Lindsay Blank ◽

Eleanor Holding ◽

Elizabeth Goyder

Keyword(s):

Public Health ◽

Health Research ◽

Collaborative Research ◽

Online Survey ◽

Public Health Practice ◽

Rapid Review ◽

Success Rates ◽

Evaluation Scheme ◽

Health Practitioners ◽

Public Health Practitioners

Abstract Background The national Public Health Practice Evaluation Scheme (PHPES) is a response-mode funded evaluation programme operated by the National Institute for Health Research School for Public Health Research (NIHR SPHR). The scheme enables public health professionals to work in partnership with SPHR researchers to conduct rigorous evaluations of their interventions. Our evaluation reviewed the learning from the first five years of PHPES (2013–2017) and how this was used to implement a revised scheme within the School. Methods We conducted a rapid review of applications and reports from 81 PHPES projects and sampled eight projects (including unfunded) to interview one researcher and one practitioner involved in each sampled project (n = 16) in order to identify factors that influence success of applications and effective delivery and dissemination of evaluations. Findings from the review and interviews were tested in an online survey with practitioners (applicants), researchers (principal investigators [PIs]) and PHPES panel members (n = 19) to explore the relative importance of these factors. Findings from the survey were synthesised and discussed for implications at a national workshop with wider stakeholders, including public members (n = 20). Results Strengths: PHPES provides much needed resources for evaluation which often are not available locally, and produces useful evidence to understand where a programme is not delivering, which can be used to formatively develop interventions. Weaknesses: Objectives of PHPES were too narrowly focused on (cost-)effectiveness of interventions, while practitioners also valued implementation studies and process evaluations. Opportunities: PHPES provided opportunities for novel/promising but less developed ideas. More funded time to develop a protocol and ensure feasibility of the intervention prior to application could increase intervention delivery success rates. Threats: There can be tensions between researchers and practitioners, for example, on the need to show the 'success’ of the intervention, on the use of existing research evidence, and the importance of generalisability of findings and of generating peer-reviewed publications. Conclusions The success of collaborative research projects between public health practitioners (PHP) and researchers can be improved by funders being mindful of tensions related to (1) the scope of collaborations, (2) local versus national impact, and (3) increasing inequalities in access to funding. Our study and comparisons with related funding schemes demonstrate how these tensions can be successfully resolved.

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After Action Review of the 2019 measles outbreak in Clark County, Washington, U.S.A

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.598 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Stoto ◽

R Piltch-Loeb ◽

R Wolfe ◽

R Albrandt ◽

A Melnick

Keyword(s):

Public Health ◽

Religious Community ◽

Local Health ◽

Mutual Aid ◽

Social Distancing ◽

Clark County ◽

After Action Review ◽

Measles Outbreak ◽

Health Practitioners ◽

Public Health Practitioners

Abstract Issue Clark County experienced a measles outbreak that challenged public health authorities. Description of the practice: We conducted a formal After Action Review with state and local health officials, school officials, and others to identify lessons for public health practitioners facing future outbreaks. Results Following the early identification of measles in a child who had recently arrived from Ukraine, active surveillance identified 71 confirmed cases, most in unvaccinated persons under 18 years of age. 4,138 contacts were traced and public health personnel made daily monitoring calls to 816. 53 potential exposure sites in healthcare facilities, schools and other public places were identified and communicated to the public. As a social distancing measure, unvaccinated students, teachers, and staff were excluded from schools in which exposure had occurred. Ascertaining susceptibility status was challenging. The national anti-vaccination sentiment and a parallel outbreak in a New York religious community created challenges in representing community risk while avoiding stigmatization of a community in which the first reported case was identified. Rather than respond to every false claim on social media, the health department developed talking points about emerging issues and engaged the community in dialogue. Lessons Responding to the measles outbreak required innovative approaches to surveillance and contact tracing, social distancing (school exclusions), and emergency risk communication. The response required extensive coordinated efforts of the county and state health departments, school systems, and many other organizations. Mutual aid enabled an influx of resources but managing the surge of responders proved challenging. Key messages Public health emergencies require effective emergency management practices. Carefully conducted After Action Reviews of health emergencies can help public health practitioners identify challenges and innovative practices.

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