A rapid evidence review of health advocacy for communicable diseases.

Abstract

Advocacy has been identified as a key strategy for health promotion and public health and a powerful tool to promote equity. In the context of public health, advocacy strives to optimise health by addressing the environmental, social, political and economic factors that impact on health and seeks to influence the policies and practices that create the conditions for change [1]. This report is a rapid review of the evidence on public health advocacy for communicable diseases.

Objectives

This evidence review seeks to examine and encapsulate international evidence on public health advocacy initiatives, to identify gaps in the evidence, and to provide recommendations.

Findings

No evidence reviews of public health advocacy initiatives for communicable diseases were found in the literature. However, this review did identify a range of sources of evaluated health advocacy interventions, models and toolkits, and examples of best practice in the wider health advocacy arena that could be used to inform the development of effective strategies and resources for communicable disease.

A North American review identified the characteristics of public health advocacy campaigns that were effective in changing industry practices that damage health [2]. The reviewers identified that most campaigns employed multiple strategies and that at least half the campaigns used the three strategies of coalition building, media advocacy and public mobilisation. The importance of the social context to the success of a campaign was underscored in this review.

Toolkits have been developed by advocacy organisations to provide high quality resources for use by experienced and novice health advocates. These resources include templates for letters and publicity, advice on engaging the media and relevant stakeholders, and key messages about the issue of concern. An examination of a number of these toolkits identified a level of overlap that suggests a common base of core components and principles for effective advocacy across different topics.

The methodological challenges of evaluating advocacy initiatives provide a forceful argument for adopting a more considered and systematic approach to evaluation. Recent developments have strengthened the knowledge base for such evaluations, and the recommended utilisation of a theory of change benefits the development of an advocacy initiative by making explicit the intended relationship between actions and outcomes.

Conclusions

Health advocacy for communicable diseases is clearly still at a nascent stage and the current evidence base is very underdeveloped. The duration and complexity of public health advocacy campaigns and initiatives makes the need for theory-based evidence imperative. The shared consensus in the literature about core components of health advocacy initiatives and the existence of templates and toolkits in the area means that foundations do exist upon which to advance advocacy for the prevention of communicable diseases.