All Advocates Don’t Advocate the Same: Identifying Differences Policy Advocacy Engagement Among Frontline Health Professionals In Acute-Care Hospitals

Background and Purpose: Despite an increased interest in understanding how policy advocacy can be optimized to address systemic issues and promote equity within the healthcare system, the extent to which frontline health professionals engage in policy advocacy remains understudied. This study examined differences between frontline health professionals’ engagement in policy advocacy to address unresolved problems in seven core domains: (1) ethical rights, (2) quality of care, (3) culturally competent care, (4) preventive care, (5) affordable care, (6) mental health care, and (7) community-based care.

Methods: Secondary data was used from a cross-sectional study consisting of a convenience sample of 295 frontline health professionals including 94 social workers, 97 nurses, and 104 medical residents recruited from eight acute-care hospitals in Los Angeles, California. A series of one-way ANOVAs were conducted to examine differences in the extent to which respondents engaged in policy advocacy relative to the seven core problem domains, as measured by the Policy Advocacy Engagement Scale (Policy-AES scale).

Results: A statistically significant difference was detected in the extent to which the respondents engaged in policy advocacy in the core problem domain of preventive care (F = 7.963, p < .001). Post-hoc test results revealed a significant difference between medical residents and social workers (p < .001), with medical residents reporting significantly higher levels of policy advocacy engagement. There were no differences detected between medical residents and nurses, as well as between nurses and social workers. A statistically significant difference was detected in the extent to which the respondents engaged in policy advocacy in the core problem domain of mental health care (F = 8.558, p < .001). Post-hoc test results revealed a significant difference between social workers and medical residents (p = .001) and between social workers and nurses (p < .001), with social workers reporting significantly higher levels of policy advocacy engagement than both groups. There were no differences detected between medical residents and nurses. No differences were detected in the extent to which respondents engaged in overall policy advocacy, as measured by the Policy-AES scale (F= .131, p = .877).

Conclusions: Frontline health professionals are expected to engage in policy advocacy as part of their core job responsibilities. Despite employed in similar work settings, findings demonstrate variation in policy advocacy engagement between frontline health professionals. Managers have a critical role in identifying where differences exist and developing organizational strategies that encourage and enhance policy advocacy engagement (e.g., supervision, training).