To orient learners to the topic, trainer poses questions to the group:  

What are the ways that you, as a health care provider, have advocated on behalf of young people? Describe the issues and who you were trying to influence? What ways did you go about doing this?  What kinds of success have you had in advocating on behalf of young people?

Trainer summarizes the brainstorming, pointing out that there are numerous ways to advocate and that the goal of the training is to improve health providers’ skills and motivation to be involved in advocacy.

The intent of this activity is to demonstrate to the learners that they can and, perhaps already have, been involved in advocacy. In addition, they will see that other health professionals are doing it as well. It is the prelude for broadly defining advocacy, which is the next objective.

Website 1

Refs 1-7

Ask participants what they understand “advocacy” to be.  Verbally summarize the learners’ ideas and display the following definitions for comparison:

Advocacy :

•actively supporting a cause and trying to get others to support it as well

•building support for the health of young people, around a particular problem,  practice, programme, priority, or policy

Class discussion

Discussion setup:

Think of a person (health professional or anyone else) that you would describe as an effective advocate (for any issue or population).  What are the skills and qualities that you think make that person effective?

A class member writes down the skills and qualities that are named in response to the question above. The trainer summarizes and elaborates on these skills and qualities.   The skills and qualities list should remain posted throughout the rest of the training module as a reference.    

KNOWLEDGE

D. Describe advocacy at three levels – individual, community, and national – for enhancing:

•social awareness creation (at individual and family levels)

•social mobilization

•community participation (community self-help groups/local interest groups)

•community ownership

•evidence-based advocacy and policy dialogue

•policy modification / enactment

Exercise: “Tobacco use among young people is dramatically increasing in your area.”

Participants form working groups no larger than 6 learners, with each group representing one of the three levels of advocacy – individual, community, national.  Each group formulates 1-2 strategies for reducing or preventing tobacco use for their assigned level (individual, community or national) and then discusses the how their strategy is appropriate at that level (as listed in Objective D).  

After the group work is finished, convene the class and have each group present 1-2 ways they would advocate to reduce/prevent teenage tobacco use at the assigned level.  In class discussion, identify differences in the approaches to advocacy on each of the three levels.

Example for the group assigned to consider level advocacy on the national level

Possible strategy: increase the tobacco tax and expand enforcement of ban on sales to minor through policy modification/enactment.

Advocacy approach: use evidence-based information to mobilize support among policy-makers, as well as community or national constituents and interest groups who could help persuade policy-makers.

Present Annex 1 showing the relationship, for the different levels of advocacy, between the amounts of effort invested and the impact of the advocacy.

A. Learn the steps in formulating an advocacy message

•gather information

•conduct needs assessment/search for available evidence/conduct key stakeholders analysis

•define the arguments “for” and prepare to respond to arguments against

•ensure social & cultural sensitivity of your arguments

Small group exercise

Using Visualization in participatory programming (VIPP)

Exercise Scenario: Due to budget restrictions, the Ministry of Education wants to cut sex education from the school curriculum. This change has the support of local religious groups, as they believe that sex education encourages sexual activity.  Until now the school had been using an evidence based approach that had strong support from health educators, students, and many parents.

Questions for small groups to address: a. What information would you gather to make your argument for keeping the program and where would you go for it? b. Is there evidence supporting this position? c. How would you identify existing needs assessment or conduct one? d. What may be the particular interests/sensitivities around these issues within your community?

Each group prepares three VIPP cards for each of the following headings related to the questions above:

a.Information that is needed (yellow VIPP card)

b.Sources of information (green VIPP card)

c.Existing or new needs assessments (blue VIPP card)

d.Potential sensitivities, interests within the community  (pink VIPP card)

VIPP cards are put on wall/board under each of the four headings.  General class discussion follows once the cards are clustered on wall.

(Trainer can prepare the four headings on VIPP cards during small group discussion.)

Refs 9:sessions 5, 12





Websites 2, 3

Website 4: Parts III + IV on using VIPP

B. Tailor the message to key audiences/stakeholders.

•identify target audience(s)

•determine the interests and sensitivities of the target audiences

•use clear, objective and persuasive language that consider the interests and sensitivities of the target audiences

Small group exercise

Using the same Exercise Scenario and the same groups as in Objective A, each group writes a single advocacy message tailored to one of the audiences listed below to which they have been assigned.  

Trainer reminds groups during the exercise to link the message to something that their target audience can relate to, something that is already important to them, something that keeps in mind any particular interests and sensitivities they may have. Examples of targeted messages include:  

•School-aged Students: “It helps to answer our questions that we can’t ask anywhere else.”

•Minister of Education: “You want to invest in strategies that have been shown to be effective.”

•Parents: “The vast majority of parents support sex education in the schools; it does not replace the role of parents.”

•School Administrators and Teachers. “Teaching sex education in the schools has been shown to be effective in preventing pregnancy, which is a leading cause of dropping out of school.”

•Religious Leaders. “Teaching sex education does not increase sexual activity among teenagers; in fact, it can encourage them to delay sexual activity.”

After each group has identified their single advocacy message, the trainer asks each group to state their key message, and asks one person from each group to write the message on the board/flip chart/VIPP card along with the type of audience they were assigned. (e.g. School-age Students = “It helps to answer our questions . . .”) In summary, the trainer points out the differences in the message depending on the audience, which is the objective of this session.

C. Describe how to gather and build support

•identify and mobilize opinion leaders

•involve young people

•create coalitions

•mobilize the power of established organizations ( to make mail outs, statements, petitions)

•outreach to general public

(mass communication strategies)

Ref 9:session 4, 14

Website 1

D. Strengthen working relationships with the targeted decision-makers

•assess the perspectives of the decision-makers

•develop strategies for face-to-face contact

•employ ways of enhancing relationships (honors, awards) with targeted decision makers

•arrange for a visit by key decision-makers to your school or clinic

Using the Goal II Exercise Scenario regarding sex education in the school curriculum, pose the questions below:

What are the ways of determining the perspectives of the decision-makers on this issue?  (e.g. voting record, public statements, public documents, direct inquiries to the decision-maker and/or their staff)

What do you do to prepare for effective face-to-face contact?  

•prepare clear focused message and /or one-page fact sheet,

•have materials to leave with them,

•offer yourself as a future resource,

•describe the organization/constituents that you represent,

•prepare arguments to make to address opposing opinions,

•consider bringing credible allies with you (member of the religious community, respected educator or practitioner, a young person, a parent from the community/constituency).

When might it be appropriate to arrange to have one or more key decision-makers visit your work setting to learn more about effective prevention and the health needs of young people? Has anyone in the class tried this approach for strengthening relationships with targeted decision makers?

A.  Identify various ways to use the media to communicate your advocacy message

•Letters to newspaper editors

•Opinion-editorials

•Press kits and news releases

•Press conferences

•TV and radio interviews and programmes

Mini lecture

Class discussion

Mini lecture describing the various types of media interactions that an advocate can use (listed under Objective A.)    

Exercise Scenario: The Health authority in your city wants to open a “Do-it-safe room”, a place where drug addicts can exchange needles, take methadone, and be counseled. They know that this initiative will have some opposition, especially among the neighbors. They ask you to plan an education effort specifically targeted to the public.

Trainer asks learners:  Which of the various media formats would be most useful for educating the public on this issue? How do you address their interest in having a story that sells with your priority issue?

B. Understand the steps in preparing for a media interview

•Develop key message tailored to the audience and media format

•Prepare 3 positive, evidence-based points that support the message

•Use anecdotes and descriptive language

•Practice with colleagues

•Identify possible questions and practice responses in advance

•Understand the possible pitfalls in interactions with the media.

Small group exercise

Role play and facilitated discussion

Mini lecture

Exercise Scenario: You are asked by a TV producer to participate as an expert in a talk show dealing with the use of emergency contraceptive among adolescents. The groups that are opposing your position are a local pro-life association and a religious organization.  Parents have differing views on the issue but the local Contraception Society supports your position.

Trainer asks learners to return to their same small groups.  Each group prepares a main message that the advocate would want to communicate during the TV interview.  Then, each group identifies three points that support the main message.  

Role-play the TV interview with the trainer serving as the reporter asking questions. Two to three learners can role play the part of advocate, working together during the interview to make sure they have made all 3 of their positive points.  

Trainer should remind learners before the practice interviews that they should not let the interview end until they have delivered their main message and three positive points.  At the conclusion of each practice session, ask the class what they think the 3 positive points were that the advocate(s) were trying to make during the interview.

The trainer explains that the best way to address the possibility that the reporter will lead the advocate in an undesired direction is to prepare to make the 3 positive points and to prepare responses to likely questions.  Because the advocate rarely can review and/or edit a written story, the best way to assure that the reporter accurately reflects your ideas is to never say what you do not want them to report (there is no such thing as “off the record” comments), to make your main points succinctly and clearly, and if possible, to tape record the interview with the reporter.  This alerts the reporter that you have a record of what you said.  

Trainer concludes the module by summarizing the primary goals and emphasizing the value of the media as a way of getting the advocate’s message out to many audiences. It is a great opportunity.