Health Advocacy Skills
- Describe what it means for a CHW to be an advocate for their patients.
- Identify settings where CHWs advocate for individual patient needs.
- Explain how CHWs promote self-advocacy in patients, and why self-advocacy matters.
- Define the three main types of systems-level advocacy and provide examples of each.
- Summarize the CHW's role in community advocacy — what they should and should NOT do.
Advocacy is core CHW work
The US healthcare system isn't equal for everyone. Some groups get sicker than others because of it. CHWs are recognized at the state and national level as a way to help address this — by supporting the people most affected by sickness and pushing for a healthcare system that's fair for everyone.
Advocacy means speaking up for someone and helping them get what they need. It's an important part of CHW work — both for individual patients' needs and for the populations you work with at a systems level.
Health care advocacy: the individual level
Who CHWs talk to when advocating
Advocacy means speaking up for someone and helping them get what they need. CHWs may advocate by talking to:
- Doctors and other medical providers
- Home health care companies
- Property managers
- And others who can help patients get what they need
Common situations where CHWs advocate
On occasion, individuals may need you to advocate for them in other ways such as, investigating and troubleshooting barriers in confusing or frustrating systems.
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Rights violations to recognize
Advocating for someone can also mean recognizing rights violations and connecting people with the right services:
- Abuse of a child, older adult, or person with a disability
- Custody issues
- Domestic violence
- Harassment
- Discrimination
Promoting self-advocacy
If you always advocate FOR your patients, they might rely too much on others to speak up for them. Instead, help them build the confidence and skills to advocate for themselves.
Make a phone call together — let the patient do most of the talking; you're there to help if needed. If you end up taking over the conversation, debrief afterward: How did they feel? Would they do it differently next time? If they make the contact on their own, check in afterward.
The key: find the right balance between supporting independence and helping when necessary. Patients who are involved and take an active role in their care tend to have better outcomes. Teaching your patients to advocate for themselves is an invaluable skill that will benefit them in all aspects of their lives.
The CHW's role in legal advocacy
You're not a legal expert and cannot give legal advice. But you should recognize signs of danger and know who to contact.
When rights are violated
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A patient asks you to make a benefits phone call for them, even though they're capable of doing it with a little support. What's the best way to promote self-advocacy?
Beyond the individual — three approaches
CHWs aren't just one-patient-at-a-time advocates. They're leaders who can shape laws, policies, and rules that affect the community. Systems-level advocacy means working to change laws, policies, or rules that affect the community. Three approaches make it work:
- Research
- Policy advocacy and lobbying
- Community organizing and outreach
Approach #1: Research
Research is the most important thing you can do for systems-level advocacy. It means understanding the problem and showing others why a policy change is needed.
Research activities include:
- Finding out what assets your community has and what it needs
- Studying how similar policies have worked in other places
- Explaining why the policy or change is necessary
- Making sure diverse community members take part in the research
Approach #2: Policy advocacy and lobbying
Aims to influence public policy at the local, state, or federal level. Here's what you can advocate for:
Setting aside more money for health research and deciding where it should go.
Types of policy advocacy activities
Approach #3: Community organizing and outreach
Bringing people together and building coalitions to create the changes you want to see.
Community organizing strategies
Create Media Campaigns
Use social and traditional media to spread awareness, get people involved, and shift minds.
The CHW's role: rules for systems-level work
CHWs have special qualities — belief in fairness, ability to build trust, and a desire to help individuals and communities make their own decisions. But there are rules to follow.
Rules for systems-level advocacy
DON'T...
- Assume you know what problems affect the community most. Listen.
- Be the only leader. Help others become leaders.
- Decide who participates. Invite everyone affected.
- Prioritize tasks or make key decisions. The community decides.
- Do all the work. Build others' skills so they can take charge.
INSTEAD, DO...
- Listen. Create opportunities for people to meet and ask open-ended questions.
- Learn the community's history — past organizing, attempts, and accomplishments.
- Recruit and honor diverse participation.
- Provide training in facilitation, planning, community diagnosis, and media advocacy.
- Mentor participants and leaders — help them build skills and confidence.
- Facilitate critical thinking — pose open-ended questions and run meetings.
- Help build on community strengths via a community diagnosis.
- Support strategy by facilitating a power analysis and winning support for proposals.
- Help with implementation — activities, funding, outreach, training, and resources.
Categorize each example by its type of systems-level advocacy.
🌟 Lesson takeaways
CHW advocacy works on two levels. On the individual level, CHWs help patients speak up, navigate confusing systems (insurance, disability, charity care), and connect to legal services when their rights are violated — while encouraging self-advocacy and finding the right balance between independence and support. On the systems level, CHWs leverage research, policy advocacy/lobbying, and community organizing/outreach to shift the rules that shape health outcomes. The best CHW advocates don't just do — they teach. The best community organizers don't lead — they facilitate. The end goal is communities that can advocate for themselves.
At the end of this module, you'll join a live discussion with your cohort and an instructor. Great work — we'll see you there.