Policy, Politics and Global Health
Think of a more suitable policy proposal idea. Use all the same subheadings throughout your paper as the ones that are provided within the grading rubric. Also – just as a quick FYI, the average length of this paper is between 25 and 30 pages. In this paper, students are required to: “Develop and thoroughly analyze a public policy in order to advocate for one (propose one) that improves the health of the public and/or the nursing profession globally (local, state, national, or international). To do this, you will reflect on several aspects of being a policy maker within the nursing position.” Topic should not be at the level of a single unit or single facility. Can be at the level of a large multi-facility healthcare system, but students often struggle with policies at this level. Think County, State, Federal, entire School District, Board of Nursing regulation, Joint Commission standard, etc. Paper is a plan for a Policy Proposal (not a procedure, standards, or guideline for implementation) This area below called “Explaining the Rubric” provides detailed tips for each section of the rubric. This can serve as a guide to organizing and writing your paper, and also is a terrific checklist when you do a final review before submitting the assessment. First come up with a one sentence policy statement about what ‘law’ or policy you want to pass, THEN, find your 2 peer-reviewed/academic/scholarly journal articles with 1 RN as author, published within the last 5 years, that supports your policy idea or that you can connect to your policy idea. Then think about your decision maker for part B. For a state policy you would NOT use a senator. You want a state representative. Then find someone who you can prove would be interested in your policy … maybe they are a nurse or have been on a health committee. If it is a national policy, the senator would be the best choice. Then think about who your collaborating organization will be for part C. You will need to cite references to support that this singular organization should be interested in your policy [C1a and C2b].[unique_solution] The references could include the organization′s website that shows their mission statement that supports your idea. Additional citations include conference agenda’s that address your policy, articles the group published on your topic, etc. C159 Rubric Tips – Explaining each section of the Policy Proposal Paper Part A In this section you’ll explain your rationale for the problem and your policy idea. A1- Public Policy Issue This section serves as a brief introduction to your paper. Describe the problem you are trying to solve. Then clearly state your policy idea in a single sentence (or two at the most). A1a – Issue Selection Briefly describe why you selected this issue. Why is it a problem for your community, your state, or the nation? A1b – Issue Relevance Here you will write about why this issue is important to the public. Why should this issue be addressed as a public policy? Be sure to use at least two citations from academically appropriate literature. “Academically appropriate literature” includes articles from peer-reviewed professional journals, published within the last 5 years. The literature can support Why your issue is a problem, or you can use articles that support the actual policy idea. A1c – Financial Impact Discuss the financial impact of your policy on the healthcare system. In general terms you may discuss what types of things would cost money (and time and effort) and then discuss the positive impact the policy would have on health. For example, if your policy idea is to improve staffing, you can discuss how it would cost money to hire more nurses; however, the positive financial impact, over time, would be: reduced turnover, improved job satisfaction, and better patient outcomes. As a result, money will be saved and reimbursements will increase. A2 – Personal Values Discuss how your own personal/professional values relate to this policy idea. You may write in 1st person language in this section and in other sections that ask you for your personal perspective. A2a – Ethical Principle Discuss an ethical principle or theory relative to your policy topic. You can find a list of Nursing Ethical Principles and Theories in the “Ethical Theories Applied to Nurses’ Policy Positions” unit of the Course of Study (COS). In this section, there is a link to a handout from the ANA, which identifies and defines nursing Ethical Principles. We suggest you pick one from this list and describe how that nursing ethical principle could apply to your proposed policy. The ANA Ethical Theories and Principles document can also be found here: http://nursingworld.org/MainMenuCategories/EthicsStandards/Resources/Ethics-Definitions.pdf Part B: The Top-Down Approach In this section, you’ll discuss your plan for going directly to a Decision Maker and asking them to set a mandate for policy change. B1 – Decision Maker Identify the decision maker for the proposed policy. You must write a real name and actual title of the person. The cohort video explains how to determine who your decision maker should be. B1a – Explanation In about a paragraph, briefly summarize why this policy is important (summarize the main points from Part A of your paper). Then, in a sentence or two, explain why you selected your Decision Maker. Be sure to use at least two peer-reviewed journal articles that have a nurse as an author that were published within the last five years to support why this policy idea is important. These include articles published in nursing journals, or articles published in other professional journals as long as at least one author is a nurse. Its fine to use references that you used in earlier sections, but you must include at least 2 citations to nursing articles in this section! B2 – Challenges Discuss some of the challenges you think the decision maker may face in trying to get the bill passed into law (or made into a “mandated” policy). These are often objections raised by lobbyists, groups, and members of the public who are opposed to the policy. B3 – Options What choices/options does the Decision Maker have when they hear your proposal? I usually recommend that students try to identify 3 options. The first option is to do nothing. The decision maker has the option of reading your policy proposal and deciding to leave things as they are (the status quo). Why would the option be a good one? Or not? A second option for the decision maker is to set a different policy. In this case, it might be that the decision maker decides to require some alternative, or part-way, measure. Why would the option be a good one? Or not? A third option might be to support and pass your policy proposal. Why would the option be a good one? Or not? Be sure to provide a brief assessment of each option. B4 – Course of Action In a few paragraphs, discuss the challenges you talked about in B2 and talk about what the decision maker could do (with their authority/influence and within their scope of practice) to address each of these challenges. For example, if one of the challenges is that the general public and other lawmakers may not understand the health risks and importance of vaccines, you might recommend that your Decision Maker invite the State Epidemiologist to the public hearing to present information about risks of disease and benefit of immunizations. Remember to address each challenge, i.e.: For the challenge of_____________, the decision maker could________________. For the challenge of_____________, the decision maker could________________. For the challenge of_____________, the decision maker could________________. B5 – Success of the Policy Brief We recommend that you identify successes in both the process and long-term outcome of your policy change. Process successes (small step-wise successes) for the Top-down approach happen at each stage of the policy process. For example, if you are trying to get a law passed, your first success is when a legislator agrees to sponsor a bill, the next success is when the bill passes committee hearings, etc. Long Term success describes what happens after your policy is implemented. After your policy passes, what would be different? For example, if we were changing childhood immunization requirements, a long-term success would be that: One year after the new immunization law is passed, the incidence of vaccine-preventable illnesses decreases by 20%. Section C: Bottom Up Approach In this part of the paper, you’ll describe your plan for working with a relevant stakeholder group (community group) to educate others about your issue, to advocate for your policy change, and to gain support for the change. C1 – Collaborating Organization Identify the organization you would choose to be your partnering organization. C1a – Summary of Expressed Interest Describe how you know this organization would be interested in working with you to build a coalition for the bottom up approach. Do they have information on their website or even on their Facebook group page (if they have one – or even some other manner in which they use social media? Printed materials? Have they discussed this issue at conferences? Be sure to cite your source, such as the organization’s website address, monthly newsletter, or personal communications at a meeting. C2 – CBPR Principles CBPR principles are evidence-based principles for group process. Research on community groups has shown that groups which use at least some of these principles (strategies) for working together are most successful in achieving the group′s goals and purpose. Identify three CBPR principles you could use as you work with your group to advocate for the policy idea. You can find a list of 9 CBPR Principles in your Course of Study: Open the Policy Process unit from the left-hand menu bar, when this section opens, scroll down to the “Apply: Bottom-up Approach” section. There you’ll find a link to Promoting Healthy Public Policy through Community-Based Participatory Research: Ten Case Studies. Pages 7 – 15 provide an overview and introduction to Community Based Participatory Research (CBPR). A list of the 9 CBPR principles can be found at the bottom of page 13. From this list of 9 Principles, you’ll select 3 principles you could use in your work with your selected group. C2a – Approach and Collaboration Describe how you would approach the organization you have chosen as your collaborating partner organization. Who would you contact? How would you ask for their support? How will you recruit volunteers from that group to work with you on the policy change? How often do you anticipate meeting with group members? C2b – Goal Alignment Discuss how you know that your partner organization has goals that are similar to the goal of your policy. Have they done work with this before? Is there something in their mission statement that demonstrates goal alignment? Etc. Be sure to cite a source for how you know this information. C2c – Action steps List 3-5 important action steps that you and your partners will take to educate others about the issue, to advocate for your policy, and to gain support from stakeholders. Would you have a town hall meeting? Would you have a sub-committee of your group do some research on the subject? Would you arrange for meetings with other organizations or individuals who may be interested in supporting your idea? Sample ideas for your group to work (ACTION STEPS C2C) on for the bottom up – Section C…. 1. Town Hall meetings across the state of_____________ Then later under C2F, you could measure success by taking attendance/count signatures on a petition. 2. A Social Media Campaign (Facebook/Twitter) Then later under C2F, you could measure success by the number of ‘likes’, ‘shares’, and ‘followers’, ‘retweets’ etc. 3. Public Service Ads Then later under C2F, you could measure success by the number of rotations/times the ad plays on TV/radio and how many people are impacted by your public service ad. SAMPLE PUBLIC SERVICE ANNOUNCEMENT https://www.youtube.com/watch?v=Db6vGo7QJ9M https://www.youtube.com/watch?time_continue=2&v=EyVLKHEqTu0 A three-month ad campaign called ″Tips From Former Smokers″ that ran last year caused about 100,000 people to permanently quit smoking, according to estimates by a Centers for Disease Control and Prevention report released Monday. https://www.huffpost.com/entry/tips-from-former-smokers-cdc_n_3901167 C2d – Roles and Responsibilities We recommend identifying 3 – 5 important roles for your group members. It helps to think about what you need the community group to do – then you can identify specific individuals (BY ACTUAL NAME AND TITLE) to take on those functions. For example, someone will need to serve as the facilitator of your meetings; you might be the best person to do take on this role since the initial idea is yours. If you have planned a town hall meeting you may want to include a subject matter expert from your partner organization to lead the public session. The important part is to identify what your group needs people to do in order to accomplish your Action Steps, and then identify group members (by position or area of expertise) who have the knowledge, skills, or experience to take on those roles. Special note with respect to Roles & Responsibilities in terms of addressing “problem solving and capacity building”… This is probably one of the harder sections of the paper for students. In this area, you need to describe how your community organization team members (that they assigned….by full name as well as title) can demonstrate problem solving and capacity building skills. Capacity-building roles help the community become independent from the organization in the long run. It is how the organization will help the community that is being impacted by the issue and proposed policy to become self-functioning or develop the ability to generate strategies to meet and maintain their goals by working with the strengths of the community and/or community members; how the organization will help the community to overcome obstacles that inhibit them from meeting their goals. Definitely use the exact words of capacity-building and problem-solving [properly] in this section of the task. In C2d in regards to problem-solving and capacity-building: Review the following desсrіption of capacity-building, as it applies to nonprofits in this case. https://www.councilofnonprofits.org/tools-resources/what-capacity-building What this means is that there needs to be a ″two-way conversation″ between the person in each ″role″ and whomever they are speaking to. For example: Let′s say the president of the organization you are working with leads a Town Hall Meeting. Not only would she ″talk″ to those people, but she would ask for their input, and ask what problems they think may occur, and what resources they have available, and what strengths they could bring to the coalition you are trying to build, and if they would be a part of that ″working group.″ This shows collaboration and involvement and the beginnings of problem-solving and then the capacity-building (building the group). In this section we want to see the ‘back and forth’ interaction between group members as they grow together as a team, performing tasks and moving the policy forward. If someone is making a brochure, they would get ideas from the team, bring the finished product before the group, get input, that sort of thing. The document below, has some additional examples of capacity-building. Israel, B. A., Coombe, C. M., Cheezum, R. R., Schulz, A. J., McGranaghan, R. J., Lichtenstein, R., … & Burris, A. (2010). Community-based participatory research: a capacity-building approach for policy advocacy aimed at eliminating health disparities. American journal of public health, 100(11), 2094-2102. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951933/pdf/2094.pdf Another example: It is not unusual for large institutions (such as hospitals or businesses or even universities) to note that there is some kind of problem in their community that needs to be addressed. A representative from one of these large organizations will then reach out to local community groups and start to work with them in order to address the problem….but generally speaking the larger entity (the hospital/business/university) does not want to have to be involved in this problem/issue FOREVER so they make sure that the members of community group that they are working with are able to problem solve and network with others on their own (this could be in the form of building alliances, strengthening relationships with key individuals etc.). In this way, the person from the larger entity can then step away because the community group members are now self-sustaining in terms of working on this problem. In that way, the hospital or business or university (or whatever) can step away from this and go on to identify a new issue and begin to work on that…So in a nutshell, you need to demonstrate how you could “pass the baton” so to speak to the people you are working with (in the community group) because those team members can now problem solve and engage in capacity building (through networking and building relationships etc.). For the purposes of this paper, you should give specific examples of this. Take a look at this article (see below) on capacity building that gives some examples of this in action. Don’t forget to cite and reference the article if you use it in your paper. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3557849/ In keeping with our earlier example from above…. Roles/Responsibilities – C2D 1. Assign that to someone from your group that has done some public speaking in the past on your topic. 2. Assign the social media campaign to their current webmaster or similar 3. Assign public service ad stuff to their media relations person . C2e – Key Elements Discuss how you would use each of the three CBPR principles as you work with your community group. Provide an example of how your group might use this principle in your work. Then discuss how using the principle will help your group meet its goal. Be sure to provide a logical discussion with substantial detail of the key elements for developing a collaborative evaluation plan, using the CBPR principles. This might look like: The first CBPR principle we selected to use is _______. Our group will use this principle by doing _____________. Using this principle will help us achieve our goals by __________________. The second CBPR principle we selected to use is _______. Our group will use this principle by doing _____________. Using this principle will help us achieve our goals by __________________. The third CBPR principle we selected to use is _______. Our group will use this principle by doing _____________. Using this principle will help us achieve our goals by __________________. C2f – Evaluation Discuss how you will evaluate each of the action steps. For example, if you hold a town hall meeting, you might count how many people came to the meeting and how many agreed to support your policy idea. A long-term success would be evidence of actual change that you expect to see if the policy is adopted. This might be: a decrease in the number of vaccine preventable illnesses, or a decrease in nursing turnover, or a decrease in re-hospitalizations, etc. You just need to identify one indicator for long term success. Section D: Evaluating the Effectiveness of the two Approaches In this section, you’ll discuss the pros and cons of the Top-down approach and of the Bottom-up approach. D1 – Strengths of Each Approach Describe at least 1 or 2 strengths of the Top-down approach (the approach you developed in Part B) and 1 – 2 strengths of the Bottom-up approach (the approach you discussed in Part C). D2 – Challenges of Each Approach Describe at least 1 or 2 challenges (weaknesses/negatives) of the Top-down approach, and 1 or 2 challenges of the Bottom-up approach. D3 – Most Effective Approach Discuss which approach you would recommend, based on your analysis of each approach. Be sure to pick only ONE approach (either Top-down or Bottom-up) to recommend and provide your rationale for why you would recommend it. Professional Communications is a required aspect to pass this task. Completion of a spell check and grammar check prior to submitting your final work is strongly recommended. You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course. Note: Your submission may take the form of an essay, multimedia presentation, etc. Be sure to cover each prompt in sufficient detail and support no matter what form you use. A. Prepare your reflection essay (suggested length of no more than of 3 pages) of the values and ethics of a public policy issue by doing the following: 1. Analyze a health or nursing profession public policy issue that impacts a group of people and requires a policy change. a. Discuss why you selected this public policy issue. Note: If you select a local policy, be sure your discussion reflects how the policy will affect more than a single unit, department, or organization. b. Discuss the relevance of the public policy issue to the health or the nursing profession, using two pieces of academically appropriate literature from the last five years. c. Describe the financial impact of the public policy on an organization or on a community. 2. Analyze how your values impact your position on the public policy issue. a. Discuss the ethical principle (e.g., autonomy, beneficence, non-maleficence, justice) or theory that underpins your perspective. B. Develop a policy brief (suggested length of no more than 6 pages) for the public policy issue discussed in part A in which you do the following: 1. Identify the decision maker (name and title) who will receive the policy brief. a. Explain why the public policy issue requires the decision maker’s attention, using relevant nursing research from the last five years to support your position. 2. Discuss the main challenges of addressing the selected public policy issue. 3. Discuss the primary options and/or interventions for the decision maker, including why they are tangible. 4. Propose a persuasive course of action for the decision maker, including ways to avoid the challenges identified in part B2. 5. Discuss how you will evaluate the success of your policy brief (top-down approach). C. Create a plan (suggested length of no more than 3 pages) for working with an organization or a community to address the public policy issue analyzed in part A by doing the following: 1. Identify an organization or community that has expressed interest in your selected health or nursing profession public policy issue. a. Summarize evidence supporting why the organization or community has expressed interest in the selected public policy issue. 2. Identify three CBPR principles you could use to work with the organization or community to address a policy change for the public policy issue. a. Explain how you could approach and collaborate with the organization or community. b. Discuss how the goal of the community or organization aligns with your goal for the selected public policy issue. c. Discuss the action steps that need to be taken to achieve your goal from part C2b. d. Discuss the possible roles/responsibilities of the community or organization members, including problem-solving and capacity-building roles. e. Discuss key elements of developing a collaborative evaluation plan, using CBPR principles. f. Discuss how you will evaluate the success of your community or organization plan (bottom-up approach). D. Analyze (suggested length of 1 page) the strengths and challenges of the top-down and bottom-up approaches in achieving policy change(s) to support your selected public policy issue by doing the following: 1. Discuss the strengths of each approach to implement change for the selected public policy issue. 2. Discuss the challenges of each approach to implement change for the selected public policy issue. 3. Discuss which approach you would recommend as the most effective to address the selected public policy issue.