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INTRODUCTION

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  • What are some ways I can get involved in community advocacy?

  • What are the principles of community engagement?

  • Who can I partner with to make my community advocacy more effective?

  • What are some examples of successful community advocacy efforts?

  • What have successful community advocates learned about working with communities?

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This chapter will address the following American College of Graduate Medical Education competencies: practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice.

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Practice-Based Learning and Improvement: A growing number of pediatric health care providers embrace their role as change agents for creating a healthy environment. This chapter will help providers understand community advocacy within the context of the socioecological model so that they can help communities make sustainable and effective change.

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Interpersonal and Communication Skills: This chapter will enable the practitioner to enhance effective exchange of information, collaboration with patients and families as well as with other health professionals.

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Professionalism: Professionalism is important in advocacy just as it is in clinical care, and this chapter will address the principles of community-based participatory research (CBPR) which includes commitment to professional responsibilities, acting on ethical principles, and sensitivity to diversity and values of respect.

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Systems-Based Practice: Engagement in advocacy demonstrates that the pediatric health care provider has an awareness of the larger system of health care delivery, and this chapter will highlight examples of the ways providers can interact with the system to optimize patient outcomes.

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Pediatric health care providers feel very comfortable in the confines of an examination room. Cocooned in a 12 × 12 ft2 room with a familiar family, they can address the most sensitive issues with skill and compassion. The patient and family then leave this space, which is equally secure though less familiar and comfortable for them, to return back to their real world. For patients and families, their real-world environment includes not only their familiar household, but also their child’s school, neighborhood, community, the state, nation, and larger world. This wider nonmedical home is obviously where day-to-day living takes place and health is determined. Providers, from the security and elevated status of their office, are frequently guilty of thinking that what happens in their confines translates seamlessly to their patients who live in what can either be a supportive or antagonistic environment. Unfortunately, this is not the case. As illustrated by the obesity epidemic, families return to environments of increased portion size, reduction in opportunities for physical activity, decreased cost of sugar-sweetened beverages, and other factors that can make following the advice and achieving the goals set in the examination room difficult and challenging.

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What are pediatric health care providers to do with this reality? A growing number of providers embrace their role as change agents for creating a healthy environment. As valued and respected members of society, pediatric health care providers have a ...

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