What is public health advocacy? Defining the field and identifying effective practice and required competencies
1
School of Health Sciences and Nursing, Macquarie University, Sydney, Australia
2
School of Public Health, Adelaide University, Adelaide, Australia
3
College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Douglas, Australia
4
School of Health Science, UNSW, Sydney, Australia
5
School of Public Health, The University of Queensland, Brisbane, Australia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Advocacy capabilities are widely recognised as essential for public health professionals, including for improving health equity. However, there is no consensus definition of public health advocacy or the capabilities required to perform it. Additionally, evidence of effective advocacy strategies is limited. We explored practitioner perspectives on public health advocacy definitions, strategies, barriers and competencies.
METHODS:
Self-identified public health advocates from Australia and New Zealand, recruited through purposive and snowball sampling, completed an online survey (December 2024-April 2025). Quantitative data were summarised using descriptive statistics. Open-ended responses were analysed using inductive content analysis and code frequencies to summarise response patterns.
RESULTS:
One hundred and one advocates completed the survey (69% female). Respondents defined public health advocacy as targeted at improving population health (49%), and policy and practice (29%). They also defined advocacy as purposeful and strategic (35%) and change-seeking (21%). Influencing (34%), informing and educating (19%) were regarded as key methods of practice. Perceived effective strategies included building strong relationships (59%), cultivating influence with politicians and decisionmakers (57%), and leveraging media (46%). Barriers included inadequate organisational resourcing (funding, 63%; time, 61%; personnel 47%), limited access to decision makers (56%), organisational concerns about repercussions (39%), low priority (32%) and insufficient training (32%). Required competencies for performing advocacy included communication (87%) and collaboration (53%) skills, subject matter expertise (49%), knowledge of political processes (40%), and familiarity with advocacy approaches and methods (30%).
CONCLUSIONS:
Despite the absence of a shared definition, clear commonalities exist in how public health advocacy is conceptualised. Advocacy practice could be strengthened through implementing more rigorous evaluation of strategies to build an empirical evidence base of effective advocacy strategies. There is also a need for greater organisational prioritisation and resourcing of advocacy, alongside education and training in the identified competencies to build workforce capacity and address inequities.
Advocacy capabilities are widely recognised as essential for public health professionals, including for improving health equity. However, there is no consensus definition of public health advocacy or the capabilities required to perform it. Additionally, evidence of effective advocacy strategies is limited. We explored practitioner perspectives on public health advocacy definitions, strategies, barriers and competencies.
METHODS:
Self-identified public health advocates from Australia and New Zealand, recruited through purposive and snowball sampling, completed an online survey (December 2024-April 2025). Quantitative data were summarised using descriptive statistics. Open-ended responses were analysed using inductive content analysis and code frequencies to summarise response patterns.
RESULTS:
One hundred and one advocates completed the survey (69% female). Respondents defined public health advocacy as targeted at improving population health (49%), and policy and practice (29%). They also defined advocacy as purposeful and strategic (35%) and change-seeking (21%). Influencing (34%), informing and educating (19%) were regarded as key methods of practice. Perceived effective strategies included building strong relationships (59%), cultivating influence with politicians and decisionmakers (57%), and leveraging media (46%). Barriers included inadequate organisational resourcing (funding, 63%; time, 61%; personnel 47%), limited access to decision makers (56%), organisational concerns about repercussions (39%), low priority (32%) and insufficient training (32%). Required competencies for performing advocacy included communication (87%) and collaboration (53%) skills, subject matter expertise (49%), knowledge of political processes (40%), and familiarity with advocacy approaches and methods (30%).
CONCLUSIONS:
Despite the absence of a shared definition, clear commonalities exist in how public health advocacy is conceptualised. Advocacy practice could be strengthened through implementing more rigorous evaluation of strategies to build an empirical evidence base of effective advocacy strategies. There is also a need for greater organisational prioritisation and resourcing of advocacy, alongside education and training in the identified competencies to build workforce capacity and address inequities.
| eISSN: | 2654-1459 |
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