Concentration in Advocacy and Activism

Concentration in Advocacy and Activism

Concentration Directors

Esther Entin, MD
Clinical Associate Professor of Family Medicine
Email: ejentin@aol.com

Liz Tobin Tyler, JD, MA
Clinical Assistant Professor of Family Medicine
The Warren Alpert Medical School of Brown University
Clinical Assistant Professor of Health Services, Policy and Practice
Brown School of Public Health
Adjunct Professor
Roger Williams University School of Law
Email: elizabeth_tobin-tyler@brown.edu 

The Alpert Medical School has a longstanding commitment to community service, patient advocacy and population health. The mission statement of the Alpert Medical School lists two major goals for its graduates: “that they be broadly and liberally educated men and women, and that they view medicine as a socially responsible human service profession.” The Medical School curriculum also emphasizes the importance of understanding health in its broader social, economic and cultural context and teaches the valuable role that physicians play in promoting health equity and advocating for vulnerable patients and populations.

The Scholarly Concentration in Advocacy/Activism will promote student work and scholarship that explore these concepts.  Topics might include:

  • The role of physicians in addressing the social determinants of health
  • Collaborative (cross-disciplinary) approaches to reducing health disparities and advocating for the underserved (this includes participating in interprofessional collaborations such as medical-legal partnerships as well as partnering with concentrations with similar goals such as Caring for Underserved Communities, Health Policy, and Women's Reproductive Health)
  • Understanding and shaping law and public policy as it relates to the health of vulnerable and underserved populations
  • Connecting clinical care and the health care system with community and population health goals
  • Elevating the voice of marginalized and underserved populations about their health needs
  • Identifying community resources, organizations, stakeholders, and infrastructure toward collaboration.

CURRICULUM

Learning Objectives

  • Concentrators will gain an understanding of advocacy on behalf of patients and their communities as an essential part of professionalism.
  • Concentrators will examine the role of social determinants and societal injustice in creating health disparities.
  • Concentrators will learn to identify issues and analyze health and social policies that affect the health of vulnerable patients and populations.
  • Concentrators will develop skills and experience in: (1) translating patient information into data that can inform policy; (2) using their voices as clinicians to advocate for patients and communities; and (3) organizing effective policy advocacy strategies for different audiences - healthcare institutions, policymakers, the media, and the legislature.

Concentrators will design and carry out a summer research project between years I and II.  Students will continue to pursue their advocacy and activism project throughout the remainder of their medical school education, particularly during the second year.  Concentrators will  produce a scholarly product such as a published paper in a peer-reviewed journal, a presentation at a national meeting,  or a policy brief with a targeted distribution to key area decision-makers of a quality that is suitable for broader distribution. This  product should be created with the guidance and feedback of their project mentor. The student will be expected to communicate regularly with the concentration directors about the direction and status of their scholarly work and advocacy activities.  

Timeline of Activities

Year I: Through the Healthy Systems and Policy course, all students receive didactic sessions on a wide range of issues related to health disparities, the social determinants of health and the role of physicians in policy advocacy that can help them to shape a project proposal.  Students interested in pursuing the advocacy and activism concentration will identify a mentor and propose a project for summer following Year I. The mentor will continue working with the student through completion of the scholarly product.

Summer between Years I & II: Experiential Learning/ in-depth study. Experiential opportunities may include workingat a state or local government agency, such as the RI Department of Health, a community-based organization, or a policy or advocacy organization.  Research and policy analysis should focus on an issue related to health disparities, the social determinants of health and/or promotion of health at the community or population level.  Ideally, summer immersion experiences should include direct service work with vulnerable patient populations and their communities.

The rationale for direct service learning is that (1) it connects policy analysis and advocacy efforts with the needs and concerns of the people most affected by it; and (2) it promotes investment by the student in the community s/he is studying and advocating for. 

Year II: Students are encouraged to pursue coursework in electives related to health disparities and health equality,  health policy and community health, or other areas related to their areas of interest. In addition, Poverty, Health and Law is a six-session evening seminar offered each spring and is held jointly with Roger Williams University Law and Rhode Island College Masters of Social Work students. Concentrators are required to participate in the seminar.

Year III:  Throughout their third year core clerkships, advocacy and activism concentrators will be encouraged to keep a case-series related to their chosen issue. They will keep a reflective journal as they complete various clerkships, documenting ways in which the issue they are studying affects their patient population as they encounter the health care system.  They may also reflect on opportunities for advocacy and activism within the clinical care experience.  For example: obtaining adequate translators both linguistically and culturally to meet the patients' needs and improve compliance with health care recommendations; becoming knowledgeable about appropriate community resources for patients' legal, social, and economic concerns; educating clinical team members about the social determinants of health and identifying ways to incorporate this knowledge into direct patient care.

Year IV: Concentrators will be encouraged to take electives related to their areas of interest, including clinical electives, study electives, and coursework.  Concentrators will share their scholarly project with classmates.  The project will be (1) an article for a peer-reviewed journal (2) a presentation suitable for a regional or national meeting; or (2) a policy paper with a targeted distribution to key area decision-makers that is suitable for broader distribution.

Concentration Related Electives

Pre-clinical:

BIOL 6503: Poverty, Health and Law
BIOL 6655: Health Care of Underserved
BIOL 6504: Health Care in America

Clinical:
Child Maltreatment
Controversies in the Health Care Policy
HIV/AIDS
Occupational and Environmental Medicolegal Medicine

Project Examples

  1. A study of Access to Health Care of Undocumented Children in Rhode Island.
    1. An in-depth analysis of the issue and its demographics in RI
    2. An understanding of policies and regulatory issues that help or hinder access
    3. Identifying and meeting with people in RI including families, community activists, legislators, policy makers and other stakeholders in RI
    4. A study of model programs across the US
    5. A proposal, plan and implementation strategy to improve access
  2. Nutrition and Exercise for Rhode Island Teens
    1. An in-depth analysis of the issue and its demographics in RI
    2. An understanding of laws, policies, and regulations that impact the issue
    3. Identifying groups and initiatives addressing the issue, including teens
    4. Study model programs from around the US
    5. Develop a proposal, plan, and implementation strategy to improve nutrition and exercise among teens in RI
  3. Improving Recreational Opportunities for Special Needs Youth in South Providence
    1. An in-depth analysis of the issue and its demographics. (follow families and kids, map playgrounds, analyze for access and safety)
    2. An understanding of policies, laws, and regulations that impact the issue. Explore planning/zoning processes. Perhaps do “Child heath Impact” study on proposed building or roads projects
    3. Identify groups and initiatives already involved, key stakeholders, policy makers, and neighborhood organizations
    4. Develop a proposal, plan, and implementation strategy to improve opportunities for recreation for Special Needs children in South Providence
  4. For more examples of potential projects, please visit the Patient Advocacy Coordinating Council's list of "orphaned" projects

2011 and 2012 Accepted Students and Scholarly Concentration Projects

Student Project Title Mentor
Damiano, Ella
Increasing SNAP usage at RI Farmers’ Markets
Dr. Edward Feller
Burke, Colin
Putting a face to Providence’s homeless veteran population: A population study
Dr. Thomas O'Toole
Chu, Katrina
Socioeconomic Disparities in Cancer Care: a Broad-Based Analysis and Multi-level Advocacy Dean Marjorie Thompson, PhD
Hussain, Rashid
Global and Local Health Inequities
Stephen McGarvey
Mohan, Suresh
Recording Ethnicity, Race and Language: A comparison of documented and self-identified demographics Dr. Megan L. Ranney, MD, MPH

Maximum Number of Students

Four students per year

Faculty Mentors

The concentration directors and staff will help you identify appropriate mentors for projects.

Funding Opportunities (alternatives to Summer Assistantships)

At the present time there are no resources other than the generally available Summer Assistantships (SA’s) that can be used by students in an Advocacy & Activism Concentration.