Shilton Trevor
National Heart Foundation of Australia, 334 Rokeby Road, Subiaco, Western Australia.
Promot Educ. 2006;13(2):118-26. doi: 10.1177/10253823060130020106.
Advocacy is an evolving and underdeveloped element of public health practice. Historically, it was used to describe activities undertaken by persons on behalf of the poor, the sick or oppressed. In the seventies, led by tobacco control advocates such as Pertschuk in the United States, Gray in Australia and Daube in the United Kingdom, public health advocacy became more focused on structural and policy change. Since the Ottawa Charter (WHO, 1986), the health promotion movement has embraced a broader view of the role of advocacy. The public health community now see advocacy as social action primarily aimed at effecting changes in legislation, policy and environments that support healthy living. Advocacy is defined by the World Health Organization as a combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or programme (WHO, 1995). This paper describes a model for understanding and mobilising physical activity advocacy. It outlines a three step process: 1. Gathering and translating the most pertinent physical activity evidence. Why advocate for physical activity? 2. Developing from the evidence, a physical activity advocacy agenda and articulating a plan (or plans) of key actions that will increase population levels of physical activity. What should be advocated? 3. Implementing a mix of advocacy strategies to influence and mobilise support for the physical activity agenda. How should advocacy be implemented?
倡导是公共卫生实践中一个不断发展且尚不完善的要素。从历史角度看,它被用于描述人们代表穷人、病人或受压迫者开展的活动。在20世纪70年代,在美国的佩尔舒克、澳大利亚的格雷和英国的道布等控烟倡导者的引领下,公共卫生倡导更侧重于结构和政策变革。自《渥太华宪章》(世界卫生组织,1986年)发布以来,健康促进运动对倡导的作用有了更广泛的认识。如今,公共卫生界将倡导视为主要旨在推动支持健康生活的立法、政策和环境发生变化的社会行动。世界卫生组织将倡导定义为个人行动和社会行动的结合,旨在为特定的健康目标或项目赢得政治承诺、政策支持、社会认可和系统支持(世界卫生组织,1995年)。本文描述了一个理解和推动身体活动倡导的模型。它概述了一个三步流程:1. 收集并转化最相关的身体活动证据。为何要倡导身体活动?2. 根据证据制定身体活动倡导议程,并阐明一项或多项关键行动计划,这些行动将提高人群的身体活动水平。应该倡导什么?3. 实施一系列倡导策略,以影响并动员各方支持身体活动议程。应如何实施倡导?