Defining physician advocacy for adolescent reproductive health: A national survey

Background and objectives: Adolescent reproductive health (ARH) policies often impact the practice of adolescent medicine. However, physicians' understanding of their roles as advocates and the extent to which adolescent medicine physicians have a voice in the policy sphere are unclear. This study explores the ways in which adolescent medicine physicians define professional advocacy and reflects on how a wider array of potential advocacy activities relate to ARH policy scenarios.

Methods: In 2008, we invited all U.S. board-certified adolescent medicine physicians (N=521) to complete an online survey. Items include perceptions of and experiences with advocacy, advocacy activities related to four ARH policy scenarios, and demographics. Response rate was 52% (N=273); data were analyzed using SPSS.

Results: Nearly all respondents identified physician advocacy for ARH as important, and over 90% described themselves as advocates. Reported advocacy activities included teaching, producing research, speaking and serving in their communities, and lobbying politicians. The actions physicians would take in response to a particular ARH policy scenario varied by topic as well as by physician characteristics. For example, women reported being more likely than men to oppose a ballot initiative instituting parental notification for abortion. Physicians reported being more inclined to take advocacy action in response to pharmacists refusing to dispense emergency contraception than to an abortion-related ballot initiative.

Discussion: This research presents a new model for physician advocacy for ARH and in so doing, explores the possibility for physicians to have a louder voice in ARH policy.