Grassroots campaign for policy change: Fostering collaborative practice to improve public health

A campaign to advocate for a national policy agenda must have strong foundations from its beginnings, building grassroots support for public health policy change at all levels of communities and society. The public health policy advocate mobilizes this grassroots support within a formalized structure for making and/or modifying policy, identifying the public health problem and the communities of concern that are impacted by policy implementation failures or gaps. 

In the example that will be described, foundations had already been established for the changes that were identified and needed in palliative care. A previous policy on end-of life care had been adopted some years earlier. The implementation of health reform also provided a fertile opportunity for introducing community change, especially for those vulnerable sub-groups who did not have access to conventional points of access in the health systems.

A collaborative practice approach to policy development was demonstrated to be highly effective in bringing about rapid change, and in disseminating change attitudes and practices into the community. In this example of policy development, highly collaborative approaches were utilized in integrating the palliative care paradigm into the health reform movement, building consensus around expanding an existing policy on end of life care to help achieve the triple aims of better health, better health care, and lower costs. Key to the success of the movement was data collection and review of the scientific evidence that would support and sustain policy change in the long term such as evidence of effectiveness and reducing health care costs.