Abstract

Sexual and reproductive health stakeholders’ perspectives: Advocacy successes, failures, and needs in the U.S.

Meredith Manze, PhD, Amy Kwan, PhD, Heidi Jones, PhD, Lynn Roberts, PhD, Diana Romero, PhD CUNY School of Public Health

APHA 2022 Annual Meeting and Expo

Background: Despite active advocacy for access to sexual and reproductive health (SRH) services in the U.S., persistent restrictions have created barriers to care. We sought the perspectives of key stakeholders on what makes for an effective SRH physician advocate and the successes, failures, and needs of abortion advocacy.

Methods: We interviewed 15 SRH key informants (KIs) in sectors with expertise in organizational policy and advocacy (n=6); clinical leadership and education (n=3), media (n=3), and reproductive justice (n=3) as part of a mixed methods evaluation of a physician advocacy training program. The analytic team coded repeating ideas and conducted a thematic analysis, organizing findings within KI perspectives on the role of physician advocates in SRH; successes, failures, and needs in abortion and contraception advocacy; and recommendations on the composition and components of an ideal advocacy training program.

Results: KIs felt successes included mandated access to contraception under the Affordable Care Act and the application of reproductive justice and storytelling to abortion advocacy. Failures included misplaced political focus and increased abortion bans. Participants highlighted the importance of building community across disciplines and diminishing silos. They felt skill building related to communication, developing relationships with change makers, and understanding political systems was critical for effective advocacy, and that clinician advocacy training programs should include non-physicians and be designed to build relationships over time.

Conclusions: KI perspectives can be used to inform advocacy training programs and for the SRH field to strategize their approach to increasing equitable and widespread access to SRH services.