Name
Western Governors University
D025 Essentials of Advanced Nursing Roles and Interprofessional Practice
Prof. Name
Date
Advocacy is a foundational component of nursing practice and involves the intentional use of professional knowledge, ethical responsibility, and leadership to protect and promote the rights and well-being of individuals and populations. Nurses are introduced to advocacy early in their education and continue to refine this competency throughout their careers. While bedside advocacy—such as ensuring patient safety, informed consent, and appropriate treatment—is well established, advocacy aimed at improving community and population health outcomes often receives less emphasis. Advanced professional nurses (APNs) are uniquely positioned to address this gap by influencing public policy and systems-level change that target prevention and health promotion at the community level.
Advocacy at the community level differs substantially from advocacy conducted in direct clinical care. When advocating for individual patients, APNs focus on immediate health needs, clinical decision-making, and coordination of care to improve patient-specific outcomes. In contrast, community advocacy emphasizes prevention, health equity, and long-term outcomes by addressing structural and policy-related determinants of health that affect large populations.
These differences are outlined in the table below.
| Aspect | Community-Level Advocacy | Individual Clinical Advocacy |
|---|---|---|
| Primary focus | Prevention and population health through policy change | Treatment and management of acute or chronic illness |
| Key collaborators | Policymakers, educators, community leaders, public health officials | Physicians, nurses, pharmacists, and allied health professionals |
| Scope of impact | Broad and indirect effects on population health outcomes | Direct and immediate effects on individual patient outcomes |
Through community advocacy, APNs engage with legislative and social systems to influence conditions that shape health behaviors, whereas clinical advocacy remains centered on interprofessional teamwork within healthcare settings (Bondurant & Armstrong, 2016; Nickitas et al., 2018).
Effective community advocacy relies on strong interprofessional collaboration, often organized through an Advocacy Action Team (AAT). These teams typically include nurses, educators, public health professionals, and community representatives who share a commitment to addressing health inequities. Evidence supports two primary strategies that enhance teamwork and advocacy effectiveness.
First, establishing clear guidelines and a shared mission ensures that team members understand their roles, responsibilities, and collective goals. A unified purpose promotes accountability and coordinated action. Second, engaging in structured critical reflection allows teams to evaluate progress, identify barriers, and adapt strategies based on outcomes and stakeholder feedback. This reflective process supports innovation and sustained engagement, particularly when advocacy efforts encounter resistance or limited resources (Sims et al., 2015).
Public health data highlight smoking as a significant contributor to poor health outcomes in Winnebago County, Illinois. According to the 2021 County Health Rankings and Roadmaps, the adult smoking rate in the county is 21%, which exceeds both the Illinois and national averages of 16%. This elevated prevalence places Winnebago County among the least healthy counties in the state and underscores the need for targeted, prevention-focused interventions.
Adults with lower levels of educational attainment represent the population most vulnerable to smoking in Winnebago County. Educational disparities are frequently rooted in adverse childhood socioeconomic conditions, including poverty and limited access to quality education. Compared with national data, Winnebago County demonstrates lower educational achievement and higher rates of childhood poverty, both of which are strongly associated with increased smoking rates in adulthood.
| Characteristic | Winnebago County | United States Average |
|---|---|---|
| High school diploma attainment | 88% | 94% |
| Some college education | 59% | 73% |
| Childhood poverty rate | 27% | 10% |
Research consistently demonstrates that lower educational attainment and early-life socioeconomic disadvantage contribute to persistent health-risk behaviors, including tobacco use (Gagne et al., 2020).
Limited access to quality education during childhood is a critical social determinant of health influencing smoking prevalence in Winnebago County. Children raised in poverty face increased risks of academic underachievement and school dropout, which in turn elevates the likelihood of smoking initiation in adulthood. Healthy People 2030 emphasizes education access and quality as key determinants of long-term health outcomes, reinforcing the need for early educational interventions to disrupt intergenerational cycles of disadvantage (Healthy People 2030, n.d.).
Winnebago County currently enforces a Tobacco Free and Smoke Free Environment Policy that restricts tobacco use in indoor spaces and near public buildings. While this policy aligns with state regulations and reduces exposure to secondhand smoke, it does not address the upstream social and educational factors that contribute to smoking initiation. As a result, the policy has limited effectiveness in reducing smoking prevalence among high-risk populations.
To address the underlying educational and socioeconomic drivers of smoking, the proposed policy introduces an Extended Early Childhood Program targeted toward children living in poverty. This initiative focuses on providing comprehensive early education, academic support, and developmental resources designed to improve school readiness and long-term educational attainment. Evidence indicates that children from low socioeconomic backgrounds benefit significantly from early educational enrichment and are more likely to graduate from high school when adequate supports are provided (Healthy People 2020, n.d.).
Implementation of the Extended Early Childhood Program is expected to generate multiple long-term benefits. These include improved access to quality education, reduced school dropout rates, and a gradual decline in adult smoking prevalence. Longitudinal research, including findings from the Carolina Abecedarian Project, demonstrates that early childhood education is associated with improved physical and mental health outcomes and reduced engagement in high-risk behaviors such as smoking later in life (Healthy People 2020, n.d.).
Equitable access to the proposed program will be ensured through the inclusion of a diversity and nondiscrimination clause. This provision prohibits exclusion based on race, ethnicity, religion, sexual orientation, gender identity, or disability. Oversight will be provided by a diversity review board responsible for ensuring admissions are based on demonstrated need. Any unused reserved placements will be reallocated to children with the highest socioeconomic risk to maximize community benefit.
This advocacy initiative aligns with the American Nurses Association Code of Ethics. Provision 7.3 emphasizes nurses’ responsibility to participate in policy development and community advocacy, while Provision 8.2 highlights the obligation to address social determinants of health through collaboration with policymakers and community leaders. By advocating for expanded educational access, APNs uphold their ethical duty to promote justice, equity, and population health (American Nurses Association, 2015).
| Provision | Ethical Obligation |
|---|---|
| Provision 7.3 | Active engagement in health policy and community advocacy |
| Provision 8.2 | Addressing social determinants through collaboration and leadership |
Two primary barriers may impede adoption of the Extended Early Childhood Program. Financial limitations within the county budget may restrict program expansion, necessitating the pursuit of grants, state funding, or public–private partnerships. Additionally, resistance from stakeholders with competing priorities may delay policy approval. Addressing these challenges requires strategic advocacy, transparent communication, and coalition-building among educators, healthcare professionals, and community leaders.
Jude Makulec, President of the Winnebago County School Board, represents a critical policymaker for advancing this initiative. Given their authority over educational policy and established relationships with local leaders, Makulec is well positioned to influence program adoption and resource allocation in support of early childhood education.
To strengthen advocacy efforts, APNs should engage in professional nursing organizations such as the National League for Nursing or the American Association of Colleges of Nursing to remain informed on policy trends. Active participation in community meetings and partnerships with local stakeholders enhances awareness of evolving health needs. Additionally, developing competencies in interprofessional communication, reflective practice, and leadership supports effective collaboration and sustained advocacy impact.
Advanced professional nurses extend their influence beyond individual patient care by engaging in community-focused advocacy and policy reform. By addressing social determinants of health through initiatives such as the Extended Early Childhood Program, APNs can contribute to meaningful reductions in health disparities and improve long-term community outcomes. Advocacy, as articulated in the ANA Code of Ethics, is an essential component of nursing practice and a powerful mechanism for advancing health equity at the population level.
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/coe-view-only
Bondurant, P. G., & Armstrong, L. (2016). Nurses: Leading change and transforming care – expert opinion. Newborn & Infant Nursing Reviews, 16(3), 155–160. https://doi.org/10.1053/j.nainr.2016.07.004
County Health Rankings & Roadmaps. (2021). Winnebago County, Illinois.
Gagne, T., Frohlich, K. L., & Quesnel-Vallee, A. (2020). The role of education in social inequalities in cigarette smoking. Addictive Behaviors, 109, 106476. https://doi.org/10.1016/j.addbeh.2020.106476
Healthy People 2020. (n.d.). Early childhood development and education.
Healthy People 2030. (n.d.). Education access and quality. https://health.gov/healthypeople
Nickitas, D. M., Middaugh, D. J., & Feeg, V. (2018). Policy and politics for nurses and other health professionals: Advocacy and action (3rd ed.). Jones & Bartlett Learning.
Sims, S., Hewitt, G., & Harris, R. (2015). Shared purpose and leadership in interprofessional healthcare teams. Journal of Interprofessional Care, 29(3), 209–215. https://doi.org/10.3109/13561820.2014.941459
Winnebago County. (2014). Tobacco free and smoke free environment policy.
