Long-haul Advocacy:  Adopting a long-term, sustained advocacy approach to effective child health systems change

Long-haul Advocacy: Adopting a long-term, sustained advocacy approach to effective child health systems change

Advocacy for the Long Haul

By Stephen Scott, Scott Advocacy and Consulting, lobbyist for American Academy of Pediatrics, Iowa Chapter

Throughout this summer and fall, thousands of advocates urged their federal legislators to reauthorize the Children Health Insurance Program (CHIP). Advocates wrote or contacted their legislators, urged others to take similar action, and publicized the importance of CHIP. These sustained advocacy efforts were widely recognized as key to Congress’ extension of CHIP this winter – an important victory for children and their families and communities.

Challenges to improving child health remain, however, and addressing them requires moving beyond waiting for the next critical vote to adopting a long-term, sustained advocacy approach to effective child health systems change. Advocacy for the long-haul approach calls for a perspective and approach with at least four key elements:

  1. It’s About Relationship Building. Cultivating relationships with lawmakers, executive officials, and other decisionmakers – seeking to identify common grounds and shared interests – is critical. A long-haul advocate follows and engages decisionmakers – providing helpful information on issues throughout the year and reinforcing their positive actions whenever possible. This sustained engagement makes it more likely an advocate will be seen as a trusted authority, whose opinion on critical, emergent issues is valued.


  1. Partner, Partner, Partner. Building partnerships with professionals, advocates, opinionmakers, and others with shared interests – even if only on a few issues – is critical. Strong partnerships inform our efforts, facilitate connections, serve as a check on possibly ineffective or counter-productive actions, and provide support during difficult patches. They also produce concerted action that is more effective than scattered individual ones. Strong partnerships function best when they rest on established trust and are not being merely transactional.


  1. Honesty Is the Best Policy. Providing data, studies, and program results to decisionmakers is a key feature of effective advocacy. Unfortunately, data and program results are sometimes ambiguous or uncertain, making the picture grayer than we would like. In those circumstances, a long-term advocate is forthright in what she or he represents and does not take the data where it doesn’t go. Avoid presenting a picture of clarity by cherry-picking favorable studies, while denying the exclusion of counter-results. Also avoid over-promising program success when studies show uncertainty; failing to achieve promised results will eventually erode credibility.


  1. Have a Long-Term Perspective. A long-haul advocacy approach recognizes that systems change often requires fluid planning involving a series of steps – with many fits and starts along the way. Small steps are usually needed to lay the foundation for larger ones. Long-term gain should not be sacrificed for short-term success, and if possible, bridges should not be burned or relationships sacrificed.

So what are some first steps for an aspiring long-haul advocate can take?

  • Approach long-haul advocacy humbly – recognizing the limits of your expertise, the wisdom of others, and the inevitability of mis-steps along the way
  • Identify individuals and organizations with which to build constructive relationships and deepen your subject matter expertise
  • Read more broadly to better understand the larger context impacting the specific change you seek
  • Become familiar with a broad range of research and opinion, including resources that may question or challenge your policy goals
  • Grow your policy advocacy expertise by taking advantage of the myriad toolkits that organizations offer
  • Identify the key decisionmakers with which to engage, how to follow their activities, and potential points of connection