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Individualized Advocacy Project (IAP)

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Briefly describe the activity and its purpose.

An Individualized Advocacy Project (IAP) is when a trainee works with a faculty mentor to create an advocacy project that lasts for four weeks. Prior to starting their IAP, trainees complete an advocacy online module that's available on their BlackBoard. The advocacy module helps broaden trainees' perspective on the level of impact/change they can have on their community. An example from their module is attached (pyramid picture) that helps trainees recognize the magnitude of their impact. The IAP provides individual trainees with the opportunity to plan a systems-of-care based advocacy project that translates clinical issues into population health questions. The IAP introduces each trainee to community needs assessment, public policy formulation and implementation, legislation/rule making, financing of health care, program administration, community consultation, and program planning and evaluation. All LEND long-term trainees (LTTs) and medium-term trainees (MTTs) must identify a critical child health issue related to disability and special health care needs (e.g. obesity, access to special education services) that is especially important to them. Under the guidance of designated LEND faculty, trainees define a specific intervention (e.g. improve quality of snacks offered to children with disabilities in a child care setting). The trainee meets with a faculty member with expertise in the selected topic and with a representative of a community-based organization that addresses the selected topic. MTTs complete the plan and present a formal description to faculty and trainees of why their issue is important and their plan to address it. LTTs do similar presentations and take concrete steps towards implementing the IAP.

What are the expected learning outcomes for trainees?

The IAP encourages each trainee to follow their passions, think beyond their specific discipline, use public health tools to define a problem, engage a community partner, adapt evidence-based practices to community settings, and enlist others through informal and formal presentations. In successfully completing an IAP, each trainee must demonstrate sufficient skills in these aspects of MCH leadership. By completing an IAP, trainees will: - Develop leadership skills - Recognize the importance of identifying evidence-based practices - Understand the interdisciplinary approach when problem-solving

Briefly describe the positive impacts this activity has had on trainees.

If a trainee is there longer than just a semester, trainees often will implement their IAP. Many of them report positive experiences when implementing the systems level change while collaborating with diverse stakeholders. The average trainee takes approximately 20 hours to complete an IAP, though many trainees have gone much further and received funding through university internal grant support mechanisms, the American Academy of Pediatrics, and a variety of local foundations. With the reorganization of Mailman Center for Child Development into interprofessional collaborative groups, trainees have already begun coordinating their IAPs with broader faculty efforts to improve the health of our community: e.g. apply the "30-million-word" project in a underserved community adjacent to the Mailman Center; increase access to Parent Child Interaction Therapy for families with children with autism.

Briefly describe any lessons learned or challenges associated with implementing this activity.

Many trainees tend to be focused on clinical aspects when first starting out on their IAP. They don't have the background knowledge and/or exposure to systems-level change. To help broaden trainees' perspective, Mailman Center has hired a public health instructor to show trainees different frameworks and ways to create a systems level change. They have implemented an advocacy module and guide that provides background.

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