Health advocacy in preventive youth health physicians, a core competence of the profession? Values, knowledge and skills, and performance in daily practice
Gehoorschade bij tieners, kinderen zonder plek op school, oogproblemen door computergebruik: Problemen waarvoor veelal aandacht is gevraagd door medisch specialisten. Maar welke rol spelen jeugdartsen bij het aankaarten van gezondheidsproblemen bij de Nederlandse jeugd?
Dit project richt zich op de mate waarin jeugdartsen hier (kunnen) bijdragen. Welke waarden vinden jeugdartsen belangrijk in hun werk? Wat willen en kunnen zij doen wat betreft maatschappelijk handelen, en hoe zijn zij hierop voorbereid in hun opleiding? En hoe verhouden zij zich tot andere medisch specialisten?
Deze vragen worden beantwoord via diepte-interviews en vragenlijsten bij jeugdartsen en kinderartsen, en analyses van de onderwijscurricula. De promovendus wordt begeleid door een team met veel ervaring in onderzoek, in de praktijk van de jeugdgezondheidszorg en in het onderwijs. Het project zal worden uitgevoerd door een arts die in opleiding is tot Arts Maatschappij en Gezondheid, met de SBOH als werkgever.
Auteur: FE de Bok, AJM Hermans, D Wolff, RJ Duvivier, SA Reijneveld
Auteur: Femke de Bock
Samenvatting van de aanvraag
Preventive youth health physicians (PYHPs), i.e. community physicians specialized in prevention in youth, should be effective health advocates to protect the fundamental health rights of children. All physicians are trained in health advocacy in their undergraduate training, advocacy being one of the seven CanMeds roles upon which medical education has been based. As Health Advocates, physicians assist patients and communities in navigating the healthcare system and accessing the appropriate health resources timely. The aim of this project is to gain insight into health advocacy among PYHPs. The project focuses on the performance of these physicians regarding health advocacy in their daily practice, and on the training of PYHPs regarding health advocacy, in the undergraduate and specialty stage. Moreover, PYHPs will be compared with paediatricians as other specialists solely focussing on children and their families, regarding both performance and specialty training in health advocacy. This proposal is innovative because: - It is the first to document the performance of health advocacy by PYHPs, their valuing of health advocacy compared to other tasks, and their perceived knowledge and skills in this; - It compares PYHPs with paediatricians, thus covering specialists working in prevention, and in cure and care for children; - It yields knowledge of how future physicians are prepared for practicing health advocacy in medical (undergraduate and specialty) curricula; - It has a coherent approach, using elements of the capability approach to assess performance in daily practice, giving also clues for sustainable employment; - It yields an instrument to assess the preceding, combined with health advocacy values, knowledge and skills; - It has a potentially very large community impact by strengthening the societal role of PYHPs and physicians in general; - It closely combines science and practice, allowing its performance by a medical specialist in training. The project has been designed as leading to a PhD-thesis based on five papers, embedded in a general introduction and discussion. As such, its results will suffice the requirements for a PhD-thesis at the University of Groningen. The general aim of the project has therefore been translated into five objectives: 1. To investigate to which degree PYHPs act as health advocates for youth, what obstructing and promoting factors PYHPs experience regarding this and how health advocacy is positioned within the values that the PYHPs find important in their work. 2. To develop a questionnaire suitable for PHYPs (partially registered and fully registered) and pediatricians, to measure to which degree they act as health advocates for youth, what obstructing and promoting factors they experience regarding this, and how health advocacy is positioned within the values that they find important in their work. 3. To identify the differences and similarities between PYHPs and paediatricians with regard to health advocacy for youth. 4. To explore how health advocacy is described and taught in the undergraduate medical curricula. 5. To investigate how the competence health advocacy is described and taught in the specialist training of PYHP, and how this relates to the specialty training in paediatrics. Regarding methods, the project consists of two major parts i.e. a part based on surveys and one on analyses of curricula. First, we will collect data with a survey among PYHPs (registered and in training, each 100) on the degree to which they act as health advocates for youth, what obstructing and promoting factors they experience regarding this and how health advocacy is positioned within the values that the PYHPs find important in their work (Objective 1), and will compare this with paediatricians (n=100) (Objective 3). As part of this, we will develop a questionnaire to measure these concepts among PYHPs and paediatricians, based on the capability approach of Sen (Objective 2). Second, we will analyse curricula of undergraduate and specialty trainings regarding health advocacy. The undergraduate curricula will concern all eight Dutch medical schools, based on a mapping of the formal programme and interviews with key stakeholders such as leaders of the Bachelor and Master-programme (Objective 4). The specialty curricula will regard the two PYHPs’ specialty trainings that exist in the Netherlands, and three paediatricians’ specialty trainings (Objective 5). The results of this project have relevance for preventive youth health physicians (PYHPs) and their professional society; for teachers involved in the training of physicians and PYHPs (i.e. undergraduate and specialty); for policy makers; and for scientists. Activities for knowledge transfer will be undertaken for each of these target groups separately and combined if possible. The project team has ample experience in supervising practitioner PhD-students, and is strongly embedded in the networks relevant for an excellent knowledge transfer.