Description
Public health champions are an invaluable resource to gain and sustain momentum for innovative programs and policies. This brief shares experiences and lessons learned from a case study of FHI's Network of Champions Project to promote awareness and use of reproductive technology and research through partnerships with health professionals, policy-makers and advocacy groups. The brief also provides recommendations for future champion initiatives. A champion is a charismatic advocate of a belief, practice, program, policy and/or technology. "Champions create and communicate strategic meaning around the innovation, persistently promote the innovation, sell the idea to top management in order to secure resources, and involve and motivate others to support the innovation" (Howell, Shea & Higgins, 2005, p. 646). There are three critical factors for the success of champions: expressing enthusiasm and confidence about the success of the innovation, getting the right people involved and persisting under adversity (Howell, Shea & Higgins, 2005). The literature also describes champions as opinion leaders. Rogers' diffusion of innovations theory describes how champions spread new ideas and practices within and between organizations and communities (Valente & Pumpuang, 2007). Their function and roles in public health programs include (Valente & Pumpuang, 2007): providing an entry point for change agents to legitimate their work; communicating between communities and organizations (or within organizations) implementing programs; being a role model adopting a new practice; and acting as the 'capital' left after the innovation has been adopted. Engaging influential individuals to promote change is an innovative and evidence-based advocacy strategy. A 2007 Cochrane review by Flodgren and associates concluded that the use of opinion leaders can successfully promote evidence-based practices in clinical settings. This brief is divided into the following sections: the champions advocacy model case study: FHI's Network of Champions (NOC) Project strengths and challenges of the NOC Project lessons learned questions for further consideration recommendations for future champion initiatives
Steps for Using Method/Tool
The research brief is divided into the following sections:
1. The champions advocacy model: The "champions advocacy model" is closely associated with the "diffusion of innovations" model that theorizes how innovative individuals spread new ideas through social systems. The champions advocacy model focuses on increasing the likelihood that a new or underused strategy will become standard practice. Although the value of champions has been proven and well-documented, attributing specific changes in policy and practice to a champion's efforts can be challenging. Additional data are needed on how much and which type of support champions require, how long they need to be engaged to sustain change and the most effective ways to monitor and evaluate their impact.
2. Case study: FHI's Network of Champions (NOC) Project: This NOC project engaged seven participants from countries in sub-Saharan Africa and South Asia to promote awareness and application of underused reproductive health research and contraceptive technologies through local partnerships with stakeholders. Champions represented a range of opinion leaders, including a local program manager, two private-sector program directors and a national-level policy-maker. The champions designed activities to match their strengths. As a result, each portfolio reflected the type of change expected from that particular level of opinion leader.
3. Strengths and challenges: Strengths of the NOC Project: Mechanisms to support champion activities were well-designed and implemented. Champions reported receiving important financial support that included technical assistance and capacity building. All champions advanced family planning/HIV integration at the policy and program levels that were appropriately mapped to each individual's scope of influence. Challenges of the NOC Project: Engaging only one champion per project was insufficient. Key informants felt that supporting multiple champions in each country could accelerate achievement of public health objectives. Although all the champions felt that having a network with other champions was important, it was difficult to maintain this connection with colleagues in other countries.
4. Lessons learned: A champion may be successful at facilitating change at one level (e.g., community, national or regional) but not at others. When possible, champions should be engaged at multiple points of influence to prevent advocacy bottlenecks and to amplify their collective effect. Financial or in-kind support may enhance the likelihood that project objectives will be achieved. Strategies to prevent or address fatigue of champions are crucial. Establishing an externally managed network of champion initiatives may not be the most effective or cost-efficient model in certain settings.
5. Questions for further consideration: Additional questions on how to assess advocacy champion programs are posed. These include questions on cost-effectiveness, the value of a local peer network and types of monitoring and evaluation methodologies.
6. Recommendations for future champion initiatives: Several recommendations on implementing champion initiatives are provided. The recommendations emphasize the importance of using champions who are already considered to be influential to promote an issue. Engaging influential people to take up a specific cause may be more effective than engaging known supporters of an issue who are not considered to be opinion leaders. Some recommendations include: Select individuals who are current opinion leaders. Their standing is likely more important for creating impact than their original level of support for the issue. Ensure the level and type of champion corresponds to the desired advocacy outcome. For example, advocacy activities by community-based champions (e.g., peer educator) would differ in scope to that of a national-level champion. Consider providing multiple types of support to champions, including access to financial, technical and capacity-building assistance. Implement strategies to prevent or address fatigue among champions. Encourage champions to develop a local network of supportive peers as an alternative to an externally facilitated network.
These summaries are written by the NCCMT to condense and to provide an overview of the resources listed in the Registry of Methods and Tools and to give suggestions for their use in a public health context. For more information on individual methods and tools included in the review, please consult the authors/developers of the original resources.
We have provided the resources and links as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by McMaster University of any of the products, services or opinions of the external organizations, nor have the external organizations endorsed their resources and links as provided by McMaster University. McMaster University bears no responsibility for the accuracy, legality or content of the external sites.
