Advocacy for physical activity--from evidence to influence

Advocacy is an evolving and underdeveloped element of public health practice. Historically, it was used to describe activities undertaken by persons on behalf of the poor, the sick or oppressed. In the seventies, led by tobacco control advocates such as Pertschuk in the United States, Gray in Australia and Daube in the United Kingdom, public health advocacy became more focused on structural and policy change. Since the Ottawa Charter (WHO, 1986), the health promotion movement has embraced a broader view of the role of advocacy. The public health community now see advocacy as social action primarily aimed at effecting changes in legislation, policy and environments that support healthy living. Advocacy is defined by the World Health Organization as a combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or programme (WHO, 1995). This paper describes a model for understanding and mobilising physical activity advocacy. It outlines a three step process: 1. Gathering and translating the most pertinent physical activity evidence. Why advocate for physical activity? 2. Developing from the evidence, a physical activity advocacy agenda and articulating a plan (or plans) of key actions that will increase population levels of physical activity. What should be advocated? 3. Implementing a mix of advocacy strategies to influence and mobilise support for the physical activity agenda. How should advocacy be implemented?