Assessment of Physician Advocacy Engagement: A Scoping Review and Proposal of an Assessment Tool

Physician advocacy is increasingly recognized as a core professional responsibility that influences patient outcomes and health systems. However, advocacy engagement encompasses activities ranging from broad health system-level initiatives to individual efforts, making measurement challenging. To evaluate current engagement and identify trends, standardized measurement tools are needed. The objective of this scoping review is to identify themes and gaps of current literature on physician advocacy assessment methods to inform the development of a comprehensive evaluation framework.

PubMed, Cochrane Library, CINAHL, Ovid-MEDLINE, SCOPUS, EMBASE, and ERIC were searched in July 2025 for literature published between 2000 and 2025. A total of 233 unique articles were identified and reviewed by two independent reviewers. Eligible studies included English-language publications that contained survey or framework components evaluating physician advocacy engagement, or that assessed attributes of physician and health advocates. Methods sections were analyzed to determine how health advocates were identified. In total, 28 articles advanced to full-text review. Fourteen met inclusion criteria and underwent data charting for identifying categories including first author, year, country of origin, study aim, and identification of physician advocacy. Studies then underwent thematic analysis.

The authors found a trend in which physician advocacy evaluations frequently included the domains of legislation, knowledge dissemination, professional organization participation, and community organization engagement. Assessment intensity of engagement was consistently featured across methods.

This scoping review identified core domains and intensity as key components of physician advocacy assessment, while highlighting gaps in measuring micro-level and less common forms of advocacy. These findings informed a preliminary framework for developing a comprehensive assessment tool that requires further exploration and refinement.