Week 4 Discussion on Contextual Factors Paper

Week 4 Discussion on Contextual Factors Paper

The serious health issue of chronic obstructive pulmonary disease (COPD) calls for targeted policy and advocacy initiatives. Chronic Obstructive Pulmonary Disease (COPD), a form of persistent inflammatory lung disease defined mainly through chronic bronchitis and emphysema, increases the risk of blocked flow of air from the lungs, with smokers being more vulnerable (National Heart, Lung, and Blood Institute, 2022). The initiative’s success is determined by several internal and external contextual variables that can help or hinder the resolution of COPD-related problems. In this discussion, we will look at an educational initiative to inform nurses about COPD and give them tools to help patients manage their illnesses. The goal of providing nurses with the necessary skills and knowledge is to make it easier for them to put their understanding into practice through their contact with and instruction of COPD patients. We explore the contextual elements that may affect the efficacy of this educational intervention and its ensuing influence on COPD policy and advocacy. The advocacy priority of informing and encouraging smokers with COPD to quit will be the specific area of interest.

Promoting Factors for COPD Advocacy

Giving advocacy efforts a solid base, research, and evidence is an internal motivator for COPD activism. To persuade policymakers and stakeholders of the significance of tackling COPD and devoting resources to support associated activities, scientific evidence demonstrating the effectiveness of educational approaches and smoking cessation programs is essential. The study by Qin et al., 2021, found that good adherence to treatment for quitting smoking significantly improved the effectiveness of quitting and highlighted the determinants of compliance. Research-based evidence emphasizes the efficacy and value of such programs by emphasizing the positive effects of these measures, such as enhanced patient self-management and decreased exacerbations. Research findings further highlight the significance of tackling this health issue that quantifies the impact of COPD based on economic expenses and healthcare consumption(Oates et al., 2019). Armed with this persuasive data, advocates may successfully persuade legislators to give COPD advocacy top priority and provide funding to the disease’s fight, thereby improving outcomes for COPD patients.

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The engagement of healthcare professionals, especially nurses’ engagement, is an excellent internal element that supports COPD advocacy. With their first-hand knowledge and experience in handling COPD patients, healthcare professionals’ active participation lends credibility and influence to the cause. As primary caregivers, nurses have an exceptional understanding of the difficulties faced by people with COPD and can clearly explain their needs and concerns (Henshall et al., 2022). Their knowledge of advanced COPD prevention and treatment techniques and evidence-based methods strengthens their credibility as advocates and allows them to provide insightful viewpoints to policy conversations. When given well-informed input from healthcare professionals, policymakers and stakeholders are more likely to prioritize COPD-related legislation, resulting in better treatment and support for people with COPD.

The advocacy priority can be significantly advanced by increased public education and awareness initiatives on COPD and its effects. Agust et al. (2023) claim that people are more inclined to support policies focused on addressing COPD and reducing its incidence when they understand more about the disease, its etiological factors, symptoms, and its effects on people and society. Increased attention from lawmakers and more funding for COPD mitigation, research, and treatment can result from lobbying activities that enhance public knowledge and support. Education campaigns can also encourage people to take preventive action, seek an early diagnosis, and support programs that prioritize managing and supporting COPD (Rossaki et al., 2021). Thus, the advocacy goal can acquire momentum by raising public awareness of COPD and its impacts, leading to policymaker support, more financing for COPD projects, and better disease management and support.

Collaborative alliances with multiple stakeholders, such as professional associations, patient advocacy organizations, and government organizations, are required to fulfill the COPD advocacy goal. Advocates can increase the reach and effect of their message by forming alliances with multiple stakeholders and taking advantage of their combined networks, knowledge, and resources. Collaboration enables the exchange of information, best practices, and cutting-edge methods for managing and preventing COPD (Vachon et al., 2022). Through partnerships, advocacy groups can access the influence and outreach of professional associations, the advocacy work done by patient groups and their members, and the capacity for policymaking of governmental bodies. With a stronger collective voice and increased possibility of policy changes and budget allocation to address the needs of people with COPD, this collaborative strategy raises the profile and trustworthiness of COPD advocacy.

Factors hindering advocacy

It is difficult to advocate for people with COPD because of the pervasive stigma connected to smoking and the disease. The public may be less supportive of preventative and management-focused initiatives due to negative attitudes and preconceptions about the illness. The idea that COPD is exclusively a result of smoking leads to stigmatizing those who have it, impeding efforts to increase awareness, win over the public, and influence legislative reforms (Bergmann, 2022). It takes focused education campaigns to dispel myths, combat stigma, and create a sympathetic knowledge of COPD as a complex health issue to overcome these obstacles.


Effective campaigning faces significant obstacles because of the lack of financing and scarce resources for COPD prevention and education. Financial support is essential to conduct comprehensive smoking cessation programs, create educational campaigns, and guarantee that people with COPD have access to high-quality care (Hurst et al., 2021). Without sufficient funding, advocacy groups encounter enormous challenges when trying to gather support, carry out research, and put forth projects that have a real impact. Resources are scarce, making it difficult to spread the advocacy message, restrict the effectiveness of awareness efforts, and prevent evidence-based solutions.

The introduction of COPD advocacy on the policy agenda may be hampered by shifting political objectives and conflicting agendas within the healthcare system. Numerous urgent issues compete for attention in a failing healthcare system (FRONTLINE PBS | Official, 2021), making it possible that COPD is unlikely to receive the attention and resources it needs. The development of COPD-related policies and efforts may be halted when decision-makers prioritize other healthcare issues or fail to acknowledge the severity of COPD as a public health threat (Hurst et al., 2021). To overcome this obstacle, ongoing advocacy work is required to highlight the effects of COPD on people, families, and communities and the necessity of comprehensive policies aimed at prevention, equitable care, and support for COPD patients.


The success of COPD advocacy is dependent on managing both internal and external issues that influence its advancement. Research and evidence are essential in building a solid case for advocacy activities and persuading decision-makers of the significance of COPD therapy and prevention. To ensure that the needs and issues of COPD patients are effectively expressed, healthcare professionals, especially nurses, actively participate in the cause. The key to gaining support, encouraging prevention, and winning financing for COPD mitigation measures, research, and treatment is increased public awareness and education campaigns. Collaborations with stakeholders help to spread the advocacy message while utilizing networks, assets, and knowledge to change policies and improve COPD outcomes. Conversely, barriers to COPD advocacy, like stigma and a lack of money, must be overcome by educational campaigns, improved funding, and a focus on elevating COPD on the political agenda. By removing these obstacles, COPD advocacy can significantly improve the quality of life for those suffering from this chronic lung condition.


Agustí, A., Celli, B. R., Criner, G. J., Halpin, D., Anzueto, A., Barnes, P., Bourbeau, J., Han, M. K., Martinez, F. J., de Oca, M. M., Mortimer, K., Papi, A., Pavord, I., Roche, N., Salvi, S., Sin, D. D., Singh, D., Stockley, R., López Varela, M. V., & Wedzicha, J. A. (2023). Global initiative for chronic obstructive lung disease 2023 report: GOLD executive summary. European Respiratory Journal, 2300239. https://doi.org/10.1183/13993003.00239-2023

Bergmann, B. A. B. (2022, February 16). Take my breath away: The Role of social norms and Power in promoting wellness within a System of Care for People with chronic obstructive pulmonary disease. Www.ideals.illinois.edu. https://www.ideals.illinois.edu/items/125258

FRONTLINE PBS | Official. (2021). The healthcare divide (full documentary) | FRONTLINE. In YouTube. https://www.youtube.com/watch?v=UVvEkeH4O8o

Henshall, C., Jones, L., Armitage, C., & Tomlinson, L. (2022). Empowering nurses through inclusive leadership to promote research capacity building: A James Lind Alliance priority setting partnership in community nursing. Journal of Advanced Nursing, 78(9). https://doi.org/10.1111/jan.15342

Hurst, J. R., Buist, A. S., Gaga, M., Gianella, G. E., Kirenga, B., Khoo, E. M., Mendes, R. G., Mohan, A., Mortimer, K., Rylance, S., Siddharthan, T., Singh, S. J., van Boven, J. F. M., Williams, S., Zhang, J., & Checkley, W. (2021). Challenges in the implementation of chronic obstructive pulmonary disease guidelines in low- and middle-income countries: An official American thoracic society workshop report. Annals of the American Thoracic Society, 18(8), 1269–1277. https://doi.org/10.1513/annalsats.202103-284st

National Heart, Lung, and Blood Institute. (2022, March 24). COPD – what is COPD? | NHLBI, NIH. Www.nhlbi.nih.gov. https://www.nhlbi.nih.gov/health/copd

Oates, G. R., Niranjan, S. J., Ott, C., Scarinci, I. C., Schumann, C., Parekh, T., & Dransfield, M. T. (2019). Adherence to pulmonary rehabilitation in COPD. Journal of Cardiopulmonary Rehabilitation and Prevention, 39(5), 344–349. https://doi.org/10.1097/hcr.0000000000000436

Qin, R., Liu, Z., Zhou, X., Cheng, A., Cui, Z., Li, J., Wei, X., Xiao, D., & Wang, C. (2021, April 30). Adherence and efficacy of smoking cessation treatment among patients with COPD in China. International Journal of Chronic Obstructive Pulmonary Disease. https://www.dovepress.com/adherence-and-efficacy-of-smoking-cessation-treatment-among-patients-w-peer-reviewed-fulltext-article-COPD

Rossaki, F. M., Hurst, J. R., van Gemert, F., Kirenga, B. J., Williams, S., Khoo, E. M., Tsiligianni, I., Tabyshova, A., & van Boven, J. F. (2021). Strategies for the prevention, diagnosis, and treatment of COPD in low- and middle-income countries: The importance of primary care. Expert Review of Respiratory Medicine, 15(12), 1563–1577. https://doi.org/10.1080/17476348.2021.1985762

Vachon, B., Giasson, G., Gaboury, I., Gaid, D., Noël De Tilly, V., Houle, L., Bourbeau, J., & Pomey, M.-P. (2022). Challenges and strategies for improving COPD primary care services in Quebec: Results of the experience of the COMPAS+ quality improvement collaborative. International Journal of Chronic Obstructive Pulmonary Disease, Volume 17, 259–272. https://doi.org/10.2147/copd.s341905




What is the impact of contextual factors on advocacy and policy? Contextual factors can range from internal (the organization, the practice, the environment, the culture, etc.) to external (laws, policies, politics, regulations, etc.). However, whether originating internally or externally, contextual factors have the capability of advancing or hindering an advocacy priority.
For this Discussion, you will consider how contextual factors impact policy making, focusing specifically on how these factors might impact your advocacy priority. Consider what contextual factors might promote getting your priority on the agenda, as well as those that might work against it.
• Dawes, D. E. (2020). The political determinants of health. Johns Hopkins University Press.
o Chapter 4, “How the Game is Played: Successful Employment of the Political Determinants of Health” (pp.78–111)
• Porche, Demetrius J. (2023). Health policy: Applications for nurses and other health professionals (3rd ed.). Jones & Bartlett Learning.
o Chapter 9, “Policy Formulation and Implementation” (pp.101-112)
o Chapter 10, “Policy Analysis” (pp.113-140)
Example Exemplars
• Advocacy Coalition Framework (ACF) (Word document)Download Advocacy Coalition Framework (ACF) (Word document)

• Kingdon’s Multiple Streams Framework (KSF) (Word document)Download Kingdon’s Multiple Streams Framework (KSF) (Word document)
• Narrative Policy Framework (NPF) (Word document)
The following media resources address the contextual factors impacting the answer to the following question, “How did we get here?” regarding the current state of healthcare in the U.S.
Please select at least two from the following to view.
• CNBC. (2018, December 26). Why medical bills in the U.S. are so expensiveLinks to an external site. [Video]. https://www.youtube.com/watch?v=3NvnOUcG-ZI
Note: The approximate length of this media piece is 15 minutes.
• FRONTLINE PBS. (2021, May 18). The healthcare divide Links to an external site.(full documentary): FRONTLINELinks to an external site. [Video]. https://www.youtube.com/watch?v=UVvEkeH4O8o
Note: The approximate length of this media piece is 53 minutes.
• IntelligenceSquared Debates. (2017, October 6). The U.S. health care system is terminally brokenLinks to an external site. [Video]. https://www.youtube.com/watch?v=o0JFn7rVHdg
Note: The approximate length of this media piece is 95 minutes.
• PBS NewsHour. (2021). Health care: America vs. the WorldLinks to an external site.. https://www.youtube.com/watch?v=BytzrjEfyfA
Note: The approximate length of this media piece is 56 minutes.
Post a response detailing the following:
• Which contextual factors will promote getting your advocacy priority on the agenda?
• Which contextual factors might work against it?



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