Building Capacity for Health Advocacy Proposal Guidelines

Before tackling the list of questions, we want to share with you some of the things we at the Rx Foundation are thinking about with regard to the Building Capacity for Health Advocacy program, especially in terms of language and definitions. If the following does not resonate with how you describe your own work, that does not put your proposal at a disadvantage, but it does invite you to be really clear in the proposal about your own language and definitions, so that we come to a shared understanding of the landscape you are working in and your goals and intentions for the next three years.

Since launching this program in 2019, the Rx Foundation has been on a learning journey, each year gaining new understanding and new ways of thinking about advocacy, organizing, civic engagement, and what it means to build capacity for long-term change. We have learned from and alongside our grant recipient partners, and have engaged with practitioners, researchers, and foundations who share our belief that power is a social determinant of health.

In addition to learning from the on-the-ground work of our grant partners, we have followed research and analyses emerging from the USC Dornsife Equity Research Institute, the P3 Lab at Johns Hopkins University, and the Lead Local Collaborative. Combined, this learning brought into focus that building power is at the heart of building the capacity, infrastructure, and “connective tissue” to champion issues that promote social justice through better health and better health care over the long term. While “power” can be defined in many ways, we often refer back to the definition of community power used by the Lead Local Collaborative:   

Community power is the ability of communities most impacted by structural inequity to develop, sustain and grow an organized base of people who act together through democratic structures to set agendas, shift public discourse, influence who makes decisions and cultivate ongoing relationships of mutual accountability with decision-makers that change systems and advance health equity.

We also understand that power is relational, dynamic, and context-specific. We appreciate Hahrie Han’s Reflections on Measuring Community Power, which reminds us that:

Unlike other strategies for change, community power-building is focused not on winning one policy or campaign, but instead, on developing, winning, and then governing a broader agenda for health equity. As such, it has the potential to get at the root causes of inequity, and create vehicles through which long-term, large-scale change can be developed, won, and sustained.

A second important point that has come into focus is the importance of building the ecosystem or the field for advocacy, organizing, and civic engagement. Building Capacity for Health Advocacy is not a one-size-fits-all program, and our grant partners utilize with a variety of strategies and goals. One helpful visualization is the Equity Research Institute’s Power-Building Ecosystem Framework, which uses a “power flower” to show the connections between advocacy and policy, organizing and base-building, alliances and coalitions, and other elements of a robust ecosystem for challenging the systems and structures that produce inequities.

And one last point that has come into focus for us is that there is a great deal of variation in how people use terms like power, organizing, and advocacy. As one example, we find that applicants and grant partners use the term “organizing” to mean different things. Our current understanding of organizing aligns with the Equity Research Institute’s definition of organizing as Involving people in efforts to change their circumstances by altering the underlying structures, decision-making processes, policies, and priorities that produce inequities.Similarly, the Leading Change Network explains that Organizing is leadership that enables people to turn the resources they have into the power they need to make the change they want. This brief video from the P3 Lab offers a helpful explanation of the differences between mobilizing and organizing, which are both important but distinct strategies for social change. If you include organizing in your proposed work, we encourage you to be specific about what you mean – does your planned work include community organizing, relational organizing, or do you use this term to mean something else?

IMPORTANT NOTE: It is OK if terms like building power, ecosystems, and organizing do not exactly align with how you think about and describe your priorities, plans, and goals. We share this reflection to give you some idea of the things we are learning and thinking about, and to encourage you to be clear and specific in your proposal about how you describe the context for your planned work, your partnerships and collaborations, and your goals not only for the duration of this grant but for the years and decades beyond.