Available online 8 November 2023

To explore barriers, facilitators, and benefits of collaboration between academic pediatricians and institutional offices of government relations (OGR) to enhance policy advocacy efforts.

The Academic Pediatric Associations' Health Policy Scholars met with the government relations team in their affiliated institutions as part of their experiential learning curriculum. Afterwards, they submitted written reflections which were coded and analyzed using inductive qualitative content analysis to identify key themes.

Reflections were completed by 21 of 23 (91.3%) participants. Most participants (76.2%) were faculty at free-standing children’s hospitals and had been at their institutions <5 years (52.3%) or 5-10 years (33.3%). Institutional OGR structure varied widely and not all institutions had well defined priorities. Key themes of the reflections included that OGRs often had dynamic priorities and fiscal considerations frequently took precedence. Barriers to physician involvement with OGR often related to difficulty identifying the correct staff contact and not having the time and support for advocacy work. Facilitators included leveraging existing relationships and collaborations, including those of peer or mentor connections to the OGR staff. Anticipated benefits to both OGR and physicians included improved knowledge of advocacy opportunities, enhanced advocacy efforts leveraging physicians’ expertise and patient stories, message alignment and amplification of physician and institutional advocacy work.

Collaboration between physician advocates and institutional OGR is feasible and, with orientation and mentorship, may facilitate improved physician and institutional policy advocacy efforts. Supporting this type of collaboration may enhance physician and institutional advocacy on behalf of their shared patients and communities.

Social and structural determinants of health are increasingly recognized as contributors to child health,1, 2, 3 and are often not fully addressed in individual patient-provider encounters.2, 3, 4, 5 As a result, pediatricians and other clinicians may be interested in policy advocacy at the institutional or governmental level to effect change on a larger scale.7, 8, 9 However, they may be hesitant to participate in advocacy due to lack of knowledge, skills, or tools for effective engagement.8,

The inaugural HPSP cohort included 23 general pediatricians and pediatric subspecialists from 11 states, the District of Columbia, and Canada. Participating physicians were asked to identify and meet with a representative of their institution’s OGR team to discuss the institution’s policy priorities, if any, as well as opportunities for physician involvement in institutional advocacy efforts. Scholars were given instructions for preparation which included: watching a video on effective advocacy

The reflection assignment was completed by 21 of 23 (91.3%) HPSP Scholars. Reflections varied in length, with an average word count of 434 (median 366, range 180 to 1207 words). The majority of participants (16/23, 76.2%) were faculty at free-standing children’s hospitals, 4 (19.0%) worked at academic general hospitals and 1 (4.7%) worked at a non-academic general hospital. Respondents fell equally (n=7, 33.3%) into three groups: those that had never met with OGR prior to the HPSP assignment,

In this qualitative analysis of Scholars’ reflections on meeting with their institutional OGRs, we provide a novel assessment of the perceived barriers and facilitators to physician collaboration with OGR, and the potential value of this partnership. In this diverse group of general pediatricians and pediatric subspecialists from across the U.S. and Canada, most participants were able to identify and meet with a representative from their institution’s OGR. This indicates collaboration with OGR

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© 2023 Published by Elsevier Inc. on behalf of Academic Pediatric Association