Results Summary

PCORI funded the Pilot Projects to explore how to conduct and use patient-centered outcomes research in ways that can better serve patients and the healthcare community. Learn more.


Because healthcare professionals such as hospital social workers, nurses, and doctors work with patients every day, these professionals know about problems that patients face in getting health care. Healthcare professionals can play an important role with policy makers by speaking up to develop policies that benefit patients. But there is little research on what might make a healthcare professional likely to advocate for new policies in a hospital or in local, state, or national government.

Project Purpose

Researchers wanted to create a questionnaire to measure how much healthcare professionals push for policies that help patients.

The team wanted to use the survey to understand what makes some healthcare workers more involved in patient advocacy than others.


The research team developed a survey called the Policy Advocacy Engagement Scale. The survey included questions about how involved healthcare workers are in advocating for patients in seven topic areas, such as quality of care and access to mental health care. It also included questions about healthcare workers’ personal qualities, such as their ethical beliefs and their eagerness to be advocates for patients. Finally, it included questions about workers’ hospital environment. For example, researchers asked on the survey whether healthcare workers thought their hospital supported healthcare workers who pushed for patient-friendly policies, whether they believed their coworkers would act as patient advocates, and whether they thought their hospital staff supported  patients in speaking up for themselves.

Altogether, 94 social workers, 97 nurses, and 104 doctors in training from eight hospitals in Los Angeles, California, completed the survey. The research team ran statistical tests to determine whether the survey measured the seven topic areas as intended.

The research team also gave participants an existing survey called the Patient Advocacy Engagement Scale to measure their involvement in advocacy. Researchers compared the survey results to see which of the seven topic areas, if any, from the Policy Advocacy Engagement Scale predicted whether healthcare workers would engage in patient advocacy.


The statistical tests showed that the questions in the Policy Advocacy Engagement Scale accurately measured all seven topic areas.

Three topic areas in the Patient Advocacy Engagement Scale predicted whether healthcare workers were likely to be patient advocates their willingness to serve as a spokesperson for patients, their skills in advocating for patients, and their belief that the hospital was committed to encouraging patients to speak up about their needs.

Younger healthcare workers were more engaged in patient advocacy than older participants. Social workers did more patient advocacy than nurses.


All of the healthcare workers were from Los Angeles. Results might have been different if participants in other parts of the country answered the survey questions.


The Policy Advocacy Engagement Scale can measure the extent to which healthcare workers are involved in advocating for better patient care policies. Researchers can also use it to identify barriers that healthcare workers may face in advocating for policies that benefit their patients.

Project Information

Bruce S. Jansson, PhD, MA
University of Southern California School of Social Work
Improving Healthcare Outcomes through Advocacy

Key Dates

June 2012
December 2014

Study Registration Information


Has Results
Award Type
Funding Opportunity Type
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: March 4, 2022