Teaching health advocacy to medical students: A comparison study

Julia Belkowitz, Lee M. Sanders, Chi Zhang, Gauri Agarwal, Daniel Lichtstein, Alex J. Mechaber, Esther K. Chung

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Context: Many encourage service learning and health advocacy training in medical student education, but related evaluation is limited.

Objectives: To assess (1) impact of a required community health advocacy training for medical students on student attitudes, knowledge, and skills; (2) student characteristics associated with higher advocacy knowledge and skills; and (3) perspectives of community-based organizations (CBOs).

Design: Cross-sectional surveys.

Setting: University of Miami Miller School of Medicine (UMMSM) Regional Medical Campus and main campus.

Participants: Medical students at both UMMSM campuses.

Intervention: Required community health advocacy training for first- and second-year students including classroom experiences and hands-on project in partnership with a CBO.

Main Outcome Measures: Student characteristics, health advocacy-related attitudes, self-reported and objective knowledge, and skills. Scores were compared between campuses, with multivariable modeling adjusting for individual student characteristics. Community-based organization perspectives were assessed via separate surveys.

Results: Ninety-eight (77%) regional campus students (intervention group) and 139 (30%) main campus students (comparison group) completed surveys. Versus the comparison group, the intervention group reported greater: mean knowledge of community health needs: 34.6 versus 31.1 (range: 11-44, P <.01), knowledge about CBOs: 3.0 versus 2.7 (range 1-4, P <.01) and knowledge of community resources: 5.4 versus 2.3 (range, 0-11, P <.01), and mean skill scores: 12.7 versus 10.5 (score range: 4-16, P <.01), following the intervention. Using adjusted analysis across both groups, female gender was associated with higher attitudes score. High level of previous community involvement was associated with higher attitude and skill scores. Higher self-reported educational debt was associated with higher skill scores. Community-based organization perspectives included high satisfaction and a desire to influence the training of future physicians.

Conclusions: Medical student advocacy training in partnership with community-based organizations could be beneficial in improving student advocacy knowledge and skills in addressing community health issues and in developing sustainable community partnerships.

Original languageEnglish (US)
Pages (from-to)E10-E19
JournalJournal of Public Health Management and Practice
Issue number6
StatePublished - Dec 8 2014


  • Health advocacy training
  • Medical student education
  • Public health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy


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