Learn to influence health policy, help individuals access an increasingly complex health care system and enhance the capacity of individuals and communities to effectively voice and advocate for their own concerns as you earn a Master of Arts in Health Advocacy.
Established in 1980, the Sarah Lawrence College Health Advocacy program was the nation’s first master’s degree program in the field. The program is a nationwide leader in defining this new discipline and the related field of patient advocacy, as it prepares students to improve health care and advise and advocate for individuals.
Integrating analytical discussions and hands-on fieldwork, the Health Advocacy master’s program teaches students how to enhance the effectiveness and responsiveness of the health care system.
The program’s student body is a mix of recent college graduates and people with experience in business, arts, law, and health care.
- The program, usually completed over four semesters and one summer, leads to a Master of Arts degree (or a Master of Professional Studies, for students who have a previous MA).
- The program teaches not only the theory and practice of advocacy itself, but also includes course work in physiology, history, law, economics, health policy, and ethics, as well as individual narratives that portray the experience of illness and disability.
- Three required fieldwork internships provide practice-based application of theoretical learning, giving students the opportunity to develop valuable professional connections in their chosen area of health advocacy.
The MA in Health Advocacy can be completed on full-time basis in two years, or part-time in up to three years and requires completion of the following:
- 48 course credits (graduate seminars)
- 12 fieldwork credits (three 200 hour internships)
- Capstone Project
All courses meet once per week and are held on Wednesdays and Thursdays.
The following courses are required for the degree:
- Models of Advocacy: Theory and Practice (2 semesters)
- Economics of Health
- Ethics and Advocacy
- Program Design and Evaluation
- Health Care Policy
- Health Law
- History of Health Care in the United States
- Illness and Disability Narratives
- Physiology and Disease
- Research Methods for Health Advocacy
- Fieldwork Pro Seminar
- Capstone Pro Seminar
Students gain practical work experience and proficiency in their chosen career paths by completing three 200+ hour fieldwork practicums. Working closely with the faculty advisors, students select the first two practicums based on their specific interests and career goals. The third practicum is completed as part of a Capstone project. The site for the Capstone is selected by the student, and is intended to give the student professional experience in their area of interest. Capstone projects are designed to address the organization’s needs, to tackle a significant issue or problem, and build on the student’s strengths and competencies.
Practicums take place in a variety of settings, including hospitals, community settings, non-profit organizations, for-profit corporations, government, media, and other venues. Sarah Lawrence's location in Westchester County—just north of New York City and adjacent to New Jersey and Connecticut—provides students with a broad range of fieldwork sites from which to choose. Students may also arrange summer internships in geographic areas where they intend to work after graduation.
Fieldwork sites have included:
- American Heart Association
- Bronx Health REACH
- Center for Aging in Place
- Community Service Society of New York
- Drug Policy Alliance
- Fannie E. Ripple Foundation, ReThink Health Project
- Heartsong, Inc.
- Hospital for Special Surgery
- Leake and Watts Services, Inc.
- Mental Health Association of New Jersey
- Metro Health Care for All New York
- Montefiore Medical Center
- Mount Sinai Hospital
- National Advocates for Pregnant Women
- North Shore-LIJ Stern Family Center for Rehabilitation
- New York City Department of Health & Mental Hygiene
- Paraprofessional Healthcare Institute
- Pride Center of New Jersey
- Public Health Solutions
- Reproductive Health Access Program
- Sanctuary for Families
- Settlement Health
- State of New Jersey, Office of the Public Defender, Division of Mental Health Advocacy
- The Jed Foundation
- The Wartburg Adult Care Community
- Union Health Center Inc.
- WE ACT for Environmental Justice
- Westchester Department of Senior Programs and Services
- Westchester Medical Center
- YWCA Residence White Plains
A Capstone Project gives Health Advocacy students the opportunity to integrate all aspects of their learning.
Through this yearlong project, students engage deeply with an agency/organizational partner. Together, they select a problem or issue, and the student works to address that issue through a substantial (200+ hours) program-related project.
Select Capstone Abstracts
Home Care Workers Community Based Participatory Research using Photovoice
Little prior research has been conducted by home care workers. Demand for home care workers arises from the aging of the population and a move to home-based care. Gaps between the fast-growing demand for and supply of workers persist. With two million employed and median annual earnings of $13,000, over half the workforce turns over annually. The workforce is 89% women and over half are people of color. Working with a Sarah Lawrence College Health Advocacy Program student under the sponsorship of the Paraprofessional Healthcare Institute, seven home care workers from Home Care Associates of Philadelphia participated in community-based participatory research using Photovoice. Workers attended structured workshops to discuss issues, share photographs, and identify common themes. Workers learned from each other’s experiences to form a richer understanding of their profession. They developed a sense of community. Common themes include the empathy and emotional intelligence required to do this work, conflicts when workers strive to achieve their standards of care within the confines of managed care and Medicaid/Medicare reimbursement policies, unsanitary and unsafe working conditions, challenges balancing home and work lives, economic challenges, and lack of respect for and understanding of their work on the part of the broader public and policy makers. Home care workers developed the capacity to analyze their working conditions, articulate messages to specific audiences, and understand how they can change their work lives. Read more and watch a video about Amy's work»
Unmet Health Needs of the YWCA White Plains Residents
Health issues for women with a history of mental illness, trauma, and insecure housing are well documented. Race and socioeconomic status further impact health. Access to appropriate and effective preventative care and better coordination of care are critical for marginalized and vulnerable women aging in supportive community housing.
The YWCA White Plains Residence is the largest provider of supportive housing for single women in New York State and the only provider in Westchester County. Most of the 193 residents are in “fair to poor health”. This capstone project focused on moving from episodic emergency care to preventative and coordinated care for the residents.
A free, voluntary, non-invasive, preventative health care program was offered onsite. Student technicians visited twice a week to capture vital signs (blood pressure, oxygen levels, pulse and weight) and transmit them to a nurse for remote monitoring. To date, empirical and anecdotal results demonstrate more personal awareness of health status and the value of preventative care. Coordination between Residence caseworkers and the local hospital’s care coordination and discharge planning team improved residents’ care plans and reduced episodic treatment. The preventative program will continue for 2 more years, the recommendation is to add other culturally relevant health programming and to further efforts with the local hospital to continue the journey of better preventative health and care coordination.
Understanding Dominican Women’s Perception of Diabetes
Diabetes is the fourth leading cause of death among Dominicans living in New York City (NYC). Even though they are the fastest growing Hispanic subgroup, there is little research available related to Dominican women’s views and management of diabetes. Conventional approaches to diabetes education don't take into account the unique cultural attitudes concerning chronic illnesses. As a result, they are often labeled ‘noncompliant’ by the medical community for not following the prescribed medical treatment. A qualitative study was conducted with 10 participants to further understand how Dominican women residing in NYC perceive diabetes. One focus group, one workshop, and three individual interviews were all conducted in Spanish. The data revealed the following themes: an understanding of what proper diabetes management involves; depression; uncertainty about where to find assistance; concerns over the cost of medications; and apprehension about the cost of healthy foods. Their negative experience with the condition of fresh produce in the Dominican Republic impacted their decisions about eating healthy foods. These findings suggest that medical professionals should provide alternative culturally relevant settings for diabetes education before concluding non-compliance. There also needs to be further exploration into self-organized informal groups as a more effective setting for supporting women in managing their diabetes. Finally, more community-based research on the health concerns and barriers for Dominican women in NYC is needed.
Creating Connections: Transforming the Isolation of Illness through a Narrative Experience
Debra G. Finn
For those experiencing illness, expressive writing as an adjunct therapy can provide a wide range of benefits to health and well-being including reduction in anxiety, stress, and isolation. Visible Ink (VI) is a program within Memorial Sloan Kettering Cancer Center (MSKCC) that has worked with individuals utilizing expressive writing with cancer patients since 2008. Much research exists on the effects of narrative on the illness experience, most often as a personal and private experience. By transforming this individual initiative into a group process, this project aimed to expand the benefits of narrative. A Blog Workshop for VI/MSKCC was developed. Blogging is a more public form of narrative that can enhance interaction between patient and reader. This workshop was intended to cut through the walls of isolation and to determine the possible benefits of this form of narrative as a potential therapeutic tool. 22 patients/potential bloggers were brought together. The participants heard and spoke to experienced bloggers, and to each other. They explored a blog format that allowed improved communication with an audience of friends, family and beyond. At the workshop, 18 out of the 19 participants were able to initiate their own personal blog site and publish their first posting. All participants and panelists stayed 45 minutes beyond the allotted time, further addressing the issue of isolation through an observable sense of community. Recommendations include replicating the workshop for other VI participants, plus other patient groups, and developing a group workshop format with other communication methodologies.
Assessing Latino Caregiver’s Knowledge and Understanding of Medication Management for Children
K. Jennifer Johal
Accessing, understanding and using the United States healthcare system is difficult for almost everyone. For people with low literacy and who come from other cultures, these tasks can seem impossible. Existing literature states low parental health literacy among the Latino population is related to poor health outcomes for their children. This project under the auspices of ACN Community Outreach at NewYork-Presbyterian-Columbia University Medical Center, explores Latino caregiver’s health practices and the possible uses of technology, specifically Smartphone applications (apps) to provide information about their child’s health care. The project included two focus group sessions (one in English, one in Spanish) with a total of 17 caregivers of children under the age of five who attend a Washington Heights Head Start Program. The focus groups addressed two aims: (1) to understand caregivers' current knowledge and issues concerning medication administration and management for their children; (2) to assess the current use and effectiveness of existing technology, and Smartphone health apps by caregivers to obtain health information. The findings suggest that Latino caregivers are interested and could benefit from a culturally appropriate and linguistically responsive Smartphone health app. While both focus groups discussed features they would like to see in a health app, the Spanish speaking group emphasized their personal experiences with access, communication with providers, and challenges with navigating the health care system. Latino caregivers identified a lack of trust that they have with the medical system which suggests the need for education of physicians, pharmacists and other health care providers to improve their communication skills and understanding of the needs of the Latino population.
Choose Well, Be Well: Indiana University Health Nutrition Services Transformation
Deborah L. Jones
Indiana University Health, a statewide system of 19 hospitals, serves a state that ranks 9th in obesity and 41st in overall health in the United States. In order to be consistent with its mission to promote healing and wellness, IU Health looked at its retail food venues and mandated a transformation. Choose Well, Be Well (CWBW) is the project conducted by the HAP student in concert with IU Health’s Nutrition Services Department to create a program of evidence-based nutrition standards for general service patient menus and retail venues. CWBW was two-pronged: create a cohesive team from the ranks of Nutrition Services leaders who had never worked together, and devise flexible nutrition standards that would meet the needs of a socially, culturally, and geographically diverse system. The team succeeded in creating standards for 18 components of food and food marketing and started pilot implementation in March. Perhaps the most important accomplishment, however, was developing a way to work together that significantly improved the team’s dynamic—an improvement that can carry over to future Nutrition Services initiatives. Said one member, “I think we are beginning to trust each other.” Sustaining that cohesiveness will depend on the team’s ability to promote IU Health’s healing mission, innovate, communicate consistently with its peers at all locations, and educate its customers about healthful eating both on-campus and off.
#EpilepsyExchange: Social Media Meets Clinical Care
Peer-to-peer health care has molded the way patients handle the adverse affects that come with a medical diagnosis. It allows for patients and their caregivers through online health forums, to engage in conversation with others who share similar health concerns, share their personal journey of diagnosis and treatment, and receive emotional support that is most often times not provided by their physician. One population that does not have any available online health forums is patients with epilepsy and their caregivers. People with epilepsy need support resources such as online health forums, because they have a higher incidence of neurobehavioral disorders than the general public. Epilepsy Exchange was developed through the Mount Sinai Hospital Epilepsy Center and Digital and Social Media Department, to give Mount Sinai patients and caregivers opportunities they could not find elsewhere. Epilepsy Exchange is a private Facebook group that allows them to post narratives and engage in conversation with other group members and physicians. Since the development of Epilepsy Exchange, social media has now given a whole new meaning to clinical care for people with epilepsy.
Fostering Resilience in Grandparents Raising Grandchildren
The number of grandparents raising grandchildren in the U.S. has increased by 50 percent in the last decade. These “grandfamilies” are in need of support and more resources than are currently available for them to be successful parents the second time around. Research identifies children and adults who succeed in spite of adversity as being resilient. This means they possess certain strengths that have allowed them to benefit from protective factors, such as close relationships with their caretakers or communities, and have helped them overcome adverse situations (or risk factors) over time. This project seeks to increase access to a like-minded community, so that individuals are better able to channel and use protective factors to minimize risk and therefore become more resilient. This intervention, in partnership with Riversong Christian Learning Center in California, Maryland, is to create a monthly support group for grandparents. This will help build awareness of the strengths and resources these grandparents already possess, and identify and fill gaps in needed support thereby reducing stress and increasing caregiver self-confidence. By utilizing a modified version of the Parenting the Second Time Around (PASTA) curriculum, this program will help build the parenting skills of these grandparents with the ultimate impact of increased resilience in both the grandchildren and the grandparents. It is recommended that this support group move to the Lexington Park Library as soon as possible and apply for funding from the Department of Aging under the National Caregiver Support Act.
Reducing the Impact of Language Disparities in the Pediatric Emergency Department
Hispanic parents with limited English proficiency (LEP) who seek medical care for their children, experience several barriers which can be divided into three categories: language, literacy and cultural. These barriers include not having or knowing how to access health insurance for their child, language issues, low medical literacy levels and for some, also being undocumented.
To reduce these barriers a pilot volunteer program was developed for the Westchester Medical Center’s Caregiver Center that uses trained bilingual Hispanic volunteers in the pediatric emergency department to meet the needs of Hispanic LEP parents. The Hispanic volunteers are not certified medical interpreters, rather they provide families with resources, listen empathically to their concerns, provide support and serve as a liaison between the Hispanic family and medical staff. Of equal importance, families and emergency department employees are provided with a pictographic Communication Tool that enables day-to-day meeting of basic needs of patients and caregivers while their child receives treatment.
Initial outcome of this program suggests it will provide considerable value to patients, their families and the hospital, including increased patient satisfaction scores, reduction in misunderstandings and the elimination of medical errors.
As follow-up it is recommended for the Caregiver Center, to fully implement the volunteer program; track usage and effectiveness of both the volunteers and the Communications Tool; customize the Communication Tool for various hospital units and languages; and lastly, encourage WMC to comprehensively provide for the language needs of all patients and families.
Listening to the Voices of Patients to Improve Healthcare and Outcomes
Promising research shows that involving patients and family in efforts to improve hospital care can yield dramatic results. Better patient experience in the hospital can also lead to enhanced health outcomes. The HAP student, under the auspices of the Montefiore Health Systems Customer Service Department developed the Voices of the Patient/Family Task Force project, which sought to bring this innovative approach to Montefiore. The program’s twofold goals were to decrease the prevalence of key points of patient dissatisfaction and to ensure Montefiore’s compliance with Centers for Medicare and Medicaid requirements for responding to patient concerns. To achieve the program goals, project staff proposed the creation of a task force consisting of patients, their families and staff. The task force would serve as the mechanism for involving patients and their families in improving care at Montefiore. Through the task force, members would give their perspective on prevailing themes found in grievance narratives filed by patients. Project staff expected that the patients’ input would improve staff understanding of problems and concerns. Knowing the right problem would increase the chances of making the right fix. While substantial progress occurred in data collection of key themes, reporting, and recruiting Task Force members, Montefiore temporarily suspended the program when the project leader retired from the organization. In the meantime, the HAP student encouraged hospital leaders to continue to utilize the project data as it provides a solid foundation to guide efforts to improve patient experience.
Not Getting in on the Ground Floor: What a Hospital-Based Program Can Teach Us About Supporting Chronically Ill Students in Higher Education
Chronically ill students have poorer educational outcomes when it comes to college than their healthy counterparts, including taking longer than average to graduate or not graduating at all. While this should be a concern for institutions of higher education, none contacted were responsive to this project. This capstone project therefore focused on students involved in the Charla de Lupus program, part of the Lupus Program at the Hospital for Special Surgery. For lupus patients, there were two main factors that impacted their knowledge about college: 1) Many students with lupus did not know about the resources available to them prior to college, and often found out about them when it was too late, and 2) Many people with lupus did not consider themselves to be disabled, which meant that even if they knew about resources, they did not take advantage of them. After conducting key informant and stakeholder interviews, and a targeted survey of students with lupus, a guide for physicians about how to talk to their patients about college was created, along with a tip sheet for students. For students and parents, 93% of participants felt that: 1) The tip sheet was useful, 2) They would use it in the future, and 3) They felt more confident about college planning. Some recommendations for the future include one-on-one coaching of students when they are applying to college, and using what was learned in this project and applying it to institutions of higher education.
The Health Advocacy Graduate Program includes both recent college graduates and career-changers in pursuit of a second or third career.
Career-changers may be professionals with backgrounds in the arts, business, law, medicine, nursing, and social services. Recent undergraduates come from colleges and universities all over the country, with degrees in a wide variety of disciplines. This diversity in personal experiences greatly enhances class discussions.
Many students work and/or take classes in addition to managing families and careers. Yet all students share the desire to contribute to positive change in the health care system.
There are a variety of options to earn accelerated or dual degrees with Health Advocacy:
- Sarah Lawrence College undergraduate students can take an accelerated program that will allow them to earn a bachelor’s degree and a Master of Arts in Health Advocacy in five years.
- Dual degrees have been offered with the Joan H. Marks Graduate Program in Human Genetics, the Graduate Program in Child Development and the Graduate Program in Women’s History.
In addition, the M.A in Health Advocacy and M.S.W with NYU Silver School of Social Work dual degree launched in fall 2015. Learn more»