Models of Advocacy: Theory and Practice. Two semesters. This course explores the multiple roles health advocates assume as they create productive change on behalf of patients/consumers, families, and communities. Advocacy is practiced by improving the way health care is delivered within existing systems, by restructuring or reinventing areas of the health care system, and by eliminating barriers to health caused by environmental destruction, poverty, and illiteracy. Throughout the year, students will be exposed to leaders who practice in diverse arenas within this interdisciplinary field, including clinical settings, community-based organizations, advocacy organizations, the media, interest groups, governmental organizations, and policy settings. They will learn to analyze organizations and communities in order to understand hierarchies and decision-making within them, and be exposed to frameworks for conceptualizing and promoting the right to health. The course will also explore strategies to give health advocates and consumers more power in making decisions, defining issues, designing programs, and developing policies. The experiences of individuals and communities, and how systems respond to these experiences, will remain a central focus as students explore concepts, models, and practices of health advocacy.

Economics of Health. This course will examine the major issues facing the American health care system from an economic perspective. A wide range of topics will be covered, from the racial and economic disparities of health and health care, to financing the medical care delivery system. Students will learn how the tools and analytic approaches used by health economists can enhance understanding of major public health issues such as AIDS, drug abuse, and mental health, as well as key health care financing issues such as drug pricing, the rising cost of health care, and our fragmented insurance system.

Ethics and Advocacy. This course explores a range of ethical dilemmas confronting clinicians, patients, families, and administrators arising in acute care, ambulatory-care settings, long-term care facilities, and other institutions providing health care. Included is an examination of issues such as informed consent, competency/capacity to make decisions, refusal of treatment, withholding and withdrawal of life-sustaining treatment, physician-assisted suicide and euthanasia, confidentiality, maternal-fetal conflicts and treatment, physician-patient relationships, research ethics, and implications of new genetic advances and technology. The goal is to integrate a didactic approach to the issues with the student’s own fieldwork placements and provide students an ethical framework within which to consider dilemmas that may arise in the course of patient advocacy. In-depth discussion focuses on fundamental ethical principles of autonomy, beneficence/non-malfeasance, and justice, as well as specific legal concepts. Students are provided with a range of perspectives necessary to assess and resolve dilemmas that arise in clinical practice.

Program Design and Evaluation. This course will focus on aspects of program design for health advocates, including assessing the need for and the effectiveness of advocacy initiatives. Students will discuss and study elements of design and evaluation, the major theoretical orientations to evaluation research and the practical, ethical, and methodological problems involved in applying research methods in health-related settings. Major topics include how to approach program conception and implementation, including developing and measuring program goals and objectives, data collection techniques, types of samples used in evaluation, and statistical and data analysis techniques.

Health Care Policy. This course will examine the formulation, implementation, and evaluation of health care policy. It will focus on the interaction of the health care system with the federal, state, and local political systems. Individual pieces of health policy will be used to study the evolution of health policy and the impact of health policy on health care in the United States.

Health Law. This course introduces students to a broad range of legal and policy issues surrounding the provision of health care. The course will focus on three areas: rights of patients in their relationships with health care professionals and institutions; licensing and regulatory issues; and conflicts between the rights of individuals and the interests of society.

History of Health Care in the United States. From colonial times, access to health care has been less a history of access and inclusion and more one of exclusion and organizing to guarantee its access to the increasingly diverse population of a growing country. In this conference-based course, we will explore the varied understandings of health and medical care from colonial times to the late 20th century. Topics to be considered will include the role ethnic, racial, gender, and religious identity played in access to and provision of health services; the migration of health care from home and community — midwifery, homeopathy — to institutions — nursing, hospitals — and the social conditions that fueled that migration; the struggle for ascendancy among the different fields of medical education; and the creation of the field of public health, its role in defining and controlling outbreaks of disease, and its impact on addressing inequities in access to health care services. Course participants will prepare a major research paper investigating an aspect of the history of health care of special interest to them. The conference paper will be developed through regular meetings with the instructor and in conjunction with other course participants.

Illness and Disability Narratives The experience of illness and disability is both intimately personal and reflective of larger social, political, and cultural realities. In order to effectively work in direct patient care, or broader scholarly or organizational arenas, a health advocate must be able to interpret and understand personal, communal, and institutional narratives. This course will introduce students to written and visual narratives of illness and disability, narrative and cultural theory, as well as media studies. Students will write their own illness or disability narratives during the course session — exploring issues such as selfhood, perspective, memory, family, and caregiving. Finally, students will elicit, transcribe, and interpret the oral narrative of an individual with a chronic illness or disability.

Physiology and Disease. This course provides first-time physiology students with an introductory survey of the major areas of human physiology. The focus will be the major systems of the human body. In addition to the normal physiology of the system, representative disease states will be studied to highlight what can go wrong. Special topics will include medical terminology and medical record abbreviations. Students will be introduced to diagnostic techniques such as laboratory testing and diagnostic imaging. The course includes student presentations as well as a midterm examination. (A basic human biology course is strongly recommended before taking this course for students who have not studied human biology or anatomy and physiology at a college level or beyond.)

Research Methods for Health Advocacy. This course introduces students to the research process that supports effective health advocacy in the community. Students will learn the principles of literature review, environmental scan, issues specific to community-based work and needs assessment, and will be exposed to the process of ethical approval for research involving human subjects in the community. They will have an opportunity to apply these principles of research in the community setting, gaining an in-depth understanding of context-driven community-based participatory research, and the concept of co-production of knowledge. Students will develop assessment and evaluation skills gaining practical experience and applying statistical principles. By introducing students to data collection concepts and SPSS analysis, this course establishes foundations that will be further refined in subsequent coursework in the program.

Fieldwork Pro Seminar. This professional seminar focuses on the fieldwork requirement of the program, where students have direct, hands-on work experience. The seminar is a combination of group classroom sessions and individual meetings with the fieldwork coordinator. Goals are to identify core skills necessary for fieldwork, including researching opportunities, developing appropriate goals for internships, and maximizing experiential opportunities for networking and career development.

Capstone Pro Seminar. The Capstone Project and seminar provide health advocacy students with the opportunity to integrate their academic learning with field experience, examining how theoretical advocacy themes are made operational in workplace settings. It is designed to enhance the coherence of students’ educational experience and further develop their sense of professional identity. The project generally builds on the third and final fieldwork placement, and is supported by the “Capstone Pro Seminar.” The seminar provides students with a strategic perspective on how the field is evolving and the skills to successfully navigate a rapidly changing profession in a health care system poised for significant reform. The seminar is designed to facilitate students’ work on their Capstone Projects by providing them with a group setting in which to explore ideas and refine project parameters, connect the project to broader advocacy concepts and career development opportunities, and receive regular feedback on Capstone progress.

Electives. Students who enter the program having done graduate work in one of the required course areas, or students wishing to do additional course work, may select from graduate and cross-listed courses in other College or graduate departments.

Fieldwork. Through on-site supervised training, students learn to apply classroom theory to practice and develop their capacities as advocates. Students, the fieldwork coordinator, and faculty advisers tailor three field assignments to students’ specific interests, learning objectives, and career goals. Fieldwork affords each student an invaluable opportunity to build a network of professional connections in a specialized area of advocacy practice.

The “Fieldwork Pro Seminar” prepares students for the fieldwork experience and supports their professional progress. Students meet individually and in the Fieldwork Pro Seminar to learn how their individual experiences relate to the larger arena of advocacy in which they are working. The Capstone Project, in the final year of study, may build upon the third fieldwork placement and relate to the student’s chosen area of advocacy specialization.

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 settings from which to choose fieldwork placements during the academic year. Students may also arrange summer placements in geographic areas where they intend to work after graduation. Students select placement sites from a large database of previous internships or may develop new internship experiences.