This section gives examples of how the public health advocacy model relates to experiences in practice. The following two cases studies have been analysed to show how the key aspects of the model fit into real situations. It should be noted that the interactive aspects of the components, tasks and steps are more clearly seen in the full version of these case studies, which, together with other case studies on public health advocacy, are also available on the website.

Advocating for a Smoking Ban in Northern Ireland - The role of ASH Northern Ireland

Authors: Gerard McElwee & Anne Devlin, Ulster Cancer Foundation

Background
The Ulster Cancer Foundation established the 'ASH' committee to advocate for smoke-free environments in Northern Ireland in 1973 (amongst other smoke related issues).

On Monday 30th April 2007 'The Smoking (Northern Ireland) Order 2006' came into effect which means that it is against the law to smoke in most enclosed/substantially enclosed workplaces and public areas. This legislation is the culmination of many years of campaigning for smokefree places undertaken by ASH Northern Ireland together with local partners and international coalitions.

Providing Strategic Leadership

In scanning the external environment to identify opportunities to strengthen the case ASH focused on:

• Clarifying the main aim of the case and highlighted 10 key areas
• Linking their advocacy campaign to the Smokefree Legislation in the Republic of Ireland, in particular its successful implementation
• Identifying allies at local, national and international levels
• Identifying and using opportunities to met with/negotiate with and attempting to influence key political people/parties
• Keeping the subject on the agenda of related organisations/media etc
• Raising public awareness of the campaign and the key issues

Undertaking Core Activities - the main actions taken to support the case included:

• Awareness raising seminars about the need for smokefree public places
• Continually lobbying government and other relevant people/organisations to keep the topic on everyone's agenda
• Introducing Smokefree Premises Awards to encourage support from local business and raise general awareness
• Publicising the campaign in the media
• Clarifying the preferred option in relation to a Department of Health 20 year strategy on smoking
• Building a collation of 45 key leaders from a range of organisation around Northern Ireland to strengthen the case and maintain momentum and support.
• Building support within the media

Support activities that helped build the momentum and achieve success were:

• Attending party political conferences to hold fringe meetings on this issue
• Sending letters to Members of Parliament, Members of the European Parliament, and Members of the Local Assembly seeking their support
• Producing information leaflets and stickers to educate the public on the dangers of secondhand tobacco smoke
• Well targeted and timely press releases
• Websites providing information on and arguments for smoke free environments
• Gathering and presenting information on statistics on response to consultation process
• Methods used to increase public awareness and make it easy for the public to reply to the consulation on proposed legislation included:
• Freepost postcards
• Posters
• Letters
• Smokefree websites
• Press releases
• Newspaper cut-out voting forms
• Public meetings

The voice of older people in Donegal
Author: Ann Marie Crosse

Background
The Voice of Older People Donegal project began as a pilot programme funded by the Health Promotion Department of the North Western Health Board and the Department of Health and Children. The aim of the pilot was to develop the capacity of older people to articulate their needs and concerns and to develop methods of moving individual issues into a collective agenda and a collective voice. Over three thousand older people and agencies participated in this process. As the process was left open-ended and dynamic information flowed in and out of the discussions, new issues emerged and more isolated and hard to reach older people joined in, adding new dimensions. Overall the engendered the belief that issues of importance to people were heard and acted upon.

Providing Strategic Leadership

Scanning external environment

• A mapping process was undertaken at local, county, regional, national and European level to ascertain the level of activity and the various organisations working with or with a remit to work with older people
• Building on the initial mapping process an older person was employed to develop a second level mapping which consisted of collating data on community and voluntary groups.

Positioning movement

• Once the networks were established it was clear that it was important to cement a collective identity .To do this county representative group was formed comprising two people from each of the five network areas. This enabled a two-way flow of information.

Undertaking Core Activities

Defining the idea

• Early in the development of the project the importance of advocacy was recognised and an Advocacy Action Plan was developed involving various levels of advocacy from self-advocacy to social change advocacy. The plan covers four areas: health; ageism; transport; and information.

Strategic significance

• Decision makers were invited to join the County Forum which now comprises ten older people and eight service sector representatives.
• The development of a collective strategic agenda rather than ad hoc individualised needs-led plans was found to be more effective in influencing decision makers.

Building the movement

• Five networks were set up across Donegal to discuss issues that were important to them, formulate plans and take action to address these issues.
• Partnership working, collaboration and pooling of resources helped to join fragmented service provision together. Partnerships were made with the community and voluntary sector as well as Community Development and Family Resource centres and the State sector.
• Sessions were help on citizen involvement and linked to the Irish Senior Citizen's Parliament, Age Action, Age and Opportunity, among other voluntary organisations.

Support Activities

Communication for advocacy

• Information sessions were held in rural, isolated areas and areas of where people gathered (e.g. GPs surgeries and marts) - targeting vulnerable and isolated older people- particularly older men.
• Information outputs, which not only serve to provide information but also reflect a collective identity and purpose included:
• Monthly newsletter
• Literary magazine called 'The Silver Pen'
• Project leaflet ' The Voices of Older People at Local Level'
• Collecting information and stories
• Community arts programmes were used as a platform to vocalise issues and disseminate information- e.g. a play on ageism called Age Rage and another on a returned emigrant's story
• A series of 'Celebration Days' and Active Citizenship days were held. The aim of these days was to explore issues in which older people were interested and to develop from these a positive sense of the ageing process.

Maintaining progress

• The County Forum meets once a month to examine key issues emerging from the local level.
• Using the baseline and ongoing information and evidence two posts have been established to maintain progress within the project.

Acting ethically

• The principles of community development were core to the process as demonstrated by active participation in identifying issues, implementing responses and advocating for change.
• All new aspects of the project have been designed based on locally identified need.