1. Evaluating the Strength of the Advocacy Field A prospective look at the Missouri health advocacy ecosystem Tanya Beer Center for Evaluation Innovation & Innovation Network Ryan Barker Missouri Foundation for Health

2. Policy Target Approach Advocacy Niche Approach Field Building Approach Grantmaking and auxiliary activities are designed to build the capacity and influence of the field of advocacy organizations to shape and respond to a shifting policy environment Grantmaking and auxiliary activities are designed to advance a specific policy goal Grantmaking and auxiliary activities are designed to strengthen the presence or influence of a particular strategic function (e.g., policy analysis and research, grassroots organizing, media advocacy) within the advocacy and policy arena Three Approaches to Advocacy Grantmaking

3. Individuals and organizations working intentionally to influence a particular policy domain. What’s an Advocacy Field? Advocacy Field Building Approach

4. Through its field building work, the Missouri Foundation for Health aims to build the influence of consumer health advocates working at all levels of health policy in Missouri. Our Case: Strategies to Date: General operating support to a wide range of advocacy organizations Regular convenings to build relationships and shared analysis among a large number of advocates Development and support of a “big umbrella” coalition Technical assistance and training on advocacy skills and strategies Support with policy analysis/policy content knowledge

5. Dimensions of an Advocacy Field Field Frame Field Skills & Resources Connectivity Composition/Voice Adaptive Capacity

6. A common frame of reference through which organizations identify themselves as a field and part of a common enterprise. Field Frame To what extent to advocates consider themselves part of a common enterprise? How does the field frame affect who is within the advocates’ “field of vision”? Would other frames help a wider array of advocates begin to align their efforts? Evaluation Questions

7. The array of advocacy skills, resources and knowledge that are the building blocks for making progress on a wide variety of policy issues throughout all stages of the policy process. Field Skills and Resources To what extent to does the field of advocates as a whole include the array of skills and policy content knowledge that are important in the Missouri policy landscape? Are there chronic “skill gaps” that plague advocacy efforts repeatedly over time? Are skills concentrated in certain kinds of organizations, and how does that affect policy progress and power dynamics between advocates? How does the Foundation’s grantmaking affect the array and dispersion of skills, resources and content knowledge? Evaluation Questions

8. The capacity of advocates to communicate and cooperate in a way that allows resources to be marshaled in increasingly productive ways over time. Connectivity What kinds of connections exist between which advocates, and how does that affect their ability to capitalize on one another’s strengths? How do gaps in connectivity affect the kinds of policy solutions that emerge or the kinds of strategies advocates deploy? How does the Foundation’s grantmaking motivate (or discourage) productive connections and among whom? Evaluation Questions

9. The variety and relative power of voices that can participate meaningfully and have influence in the policy process. Composition and Voice What constituencies have access to and influence on the policy process and within the field of advocates? How does the composition of the field affect the quality of policy solutions that emerge or the likelihood of successful implementation? How does the Foundation’s grantmaking affect relative power or voice among advocacy organizations? Evaluation Questions

10. The ability of advocates to conduct sound political analysis, select the tactics that are best suited for a particular situation, and to adapt to the shifting moves of the opposition, allies, and potential allies. Adaptive Capacity What are the barriers and facilitators of adaptive capacity? To what extent do clusters of advocates conduct shared political analysis, and does it affect their ability to act strategically as a group? How does the Foundation’s grantmaking support or impede the ability of advocates to adapt their strategies in a timely and effective way? Evaluation Questions

11. Evaluation methods Bellwether & Stakeholder interviews 1 Participatory Assessment Advocate Survey & Database 2 3 Field Scoring Rubric 4

12. Adaptive Capacity 1 Participatory Assessment 2 Interviews 4 Field Rubric Example: H-Form Method Focus Groups at an annual advocacy retreat with 50+ advocacy organizations

13. Strongly Disagree Strongly Agree Reasons to Disagree Reasons to Agree STATEMENT 1 Participatory Assessment of Adaptive Capacity H-Form Method for Focus Groups

14. Strongly Disagree Strongly Agree Reasons to Disagree Reasons to Agree “We respond to the moves of the opposition in a timey way.” My organization 1 Participatory Assessment of Adaptive Capacity H-Form Method for Focus Groups

15. 1 Strongly Disagree Strongly Agree Reasons to Disagree Reasons to Agree “We respond to the moves of the opposition in a timey way.” My organization The field of consumer health advocates 1 Participatory Assessment of Adaptive Capacity H-Form Method for Focus Groups

16. Findings are being triangulated with data from interviews and the advocate survey. 8 questions selected by advocates to explore adaptive capacity, such as… We regularly commit time to analyzing the environment and deciding how to respond. We have the right balance of being proactive and reactive. We have decisionmaking processes that help us decide and respond quickly to changes in the political landscape. We have the financial flexibility to change direction when needed.

17. 1 Participatory Assessment Field Skills and Resources 2 Interviews 3 Advocates Survey

18. 1 Participatory Assessment Field Skills and Resources 2 Interviews 3 Advocates Survey

27. Evaluation methods Bellwether & Stakeholder interviews 1 Participatory Assessment Advocate Survey & Database 2 3 Field Scoring Rubric 4

28. Our aim is to help MFH answer questions like… Are there significant skill or knowledge gaps we need to address among certain types of advocates? Where should we build skills within organizations vs. linking advocates with different skill sets together? Between what kinds of advocates is there a connectivity problem and why? And with what kinds of policy issues will this trip us up? Do “missing constituencies” in the policy arena warrant supporting new organizations or building the capacity of existing organizations who represent them? Where and among whom do we need to support increased time for shared political analysis? What other constraints to adaptive capacity can be addressed via grantmaking or auxiliary supports?

29. Paired Discussion Field Frame Field Skills & Resources Connectivity Composition/Voice Adaptive Capacity 1.How would you characterize your field along these dimensions? 2.Which 1-2 dimensions are you most concerned about in your own context and why? 3. What other ideas do you have for assessing the state of the field in one or more of these dimensions?