Experiences of professional public health advocacy in the UK health and social care system: a qualitative survey study [using the Theoretical Domains Framework]

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ID: 313533
2026
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Abstract
Abstract Background Advocacy of public health principles (PHP) is crucial to tackling health inequities. Advocacy skills are therefore a core competency of Public Health speciality training in the UK. A survey of UK-trained specialist registrars found that the perceived ability to advocate for PHP varied significantly across work settings. This study explores barriers and enablers to PHP advocacy across workplaces, offering insights into how advocacy can be better supported in the UK public health landscape. Methods An online survey was sent to UK-based public health specialty trainees, consultants, and public health practitioners on the portfolio route to consultant practice currently. Free-text survey responses were analysed using template analysis and the Theoretical Domains Framework. Results Sixty-four respondents completed the survey. This study found that role clarity, organizational support, and advocacy skills significantly affect public health specialists’ ability to advocate. Barriers included unclear responsibilities, fear of consequences, resource constraints, and inadequate training and mentorship. Supportive leadership and shared values facilitated success. Conclusions To promote advocacy, the Faculty of Public Health should ensure specialists are positioned as autonomous experts, address biases in recruitment, and integrate advocacy skills further into training. Organizations must evaluate how their structure, culture, and leadership support public health advocacy.
Reference Key
openalex_W7161054533 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Kaat Marynissen, Akshay Pabary, Malcolm Moffat
Journal turkish journal of public health
Year 2026
DOI
10.1093/pubmed/fdag035
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