STRATEGY OPTIONS

One particularly useful framework for conceptualizing advocacy strategies is a model formulated by Jack Rothman during the 1960s, at a time when many health and human service professionals were working with communities in controversial, quasi-political roles. Rothman (1968) outlined three very different types of policy advocacy (or "community organization practice"), which he termed locality development, social planning, and social action.

The first of these types, locality development, is appropriate where a high degree of consensus exists about a social problem. Here advocacy is a matter of mobilizing slack resources and energizing the interested parties around a common concern. An example of locality development would be a rural health nurse working with community residents and local organizations to monitor and safeguard the quality of local well water. A professional practicing this kind of advocacy needs skills in organizing, program development, communications and public speaking, coalition building, and mediation. The individuals and communities being helped are seen as clients, and the interactions between service providers and service recipients are warm and process-oriented. The effort is inclusive and cooperative. Any conflicts that arise are settled by empathetic understanding and compromise.

The second type, social planning, also presumes considerable consensus on the nature of the problem. This kind of advocacy effort tends to be highly technical—determining the optimal distribution of a scarce resource, or the most cost-effective technology for achieving an agreed-upon service outcome. The effort might well involve high-level inter-disciplinary collaboration with other health and human service professionals. For instance, nurses might be involved in a planning a program to address radon exposure in the community. Working with other technical experts, they would help plan and carry out surveys and epidemiologic studies to characterize the problem; design testing and remediation procedures; plan a risk communication strategy; and evaluate the intervention's effects. The skills needed emphasize scientific expertise, program planning, and evaluation research. In this kind of effort, those being helped are viewed as end consumers, who need to be consulted and kept informed but not necessarily involved in the technical details. The interactions among planners in this approach are usually task-oriented and somewhat impersonal. If conflicts should arise, they are (in theory) resolved rationally in the public interest, based on the best available expert opinion.

The third type, social action, applies to situations with strong disagreement over the nature of the problem, serious interest conflicts among the



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