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Developing Effective Written Communication and Advocacy Skills in Entry-Level Health Educators Through Writing-Intensive Program Planning Methods Courses Regina A. Galer-Unti, PhD, CHES Marlene K. Tappe, PhD, CHES

Written communication is a requisite skill for practitioners in the field of health education. Advocacy skills are now considered to be both a professional competency and an ethical responsibility. Given that many advocacy strategies involve written communication, it makes sense that the skills of writing and advocacy be developed concomitantly and within a writing-intensive class. The purposes of this article are twofold: (a) to describe the role of writing-intensive program planning methods courses in the development of written communication and advocacy skills in entry-level health educators and (b) to suggest strategies for planning, implementing, and assessing writing-intensive assignments and instructional activities designed to develop students’ written communication and advocacy skills. Multiple examples of writing assignments are presented that can be used in helping students in developing their critical thinking, writing, and advocacy skills. Keywords: health advocacy; health education; writing intensive; professional preparation; health advocacy

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ritten communication skills are a requisite professional competency of health educators (National Commission for Health Education Credentialing, Inc. [NCHEC], 1986). Advocacy skills are not only a professional competency (Institute of Medicine, 2003) but also an ethical responsibility of health educators (National Task Force on Ethics in Health Education, 2000). Furthermore, advocacy is a critical strategy in achieving policy changes that support a socialecological approach to health (Altman, Balcazar, Fawcett, Seekins, & Young, 1994; Anderson, Scrimshaw, Fullilove, Fielding, & Task Force on Community Health Promotion Practice January 2006 Vol. 7, No. 1, 110-116 DOI: 10.1177/1524839904270503 ©2006 Society for Public Health Education 110

Preventive Services, 2003; McKinlay, 1993; McLeroy, Bibeau, Steckler, & Glanz, 1988; Stokols, 1996; Task Force on Community Preventive Services, 2003; Wallack, 1994; Wallack & Dorfman, 1996; Wallack, Dorfman, Jernigan, & Themba, 1993). Multiple authors note that prospective and practicing health educators need professional preparation and development experiences to develop their knowledge and skills related to health advocacy (Allegrante, Moon, Auld, & Gebbie, 2001; Auld & Dixon-Terry, 1999; Birch, 1991, 1995; Caira et al., 2003; Freudenberg, 1982; Galer-Unti, Tappe, & Lachenmayr, 2004; NCHEC & Coalition of National Health Education Organizations, 1996; Ogden, 1986; Tappe & Galer-Unti, 2001; Temple, 1999). These professional preparation and development experiences should increase participants’ knowledge and skills related to health advocacy, develop their understanding of advocacy as a social-ecological approach to health (Altman et al., 1994; Anderson et al., 2003; McKinlay, 1993; McLeroy et al., 1988; Stokols, 1996; Task Force on Community Preventive Services, 2003; Wallack, 1994; Wallack & Dorfman, 1996; Wallack et al., 1993), and enhance their confidence or self-efficacy (Bandura, 1997) to engage in advocacy activities. Self-efficacy or confidence in one’s ability to engage in advocacy is important, because efficacy expectations are associated with health educators’ participation in advocacy activities (Holtrop, Price, & Boardley, 2000). Therefore, health educators need increased opportunities to learn advocacy skills through multiple venues including, but not limited to, professional preparation programs in institutions of higher education. Many advocacy strategies, including media advocacy strategies (Wallack, 1994; Wallack & Dorfman, 1996; Wallack et al., 1993), involve written communication including, but not limited to, letters, letters to the editor, opinion editorials (op-eds), written testimony, and issue briefs. Given that written communication and Authors’ Note: This article is based on a presentation given at the midyear Society for Public Health Organization Scientific Conference in May 2002 in Cincinnati, Ohio.

Rationale for Writing-Intensive Courses The Authors Regina A. Galer-Unti, PhD, CHES, is an assistant professor at Purdue University in West Lafayette, Indiana. Marlene K. Tappe, PhD, CHES, is an associate professor at Purdue University in West Lafayette, Indiana.

advocacy are requisite skills of health educators and that many advocacy strategies involve written communication, it makes sense pedagogically to teach writing and advocacy skills concurrently through writingintensive courses. The purposes of this article are to (a) describe the role of writing-intensive program planning methods courses in the development of written communication and advocacy skills in entry-level health educators and (b) suggest strategies for planning, implementing, and assessing writing-intensive assignments and instructional activities designed to develop students’ written communication and advocacy skills.

COURSES > WRITING-INTENSIVE AND DEVELOPMENT OF WRITTEN COMMUNICATION AND ADVOCACY SKILLS Writing-intensive courses are courses in which writing is integral to students’ achieving the learning objectives of the course. The following sections include a description of writing-intensive courses, the rationale for writing-intensive courses, writing-intensive methods courses in health education, and the rationale for teaching advocacy skills in writing-intensive methods courses. Characteristics of WritingIntensive Courses Writing-intensive courses require a diversity of formal and informal writing assignments that occur on a regular basis throughout the course of the semester and that account for a significant portion of the course grade. Students in writing-intensive courses are required to produce more polished writing than in other courses and to do so through a series of drafts and revisions. This technique of writing and feedback aids students in honing their writing skills and thinking critically about the subject matter (Bean, 1996). Institutions of higher education vary widely in their requirements for writing-intensive course administration; however, the underpinning principles of drafts and revisions remain constant across colleges and universities. To sample the variety of approaches to writing-intensive coursework, enter “writing intensive courses” into a search engine, obtain a copy of The WAC [Writing Across the Curriculum] Journal, or consult with the English department on your campus.

A number of disciplines use writing-intensive courses (Bean, 1996) including nursing (Silva, Cary, & Thaiss, 1999), pharmacy (Ranelli & Nelson, 1998), and health education (Galer-Unti, 2002). Advocates of writing-intensive courses propose that these courses have the capacity to improve not only students’ written communication but also their critical thinking skills (Bean, 1996; Emig, 1977; Galer-Unti, 2002; Grauerholz, 1999; Popovich & VanVeldhuizen-Scott, 1994; Valde, 1997). Additionally, Galer-Unti (2002) found that writingintensive courses also improve students’ perceptions of confidence to use written communication skills. The value of writing-intensive courses and increased writing in classes is widely discussed in the literature of college teaching. Professors report that writing and the concomitant practice of revision tends to lead to an improvement or refinement of writing skills (Davis, 1987). Discipline-based writing-intensive courses help students in beginning to think like members of their profession (Bean, 1996) and to use the stylistic methods and terminology of their discipline (Bean, 1996; Popovich & VanVeldhuizen-Scott, 1994; Ranelli & Nelson, 1998; Simpson & Carroll, 1999). Galer-Unti (2002) found that when a writing-intensive course appears in a health education curriculum, students learn the importance that the discipline places on writing. It is also proposed that critical thinking skills are improved in writing-intensive courses. Bean (1996) attributed this to a heightened interchange between a professor and student that is a necessary requirement of a writing-intensive course. Writing is an active way to encourage students to begin to see the connections between pieces of information and demands that they articulate these relationships (Emig, 1977; Hilgers, Hussey, & Stitt-Bergh, 1999). Interestingly enough, students also report that writing-intensive courses are helpful to them. Students at the University of Hawaii at Manoa reported improvement in their writing and critical thinking skills as a result of their writing-intensive coursework (Hilgers, Bayer, Stitt-Bergh, & Taniguchi, 1995). Writing-Intensive Courses in Health Education Galer-Unti (2002) assessed undergraduate majors’ perceptions related to a writing-intensive health education methods course and found that students reported high levels of improvement in their writing and critical thinking skills. These findings are in concert with studies performed on students in writing-intensive courses in other disciplines. Galer-Unti found associations between students’ perceptions that the writing-intensive course improved their writing skills, perceptions of confidence in their writing skills, critical thinking skills, and learning in the course. The students’ perceptions of improvement in their writing skills were also Galer-Unti, Tappe / WRITING-INTENSIVE COURSES

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associated with their beliefs that the feedback on their writing assignments was helpful, the opportunities for revision were helpful, the amount of work was reasonable, and the exams had appropriate writing exercises. Rationale for Teaching Advocacy Skills in a Writing-Intensive Course Apart from the fact that many advocacy strategies involve written communication and it makes pedagogical sense to concurrently teach these skills, there are other reasons why it is logical to develop writing and advocacy skills through writing-intensive courses. One of the most difficult skills to teach future advocates is how to present their advocacy message in a clear and concise manner. Writing-intensive class assignments are designed to aid students in learning how to edit for succinctness. Furthermore, one of the keys to successful advocacy is matching the advocacy strategy to the audience. Well-developed writing assignments help students to think critically about the application of different advocacy-related strategies to different problems and ways to craft messages so that they capture the attention and interest of their intended audience. Therefore, the writing-intensive classroom provides a unique opportunity in which to educate students in the formation of well written, brief, and clear advocacy messages while, at the same time, building confidence or self-efficacy to engage in advocacy activities.

IMPLEMENTING, > PLANNING, AND ASSESSING WRITINGINTENSIVE ASSIGNMENTS AND INSTRUCTIONAL ACTIVITIES The planning, implementation, and assessment of writing-intensive assignments and instructional activities designed to develop students’ written communication and advocacy skills will vary from one institution of higher education to another because of differences in institutional support for, and requirements related to, writing-intensive courses. Some institutions may provide faculty members with workshops to help them plan, implement, and assess writing-intensive courses. Other institutions have guidelines and approval processes for teaching courses designated as writing intensive. Despite these variations in institutional commitment to and requirements for writing-intensive courses, there are ways in which faculty can begin to integrate writing-centered assignments and instructional activities into health education methods courses that enable students to concomitantly develop written communication and advocacy skills. The following sections include suggestions for planning, implementing, and assessing writing-intensive advocacy assignments.

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Planning for Writing-Intensive Assignments and Instructional Activities Planning for writing-intensive assignments and instructional activities designed to develop students’ written communication and advocacy skills begins with identifying the health education competencies and course learning objectives that will be met by writingrelated classroom activities and assignments. The next step is to identify writing assignments and learning activities linked to advocacy-related knowledge and skills and integrate these assignments and learning activities into the course syllabus. These assignments may include formal writing assignments as well as informal writing assignments. Examples of formal writing assignments that emphasize advocacy skills include the development of letters to the editor, op-ed pieces, letters to policy makers, rationale statements, talking points, issue briefs, written testimony, public service announcements, paid advertisements, and news releases. Examples of informal writing assignments that can be linked to advocacy-related classroom learning activities include individual or cooperative note taking, lecture summaries, guided journal entries, and free writes (see Bean, 1996). Planning for implementing writing-intensive courses includes assuring that the number, nature, and timing of both formal and informal writing assignments are commensurate with the institution’s expectations for writing-intensive courses. Additionally, faculty members must consider the time constraints of grading these assignments and plan accordingly. Once both the formal and informal writing assignments have been identified, it is important to develop written instructions for formal writing assignments and, if needed, for informal writing assignments. For each formal writing assignment, students should be provided with the following information related to the assignment: the role of the author and the real or hypothetical audience, the writing task, the format of the written response, the process steps for the assignment, and evaluation criteria (Bean, 1996). One example of a task for a health education advocacy-related writing assignment is the preparation of a letter to the editor advocating for comprehensive school health education (see Figure 1). Examples of potential audiences for advocacy-related writing assignments include local, state, and federal policy makers; the media; and the general public. Information related to the format of the assignment such as its length should be consistent with the advocacy-related task. For example, format guidelines for an op-ed piece should be consistent with those used by a local or regional newspaper. The process steps for writing assignments are often linked to the instructional activities (see Figure 1). The process steps may include, but are not limited to, identification of the

key facts and points related to an advocacy issue, small group or other in-class instructional activities related to the advocacy issue, submission of polished drafts of the writing assignments, in-class and out-of-class peer reviews, attendance at individual or group conferences with the instructor, and revision and submission of the final version of the assignment. The criteria for assessing the assignment may be integrated into a scoring rubric that includes points related to completion of the process steps as well as the quality of the final version of the document in terms of its content and readability (see Figure 1). Implementing Writing-Intensive Assignments and Instructional Activities The processes associated with both formal and informal writing assignments designed to develop students’ written communication and advocacy skills are directly associated with the nature of the learning activities. The first step in the implementation of writing-intensive experiences, however, is to set the stage for the course. This includes a discussion with students of the rationale for and expectations related to these experiences. This discussion, and ongoing communication with students regarding the process and expectations related to course assignments, will facilitate the successful implementation of writing-intensive activities. Formal and informal writing assignments can be linked to a wide variety of instructional strategies. Students can be required to integrate advocacy-related lecture material into formal writing assignments as well as informal writing assignments such as lecture summaries, individual or cooperative note taking, guided journal tasks, and free writes. Students can also complete summaries, guided journal tasks, and free writes after they have participated in classroom discussions, debates, and case studies related to advocacy strategies and issues. A variety of writing tasks can be integrated into simulations as students take on roles in mock community forums, legislative hearings, and city council and school board meetings. Students can also be encouraged to attend, participate in, and write about meetings such as school board meetings where they can observe how advocacy messages are received by policy makers. In this manner, students gain an appreciation for their classroom work and may be motivated to embrace advocacy and writing skills with a newfound sense of direction and purpose. Classroom learning activities related to formal writing assignments that emphasize advocacy skills include, but are not limited to, small group or roundrobin activities in which students discuss points they have developed for position papers, classroom debates, peer reviews of polished drafts of advocacy-related materials, and presentations of papers. Students, for example, can complete peer reviews of advocacyrelated rationale statements, talking points, letters to the editor, op-ed pieces, letters to policy makers, and

The Situation You are a middle school health education teacher and you believe that greater emphasis should be placed on health education in the schools in your state. You have decided to write a letter to the editor to enhance the public’s awareness of the value of health education in schools.

Your Task After reading, studying, and analyzing materials related to comprehensive school health education, you prepare a persuasive letter to the editor to advocate for comprehensive school health education. Make sure that it includes the following items: (a) a description of comprehensive school health education and (b) a rationale for expanding comprehensive school health education in your school corporation.

Process Stages for the Assignment 1. Read, study, and analyze materials related to comprehensive school health education. These include the chapters and articles on your reading list and in your course packets. Additionally, look up the most recent materials related to comprehensive school health education at the following Web sites: the American Association of Health Education (www.aahperd.org/aahe), the American School Health Association (www.ashaweb. org), the CDC’s Division of Adolescent and School Health (www.cdc.gov/healthyyouth), and the Society of State Directors of Health, Physical Education, Recreation, and Dance (www.thesociety.org). 2. Use these materials to find descriptions of comprehensive school health education and a rationale for comprehensive school health education. Use these materials to prepare a list of at least three rationales for comprehensive school health education (including citations for each rationale). Make two copies of the list of rationales: one to submit to me, the other to use during an in-class small group activity. 3. During the in-class small group activity, discuss descriptions of comprehensive school health education and a rationale for comprehensive school health education. Compare and contrast your descriptions and rationale with your classmates. 4. Prepare a polished draft of your letter and submit one copy to me. 5. Bring two copies of your letter to class and complete in-class peer reviews with two other students. 6. Revise your letter after the peer reviews and my review of your letter. 7. Submit your final letter. FIGURE 1 Letter to the Editor: Advocating for Comprehensive School Health Education Galer-Unti, Tappe / WRITING-INTENSIVE COURSES

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news releases. This has the combined effect of broadening student perspectives and helping students in improving and becoming confident in their writing and advocacy skills. Advocacy skills are best taught through a series of assignments that are dedicated to aiding students in developing certain understandings about the policymaking process and the role of advocates. First, to fully understand an issue, one needs to learn both sides of the topic. Second, the novice advocate needs to gain an understanding of the views, responsibilities, and needs of policy makers. Third, the advocate needs to develop a relationship with the media. Fourth, the advocate needs to gain an understanding of how public opinion is swayed and fostered. To fully comprehend each of these components, strategies and lessons have been developed for each of the four areas of understanding. For the first component part of developing good advocacy skills, students and future advocates must learn to see both sides of an issue. As an example of an assignment designed to aid students in seeing different facets of an issue, individuals are asked to research and take a stance on an issue of importance to the health education sector. Each student is assigned a two-page paper in which they are asked to explain and give a rationale for how they will use only policy or only health education to control the problems of high-risk drinking on a college campus. This assignment forces students to think of all arguments for one side of an issue. In so doing, this deliberately lopsided view helps students to begin to see that there is more than one viewpoint. It also aids them in developing arguments for a viewpoint they may not necessarily embrace. A second exercise involves encouraging students to move a step beyond this by preparing for a debate on a particular topic. For instance, students have successfully debated the following resolution: “Corporate America is responsible for the obesity epidemic.” In this exercise, students learn how to work with a team to research the topic and write up talking points and opening and closing statements. Along the way, students are encouraged to weigh the opposition’s arguments and strategies and listen to the opinions of others. Students take from this exercise a very valuable lesson in advocacy work: To be an effective advocate, you need to know a stance well and the opposition’s even better. The second important skill in developing advocacy acumen is to gain an understanding of the views, responsibilities, and needs of policy makers. There are many ways to accomplish this, and one way within the confines of a writing-intensive program is through the use of interviews. Students can be assigned to interview local policy makers about a variety of issues including the duties of their jobs, how they approach the formulation of policy, and how they deal with opposing viewpoints. A less direct approach, but equally interesting, is to have students attend a school board or public

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health meeting. They are asked to write a description of the protocol of the meeting and the work performed at the meeting in which they were in attendance. Developing a relationship with the media is also an extremely important component of successful advocacy work. Students can develop, as part of their writing-intensive course, a set of talking points for reporters. Writing an op-ed or a letter to the editor provides an opportunity to develop writing-intensive skills and advocacy skills. Publishing an interview with a policy maker is a more advanced but appropriate media advocacy effort. Fourth, the prospective advocate needs to gain an understanding for how public opinion is swayed and formulated about an issue. For an interesting writing assignment that also can be used in conjunction with learning about media advocacy, students can be assigned to conduct a content analysis and write up the results. Students can base their content analyses on letters to the editor, newspaper stories, or op-eds. Another way to have students learn about the skill is to research and write up the findings of a public opinion poll. This series of assignments helps students understand advocacy as a social-ecological approach to health. This series also provides students with mastery experiences that may enhance confidence in their written communication and advocacy skills. Assessing Writing-Intensive Assignments Assessing writing-intensive assignments includes providing students with feedback to improve their written communication and advocacy skills as well as assigning points or grades for specific written assignments. Evaluating students’ written communication and advocacy skills and providing them with feedback regarding these skills can be both challenging and time consuming. This feedback, however, is also a critical source of information for students to develop confidence or self-efficacy related to writing and advocacy activities. One strategy for providing students with feedback regarding formal advocacy-related writing assignments includes the use of a scoring guide or rubric (see Figure 2). The rubric should include score points related to both the skill of writing as well as that of advocacy. Careful development of process steps for informal and formal writing assignments and scoring rubrics for formal writing assignments help to not only communicate guidelines and expectations related to writing assignments to students but facilitate the assessment and grading of these assignments. The development of rubrics that adequately capture the unique aspects of the two skills as well their intersection, however, is often an ongoing cycle of application and revision. See Bean (1996) for suggestions related to the principles of commentary and strategies for saving time when evaluating, providing feedback, and assigning grades.

Development of Presentation (8 points) 1. Descriptions and Rationale: 2 points Descriptions of comprehensive school health education and three rationales for comprehensive school health education with citations were submitted prior to the in-class activity. 2. In-Class Small Group Activity: 1 point Student participated in the in-class small group activity. 3. Polished Draft of Letter: 3 points Three copies of a polished draft including descriptions of comprehensive school health education and five rationales for comprehensive school health education (without citations but can be documented) were submitted. 4. In-Class Peer Review: 2 points Student participated in peer review of two classmates’ letters.

Final Letter (22 points) 5. Purpose: 2 points 2 points: The purpose of the letter is clearly stated. 6. Description of Comprehensive School Health Education: 3 points 1 point: The description is paraphrased. 2 points: The description is accurate. 7. Five Rationales for Comprehensive School Health Education: 10 points 10 points: Five rationales that can be documented for comprehensive school health education (do not document your letter; you may refer to an agency or organization). 8. Conclusion: 1 point 1 point: The letter contains a concluding statement. 9. Letter: 6 points 1 point: The letter contains 225 to 250 words. 1 point: The letter is persuasive. 1 point: The letter is organized. 1 point: The letter contains appropriate paragraph and sentence structure. 1 point: The letter is grammatically correct. 1 point: The words in the letter are spelled correctly. FIGURE 2 Scoring Rubric for Advocating Comprehensive School Health Education, Letter to the Editor

> CONCLUSION

Lindsay, Hanks, Neiger, and Barnes (2000) reported that employers view good writing as the most desirable skill for community health educators. There is little doubt that providing opportunities to improve writing skills is a critical component of any professional preparatory program in health education. Increasing writing

within coursework provides an environment in which these future professionals learn the jargon of the profession, increase their knowledge of the field, and understand the importance of writing to the field of health education. At the same time, the importance of an understanding of advocacy as a social-ecological approach to health, advocacy strategies, and the ability to advocate are becoming more important to practitioners. Advocacy for the profession and the public’s health, long viewed as important to the practice of health education, are now recognized as ethical responsibilities of practitioners. Teaching about advocacy is a relatively new pedagogical imperative, but, thankfully, many of the skills of advocacy can be developed while enhancing writing skills. Teaching advocacy within the confines of a writing-intensive class is logical, for it has the combined effect of teaching two skills. Just as it is important to evaluate the effectiveness of health education programs, it is also important for health educators to determine the effectiveness of various approaches to the professional preparation of future health educators. Health education professionals in higher education need to expand upon the work of Galer-Unti (2002) in which she examined students’ perceptions of a writing-intensive health education methods course. Health educators should examine the effectiveness of a writing-intensive program planning methods course in improving students’ writing and advocacy skills, their perceptions related to their writing and advocacy skills, and their subsequent advocacyrelated practice once they become entry-level health education professionals. Additionally, it is important to identify the specific pedagogical approaches within a writing-intensive methods class that contribute most to the development of students’ writing and advocacy skills. Health educators need training in advocacy to be a successful part of the social-ecologic approach to health. To be effective and thus have an impact on the environment, health educators must have the opportunity to develop advocacy skills and confidence in these skills through instructional experiences that feature practice and feedback. These types of learning experiences are the hallmarks of effective professional preparatory programs, and health educators in institutions of higher education should consider utilizing writingintensive courses as an approach to developing writing and advocacy skills in future health educators. REFERENCES Allegrante, J. P., Moon, R. W., Auld, E. M., & Gebbie, K. M. (2001). Continuing education needs of the currently employed public health education workforce. American Journal of Public Health, 91, 1230-1234. Altman, D., Balcazar, F., Fawcett, S. B., Seekins, T., & Young, J. Q. (1994). Public health advocacy: Creating community change to improve health. Palo Alto, CA: Stanford Center for Research in Disease Prevention. Galer-Unti, Tappe / WRITING-INTENSIVE COURSES

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Anderson, L. M., Scrimshaw, S. C., Fullilove, M. T., Fielding, J. E., & Task Force on Community Preventive Services. (2003). The Community Guide’s model for linking the social environment to health. American Journal of Preventive Medicine, 24(3S), 12-20. Auld, M. E., & Dixon-Terry, E. (1999). The role of health education associations in advocacy. Health Education Monograph Series, 17(2), 10-14. Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman. Bean, J. C. (1996). Engaging ideas: The professor’s guide to integrating writing, critical thinking, and active learning in the classroom. San Francisco: Jossey-Bass. Birch, D. A. (1991). Helping prospective school health educators develop political advocacy skills. Journal of School Health, 61, 176-177. Birch, D. A. (1995). Promoting comprehensive school health education: Guidelines for advocacy. Journal of Wellness Perspectives, 12, 22-28. Caira, N. M., Lachenmayr, S., Sheinfeld, J., Goodhart, F. W., Cancialosi, L., & Lewis, C. (2003). The health educator’s role in advocacy and policy: Principles, processes, programs, and partnerships. Health Promotion Practice, 4, 303-313. Davis, D. J. (1987). Eight faculty members talk about student writing. College Teaching, 35, 31-35. Emig, J. (1977). Writing as a mode of learning. College Composition and Communication, 28, 122-128. Freudenberg, N. (1982). Health education for social change: A strategy for public health in the U.S. International Journal of Health Education, 24, 138-145. Galer-Unti, R. A. (2002). Student perceptions of a writingintensive course in health education. Health Educator, 34(2), 3540.

McKinlay, J. B. (1993). The promotion of health through planned sociopolitical change: Challenges for research and policy. Social Science & Medicine, 36, 109-117. McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15, 351-377. National Commission for Health Education Credentialing, Inc. (1986). A competency based framework for the professional development of certified health education specialists. Allentown, PA: Author. National Commission for Health Education Credentialing, Inc., & Coalition of National Health Education Organizations, USA. (1996). The health education profession in the 21st century: Setting the stage. Journal of School Health, 66, 291-298. National Task Force on Ethics in Health Education. (2000). Code of ethics for the health education profession. Journal of School Health, 70, 320-321. Ogden, H. G. (1986). The politics of health education: Do we constrain ourselves? Health Education Quarterly, 13, 1-7. Popovich, N. G, & VanVeldhuizen-Scott, M. K. (1994). Evaluation of student learning in a nonprescription drug course without examinations. American Journal of Pharmaceutical Education, 58, 43-49. Ranelli, P. L., & Nelson, J. V. (1998). Assessing writing perceptions and practices of pharmacy students. American Journal of Pharmaceutical Education, 62, 426-432. Silva, M. C., Cary, A. H., & Thaiss, C. (1999). When students can’t write: Solutions through a writing-intensive nursing course. Nursing and Health Care Perspectives, 20, 142-145. Simpson, M. S., & Carroll, S. E. (1999). Assignments for a writingintensive economics course. Journal of Economic Education, 30, 402-410.

Galer-Unti, R. A., Tappe, M. K., & Lachenmayr, S. (2004). Advocacy 101: Getting started in health education advocacy. Health Promotion Practice, 5, 281-299.

Stokols, D. (1996). Translating social ecological theory into guidelines for community health promotion. American Journal of Health Promotion, 10, 282-298.

Grauerholz, L. (1999). Creating and teaching writing-intensive courses. Teaching Sociology, 27, 310-323.

Tappe, M. K., & Galer-Unti, R. (2001). Health educator’s role in promoting health literacy and advocacy for the 21st century. Journal of School, 71, 477-482.

Hilgers, T. L., Bayer, A. S., Stitt-Bergh, M., & Taniguchi, M. (1995). Doing more than “thinning out the herd”: How eighty-two college seniors perceived writing-intensive classes. Research in the Teaching of English, 29, 59-87.

Task Force on Community Preventive Services. (2003). Recommendations to promote healthy social environments. American Journal of Preventive Medicine, 24(3S), 21-24.

Hilgers, T. L., Hussey, E. L., & Stitt-Bergh, M. (1999). “As you’re writing, you have these epiphanies”: What college students say about writing and learning in their majors. Written Communication, 16, 317-353. Holtrop, J. S., Price, J. H., & Boardley, D. J. (2000). Public policy involvement by health educators. American Journal of Health Behavior, 24, 132-142. Institute of Medicine. (2003). Who will keep the public healthy? Educating public health professionals for the 21st century. Washington, DC: National Academies Press. Lindsay, G. A., Hanks, W. A., Neiger, B. L., & Barnes, M. D. (2000). Enhancing student employability: Perceptions of faculty advisors and community health practitioners. Journal of Health Education, 31, 10-13.

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Temple, M. (1999). How to effectively use the Internet for advocacy. Health Education Monograph Series, 17(2), 32-35. Valde, G. (1997). Promoting student participation and learning through the use of weekly writing assignments. Journal on Excellence in College Teaching, 8(3), 67-76. Wallack, L. (1994). Media advocacy: A strategy for empowering people and communities. Journal of Public Heath Policy, 15, 420436. Wallack, L., & Dorfman, L. (1996). Media advocacy: A strategy for advancing policy and promoting health. Health Education Quarterly, 23, 293-317. Wallack, L., Dorfman, L., Jernigan, D., & Themba, M. (1993). Media advocacy and public health: Power for prevention. Newbury Park, CA: Sage.