Advocacy for humane death and dying care practices led to the valuing and realization of hospice and palliative care services in South Australia in the 1990s (Elsey, 1998). Early hospice and palliative care advocates pressed for comprehensive community services provided by knowledgeable, humane and compassionate care providers who understood and supported the need for an alternative to medical practices in this area.

Advocates also recognized the need for funding, legislation, support of relevant volunteer organizations, and capacity-building in health professionals to ensure effective delivery of hospice and palliative care services.

Social movement strategies to engage and mobilize communities have been effective at reducing HIV transmission. Community-based interventions have made significant advancements in HIV prevention, including:

• decreasing discrimination against those who are HIV positive;
• raising the levels of HIV testing and counseling amongst young adults;
• improving access to program and service quality; and
• increasing the uptake of antiretroviral treatment to prevent transmission to non-infected partners.

Engaging and mobilizing communities – including members of stakeholder groups and civil society agencies – has been critical in taking collective action towards the goal of preventing HIV transmission. To be effective, communities were found to need the following three key components:

1. empowerment through elements, such as leadership, resources, program management and the support of external partners
2. development of having a collective or shared identity as a community
3. capacity in health promotion, including the development of knowledge and skills, available resources, civic engagement, values for change and a learning culture

A community coalition in Los Angeles, California took collective action to advocate for the rights of Deaf children in accessing child abuse prevention and treatment services. The coalition took multiple steps to increase visibility, spread awareness and gain support. Some examples:

• one of the member organizations wrote an article published in a magazine for the Deaf community advocating for the protection of Deaf children.
• A presentation by coalition members was made at a local synagogue that included members of the Deaf community.
• A local social event included a focus on the collective actions of the coalition and how attendees could financially support their efforts.

These activities drew further attention to the collective action being taken and the urgency for change (Embry and Grossman, 2006).   

The urgent need to end systemic racism gained international traction following the death of George Floyd. Support for the global Black Lives Matter movement increased, leading to national and international discussions on structural racism and demands to address long-standing problems of police brutality. Calls to action included defunding the police and a global movement for justice, freedom and liberation.

The urgent need to transform long-term care (LTC) in Ontario gained broad support in 2020 during the COVID-19 pandemic. The pandemic exposed long-standing system failings. Examples of triggers included:

• an alarming mortality rate resulting from COVID-19 in LTC settings, representing a large majority of COVID-19-related deaths in Ontario
• a scathing report from the Canadian Armed Forces
• devastating stories from families who were separated from loved ones

Here is an example of a doodle used to frame the issue of poverty. The notion of people being "locked in" by circumstances outside their control is a powerful metaphor. This doodle shows some of the main factors that combine to restrict and restrain people, locking them into poverty. (Joseph Roundtree Foundation)  

The Canadian Patient Safety Institute’s #ConquerSilence campaign uses images and powerful messaging to frame patient safety issues. The campaign includes webinars, podcasts, social media content and a communications toolkit. 

L'Association Alzheimer (Alzheimer's Association | Aide pour la maladie d'Alzheimer et la démence) a été fondée en 1980 par un groupe de familles et de personnes qui soutenaient la nécessité d'une organisation dédiée à aider les soignants confrontés à la maladie d'Alzheimer et à faire progresser les connaissances à travers la recherche.

En tant qu'activistes précoces pour le mouvement Alzheimer, ils ont cherché à briser le silence autour de la maladie d'Alzheimer et à en apprendre davantage sur la maladie, y compris la prévention, le traitement et un remède. Grâce à une approche dirigée par les gens, l'association touche des millions de personnes dans le monde entier grâce à une approche multi-facettes ancrée dans l'action individuelle et collective. Le plaidoyer pour donner à toutes les personnes vivant avec la maladie d'Alzheimer accès aux services de soutien dont elles ont besoin comprend des stratégies telles que le lancement de campagnes de sensibilisation et des campagnes de base visant à influencer la législation.

Avec de nombreux chapitres en Amérique du Nord et dans le monde entier, l'Association Alzheimer comprend un réseau d'avocats et d'alliés. Ceux-ci incluent d'autres organisations Alzheimer, des universités impliquées dans la recherche, des entreprises et des sociétés pharmaceutiques. À titre d'exemple d'une organisation de la société civile, l'Association Alzheimer est une organisation à but non lucratif basée sur la communauté qui protège et défend les besoins et les intérêts des personnes et des familles vivant avec Alzheimer depuis plus de 40 ans.

Through two annual initiatives – Queen’s Park on the Road and Queen’s Park Day – RNAO members meet with members of provincial parliament (MPPs) from all of the political parties to promote healthy public policy and nursing services. Through direct engagement and advocacy with MPPs, RNAO has mobilized collective action for policy initiatives addressing areas such as poverty reduction, the use of pesticides for cosmetic use, promoting refugee health and protecting the safety and security of residents in long-term care (Grinspun et al., 2018a).       

RNAO’s Best Practice Spotlight Organization® (BPSO®) program itself was scaled up, scaled out and scaled deep – on the national level – when RNAO and the Canadian Patient Safety Institute (CPSI) entered into a formal partnership on a pan-Canadian falls prevention initiative campaign in 2007, with a focus on long-term care (LTC) (McConnell et al., 2018).

This collaboration involved the implementation of best practices, capacity building at the micro and meso levels with individuals and organizations, and engagement with national partners. The work was informed by the first and second editions of RNAO’s best practice guideline (BPG) Prevention of Falls and Fall Injuries in the Older Adult and CPSI’s program Safer Healthcare Now! on falls prevention as a critical patient safety issue Reducing Falls and Injuries from Falls.

The National Collaborative on Falls Prevention in Long-Term Care, launched in 2008–2009, included staff from 32 LTC homes and an interprofessional expert panel. The goals of the collaborative:

1. to reduce the rate of falls in older adults by educating and training staff and patients about fall prevention
2. develop a forum for improvement teams
3. participate in a methodology on quality improvement initiatives using the Model for Improvement (Langley et al., 2009).

The collaboration was highly successful – process indicators showed decreased rates of falls in the LTC homes following implementation. However, it was determined that more time and support would be needed to scale the fall prevention initiative out and deep to in order to embed and sustain the practice changes. 

In 2010–2011, the collaborative expanded to a national campaign where the program was delivered virtually to more than 45 organizations from diverse health sectors using web-based technology. This enabled greater access to the program with impressive outcomes, and showed that technology could be used as a tool to scale the program up and out.

This was followed up by creation and delivery of a fall prevention learning series in 2011–2012 to strengthen the uptake and sustainability of best practices. The training integrated implementation science, change theory and quality improvement methodology. As with the other collaboration components, the outcomes of the learning series demonstrated improvements in practice changes and reductions in falls causing injury, and organizational policies to support and sustain the change. The continued use of evaluation to determine outcomes and impact as part of quality improvement and using ongoing audit and feedback demonstrated a change that was scaled deep. 

The collaboration helped embed principles of social action movement by its focus on a credible and important shared concern – preventing falls – where urgent change was needed. Momentum was used to support the continued engagement of fall prevention champions across sectors. Networks were used to share resources and expand collaborations across communities.          ​​​​​​