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1. Essay: Political affiliations
Essay: Political affiliationsEssay: Political affiliationsRegardless of political affiliation, every
citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare
items become such high-profile components of presidential agendas. It is also little wonder
why they become such hotly debated agenda items.In Part 1 of this module’s Assignment,
you were asked to begin work on an Agenda Comparison Grid to compare the impact of the
current/sitting U.S. president and the two previous presidents’ agendas on the healthcare
item you selected for study. In this Discussion, you will share your first draft with your
colleagues to receive feedback to be applied to your final version.To Prepare:Review the
importance of agenda setting.Consider how federal agendas promote healthcare issues and
how these healthcare issues become agenda priorities.Review Part 1 of the Module 1
Assignment and complete the requirements for this Discussion.BY DAY 3 OF WEEK
1Post a draft of the Agenda Comparison Grid you completed for Part 1 of the Agenda
Comparison Grid and Fact Sheets or Talking Points Brief Assignment.APA format with intext
citations and a separate place for references. minimum of 3 references. I have provided the
grid template, all that needs to be completed is part 1.And 2 sources that will help you. you
will be able to find other sources as weORDER NOW FOR CUSTOMIZED, PLAGIARISM-FREE
PAPERSAgenda Comparison Grid Template Agenda Comparison Grid and Fact Sheet or
Talking Points Brief Assignment Template for Part 1 and Part 2 Part 1: Agenda Comparison
Grid Use this Agenda Comparison Grid to document information about the population
health/healthcare issue your selected and the presidential agendas. By completing this grid,
you will develop a more in depth understanding of your selected issue and how you might
position it politically based on the presidential agendas. You will use the information in the
Part 1: Agenda Comparison Grid to complete the remaining Part 2 and Part 3 of your
Assignment. Identify the Population Health concern you selected. Describe the Population
Health concern you selected and the factors that contribute to it. Administration (President
Name) Describe the administrative agenda focus related to this issue for the current and
two previous presidents. (Current President) (Previous President) © 2018 Laureate
Education Inc. (Previous President) 1 Identify the allocations of financial and other
resources that the current and two previous presidents dedicated to this issue. Explain how
each of the presidential administrations approached the issue. © 2018 Laureate Education
Inc. 2 Part 2: Agenda Comparison Grid Analysis Using the information you recorded in Part
1: Agenda Comparison Grid, complete the following to document information about the
population health/healthcare issue your selected Administration (President Name)

2. (Current President) (Previous President) (Previous President) Which administrative agency
would most likely be responsible for helping you address the healthcare issue you selected?
How do you think your selected healthcare issue might get on the agenda for the current
and two previous presidents?Essay: Political affiliationsHow does it stay there? Who would
you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected
for the current and two previous presidents? Note: Part 3: of the Module 1: Assignment:
Agenda Comparison Grid and Fact Sheet or Talking Points Brief is a 1-page Fact Sheet or
Talking Points Brief the you will create in a separate document. © 2018 Laureate Education
Inc. 3 Article Political Efficacy and Participation of Nurse Practitioners Policy, Politics, &
Nursing Practice 2017, Vol. 18(3) 135–148 ! The Author(s) 2017 Reprints and permissions:
sagepub.com/journalsPermissions.nav DOI: 10.1177/1527154417728514
journals.sagepub.com/home/ppn Nancy C. O’Rourke, PhD, ANP1, Sybil L. Crawford, PhD1,
Nancy S. Morris, PhD, ANP1, and Joyce Pulcini, PhD, RN, PNP-BC, FAAN2 Abstract Twenty-
eight states have laws and regulations limiting the ability of nurse practitioners (NPs) to
practice to the full extent of their education and training, thereby preventing patients from
fully accessing NP services. Revisions to state laws and regulations require NPs to engage in
the political process. Understanding the political engagement of NPs may facilitate the
efforts of nurse leaders and nursing organizations to promote change in state rules and
regulations. The purpose of this study was to describe the political efficacy and political
participation of U.S. NPs and gain insight into factors associated with political interest and
engagement. In the fall of 2015, we mailed a survey to 2,020 NPs randomly chosen from the
American Academy of Nurse Practitioners’ database and 632 responded (31% response
rate). Participants completed the Trust in Government (external political efficacy) and the
Political Efficacy (internal political efficacy) scales, and a demographic form. Overall, NPs
have low political efficacy. Older age (p4.001), health policy mentoring (p4.001), and
specific education on health policy (p4.001) were all positively associated with internal
political efficacy and political participation. External political efficacy was not significantly
associated with any of the study variables. Essay: Political affiliationsPolitical activities of
NPs are largely limited to voting and contacting legislators. Identifying factors that engage
NPs in grassroots political activities and the broader political arena is warranted,
particularly with current initiatives to make changes to state laws and regulations that limit
their practice. Keywords political efficacy, political participation, nurse practitioners, health
policy Given the rapid and turbulent changes to the U.S. healthcare system following the
2016 elections, nurse practitioners’ (NPs) political e?cacy and participation are important
for securing a?ordable, high-quality care for millions of Americans. The 2016 presidential
campaign set the stage for disarray within the Republican party (Jacobson, 2016), while the
Democratic party experienced unprecedented division in its voter base (Boys, 2016; Wang,
Li, & Luo, 2016). Campaigns were contentious, unconventional, and disruptive. Political
unrest is at its highest since 2000 (Boys, 2016; Wang et al., 2016). The implementation of
the Patient Protection and A?ordable Care Act was a concern during the 2016 campaigns. As
of January 31, 2017, 12 million newly insured individuals were added to an already strained
health-care system (Associated Press, 2017). Central to the health-care debate is a well-
documented shortage of primary care providers, predicted to become critical by 2020

3. (Graves et al., 2016). Both the Institute of Medicine (IOM, 2011) and the National Governors
Association (2012) recommended removal of restrictive state regulations to enhance access
to NP services as a necessary step to address the provider shortage. The Federal Trade
Commission (2014) ruled that physician supervision clauses in NP state practice acts create
anticompetitive environments and should be removed. Revising outdated laws or
regulations to allow NPs to practice to the full extent of their education 1 2 University of
Massachusetts Medical School, Worcester, MA, USA George Washington University, DC, USA
Corresponding Author: Nancy C. O’Rourke, University of Massachusetts Medical School, 55
Truell Road, Worcester, MA 01655-0112, USA. Email: nancyc.orourke@gmail.com 136
would ensure patients have full access to NP services (Poghosyan, Boyd, & Clarke, 2016).
Historically, many NPs have not been politically engaged or able to e?ectively create and
sustain political change (Craven & Ober, 2009; Kung & Rudner-Lugo, 2014; Moran, 2014;
Oden, Price, Alteneder, Boardley, & Ubokudom, 2000). Understanding political e?cacy, and
factors associated with political e?cacy, of NPs may facilitate the e?orts of nurse leaders and
nursing organizations to promote change in state rules and regulations. This article
presents the ?ndings of a study examining NP political e?cacy and participation. We explain
the historical involvement of NPs’ engagement in health policy, evidence of their political
e?cacy, and describe Sharoni’s (2012) framework on political e?cacy, which was used to
structure this study. Methods and data analysis follow with a discussion of our ?ndings and
the study’s implications for practice, policy, and professional organizations.Essay: Political
affiliationsBackground Political e?cacy is ‘‘an activity that has the intent or e?ect of
in?uencing government action – either directly by a?ecting the making or implementation of
public) policy or indirectly by in?uencing the selection of people who make those policies’’
(Verba, Schlozman, Brady, & Brady, 1995, p. 38). It is associated with political participation
and often referred to as one’s sense of being able to in?uence the political process (Caprara,
Vecchione, Capanna, & Mebane, 2009; Sharoni, 2012). Political e?cacy has two distinct
constructs: a personal sense of e?cacy (internal) and a system-oriented component of
e?cacy (external) (Neimie, Craig, & Mattei, 1991). Internal e?cacy is one’s sense of being able
to understand and participate in politics. External e?cacy is one’s trust that the government
will be responsive to the demands of citizens (Neimie et al., 1991; Sharoni, 2012). Electorate
politics are increasingly complex, especially in highly competitive elections (Barton, Castillo,
& Petrie, 2016). Understanding campaign and electoral dynamics and learning about
candidates require initiative; many eligible voters may feel inadequate to the task (Burden
& Neiheisel, 2013). Some state and federal laws enacted since 2012 impose new policies on
voters. Restrictions include requiring a photo identi?cation to vote, curtailing voter
registration times and early voting periods, and enforcing stricter rules for those with past
criminal convictions (Wang, 2012; Weiser & Opsal, 2014). Campaigns and elections that are
controversial and competitive are associated with increased voter turnout, usually
measured as a percent of registered voters who actually vote (Barton et al., 2016). In the
?rst 12 national primary elections of 2016, 17.3% of eligible Republican voters turned out
to vote. Essay: Political affiliationsThis is the highest rate of GOP Policy, Politics, & Nursing
Practice 18(3) primary voting since the 1980 elections. In 2016, Democrats had the highest
rate (11.7%) of primary election voting since 1992, with one exception, the unusually high

4. turnout in 2008 when the rate was 30.4% (Desilver, 2016; File & Chrissy, 2012). Harrington
and Gould (2016) state that rates of eligible voters participating in presidential elections
have decreased from approximately 64% in 2004 and 2008 to 61.8% in 2012. In 2016, only
60% of eligible voters cast a ballot (Harrington & Gould, 2016). Age, gender, race,
socioeconomic status (SES), and education are all associated with political participation,
and education in the development of civic skills is strongly predictive of political
participation (Hillygus, 2005). Schlozman, Verba, and Brady (2012) associated higher
income with increased political activity, especially with regard to monetary donations
toward political campaigns. Voting data from 2012 indicate that adults older than 65 years
of age have higher rates of voting (69.7%) than adults 18 to 24 (38%) or 25 to 44 years of
age (49.5%; File, 2013b). Historically, younger voters report feeling isolated or excluded, as
political parties have been reluctant to engage and represent their interests (Zukin, Keeter,
Andolina, Jenkins, & Carpini, 2006; Henn & Foard 2012). Recent studies report increased
interest among younger voters, with 18 to 24 years olds casting 19.9% of ballots in the 2014
election (Center for Information and Research on Civic Learning and Engagement, 2016).
The racial demographics of voters also shifted in 2012, showing increased racial and ethnic
diversity; 64.1% of eligible non-Hispanic Whites, 48% of eligible Hispanics, and 66.2% of
eligible Blacks voted (File, 2013a). While women are more likely to vote than men (63.7%
vs. 59.8%), in all other aspects of political participation, men consistently participate in
political activities at higher rates than women (Dittmar, 2015; Schlozman et al., 2012).
Higher education leads to higher rates of voting, with the voting rate of college graduates as
high as 70%, compared with 27% of those with high school education (‘‘Voting,’’ n.d.). Based
on several single state studies, certi?ed registered nurse anesthetists and other advanced
practice registered nurses (APRNs) consistently vote at rates greater than 90%, which is
higher than general population voting rates (Casey, 2009; Moran, 2014; Essay: Political
affiliationsOden et al., 2000; McDonald, 2016). Political Efficacy and Political Participation
of NPs Research on the political e?cacy and participation of NPs is limited. Studies of
registered nurses (BarrettSheridan, 2009; Vandenhouten, Malakar, Kubsch, Block, &
Gallagher-Lepak, 2011), NPs, certi?ed registered nurse anesthetists, and certi?ed nurse
midwives O’Rourke et al. report voting to be the predominate form of political participation
(Casey, 2009; Moran, 2014; Oden et al., 2000). With the exception of 2008 elections, self-
reported voting rates for NPs (89%) are higher than those of the general population (62%)
(File, 2013b, Oden et al, 2000). Among NPs, lack of time, knowledge, interest, family
obligations, and ?nancial constraints are cited as barriers to other types of political
participation (Casey, 2009; Kung & Rudner-Lugo, 2014; Moran, 2014; Oden et al, 2000).
Recent studies show mixed results on political e?cacy and political engagement of NPs in
areas other than voting (Kung & Rudner-Lugo, 2014; Moran, 2014; Oden, 2000; Ryan,
2015). Oden et al. (2000) report results of a mailed survey of public policy involvement sent
to members of the American Academy of Nurse Practitioners (AANP). Time, money, and
civic skills were identi?ed as barriers to political participation for the 440 AANP members
who responded (74% response rate). Voting was the most common political activity
reported; 87% of the participants reported consistent voting patterns (Oden et al., 2000).
There was a strong positive correlation between self-rated involvement in political

5. activities and political e?cacy (p < .001) with a majority reporting that they received policy
education from professional organizations and journals. Age, socioeconomic resources, and
prior engagement in political activities were signi?cant predictors of political participation
among a study of 170 advanced practice nurses in Louisiana (Moran, 2014). Kung and
Rudner-Lugo (2014) surveyed APRNs in Florida (n ¼ 884); 23% reported being active in
policy, despite acknowledging signi?cant barriers to practice in their state. This di?ers from
Ryan (2015), who surveyed 875 NPs practicing in convenient care clinics from 44 states and
Australia and reported political involvement in 70% of the NPs, de?ned as membership in
state or national professional nursing organizations. There was wide variation in the level
of political engagement, with less involvement in political activities by NP students,
unemployed, and retired NPs compared with those still employed. Ryan (2015) also
reported that 43.1% of NPs practicing less than 2 years reported having had education or
coursework in health policy. In 1996, healthcare policy was identi?ed as essential core
content for master’s education for advanced practice nursing (American Association of
Colleges of Nursing (AACN), 1996) Essay: Political affiliations