The success of our political process is dependent on citizens’ active participation in the policy arena. Registered nurse participation in the policy arena, specifically the health policy arena, has the potential to impact health care policy and ultimately health outcomes. This research examined registered nurses’ level of involvement in health policy, reasons for participation or lack of participation, and registered nurses’ education relative to health policy. Registered nurses’ political perceptions and practices related to involvement in health policy activities were examined within the context of the Social Cognitive Theory and the Health Belief Model of behavior change. Relationships between self efficacy components, identified benefits and barriers, and demographic data were examined relative to registered nurses’ participation in the political arena.
Factor analysis was used to identify predictors of involvement in health policy. Results indicate that a majority (73.5%) of nurses were involved in two or fewer health policy activities over a two year period, with over one-fourth (26.5%) reporting no participation in health policy activities. A majority (68.8%) of nurses reported receiving no education in health policy. Of those receiving health policy education as part of their initial nursing instruction, most (66.7%) rated their policy skills obtained as poor. There was a statistically significant increase in level of involvement in health policy for nurses who received health policy education compared to those who did not receive health policy education. Three factors were found to be statistically significant in predicting greater levels of involvement in health policy. Nurses able to identify 4 or more benefits to participation in health policy activities were almost twice as likely (AOR = 1.9, CI = 1.0-4.0) to be involved in health policy activities. Those reporting moderate to high levels of efficacy expectations were 7.6 times (AOR = 7.6, CI = 2.3-25.2) as likely to be involved in health policy activities. Finally, nurses reporting moderate to high levels of interest in influencing health policy were 11.2 times (AOR=11.2, CI=3.0-41.3) as likely to be involved in health policy activities.
Nurse educators and leaders, particularly leaders of national nursing organizations, should be able to use this information to tailor specific strategies to increase registered nurses’ involvement in the health policy arena, which has the potential to improve health outcomes.