Health advocacy and myopia prevention: a case description of what has been done and could be done to contain the myopia epidemic in children

IntroductionMyopia is becoming an epidemic among children globally, due to increased near screen exposure and reduced outdoor activity. Health advocacy—actions designed to gain political commitment, policy support, and social acceptance for health goals—can help to address this public health challenge. This paper reflects on health advocacy activities undertaken to contain the myopia epidemic and on potential future directions.MethodsWe mapped activities using the American Heart Association (AHA) advocacy framework undertaken in the Netherlands from 2018 to 2026 via the innovative multidisciplinary network ‘View Outdoors’ (2018), targeting professionals, policymakers, and the public. We used the University of British Columbia (UBC) health advocacy framework perspective to assess the approaches, gaps, and opportunities for the next phase of the movement.ResultsUsing the AHA framework, the activities of the network target policy, systems and environmental change through factsheets, national guidelines, and multisector partnerships. The UBC-framework shows that the activities comprise both agency (working within existing structures) and activism (seeking to change structures), supporting the notion that sustainable public health change requires action across multiple sectors rather than isolated initiatives. Gaps include little structured involvement of youth and parents, and dependance on a small group of champions, creating vulnerability and a risk of bias. Attention to determinants such as social inequalities and financial barriers to spectacles create opportunities for strengthening the movement in the next phase.ConclusionHealth advocacy, through multisectoral engagement, can help to contain the myopia epidemic. Taken together, application of the AHA and UBC frameworks show the strengths of the Dutch approach to regard the combining of a broad advocacy portfolio with collaborative activities that link evidence, professional practice, public messaging, and policy influence. Future advocacy actions should focus on participation of children and parents that are directly affected, so their experience and preferences directly shape the agenda and priorities of advocacy efforts. This future approach should pair its strong agency and activism with systematic evaluation of behavioral change and deeper equity-focused partnership, and should address upstream determinants (structural and social conditions) to realize its public health potential.