Workforce-Emergency Preparedness
Room: Thoroughbred 3
Wednesday, April 9, 2014, 10:45 am-12pm
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AUDIO
KC14 Session 3C on Workforce: Emergency Preparedness by NCC for PHSSR
MODERATOR
Shari Veil, Ph.D., M.B.A.
PRESENTERS
Lainie Rutkow, Ph.D., J.D., M.P.H., B.A.
Emergency Preparedness, State Laws, and Willingness to Respond among the EMS Workforce
Co-Investigators: Jon Vernick, J.D., M.P.H, B.A., Carol Thompson, M.S., M.B.A., B.S., Daniel Barnett, M.D., M.P.H., B.A. (Presenting)
Background: A growing body of research points to gaps in willingness to respond (WTR) among cohorts with response duties, including the EMS workforce. WTR becomes critical during an influenza pandemic, due to increased demands on emergency health workers and the potential for workforces to be depleted if responders contract influenza or stay home to care for sick dependents. State-level emergency preparedness laws offer one potential avenue to increase WTR.
Research Objective: We examined the association between three state-level emergency preparedness laws (ability to declare a public health emergency; requirement to create a public health emergency plan; and priority access to health resources for responders) and self-reported WTR among EMS workers during an influenza pandemic.
Data Sets or Sources: We studied 421 EMS workers from the National Registry of EMTs’ May-June 2009 mid-year Longitudinal EMT Attributes and Demographics Study, which included questions about WTR to an influenza pandemic.
Study Design: Data from the mid-year survey were merged with data about the presence or absence of the three emergency preparedness laws in the 50 U.S. states.
Analysis: Unadjusted logistic regression analyses were performed with the presence/absence of each law and then were adjusted for respondents’ demographic/locale characteristics.
Principal Findings: Compared to respondents in the states that did not allow the government to declare a public health emergency, those in states that permitted declarations had a larger percentage agreeing that they were WTR during an influenza pandemic. In adjusted and unadjusted analyses, however, this difference was not statistically significant. We found similar results for the other laws of interest.
Conclusions: While these laws show no relationship to WTR, recent research suggests that inconsistencies between the perceived and objective legal environments for EMS workers could be another explanation for our findings.
Implications for Public Health Practice and Policy: Educational efforts within the EMS workforce and more prominent state-level implementation of emergency preparedness laws should be considered. Such approaches are important steps toward determining whether state-level emergency preparedness laws are effective tools to promote WTR among EMS workers.
Jim Bellamy, Ph.D., M.P.H.
The Uptake of Emergency Preparedness Training at the Local Level: The TRAIN Experience
Co-Investigators: Glen Mays, Ph.D., M.P.H., John Wayne, Ph.D.
Background: In recent years public health emergency preparedness (PHEP) has become a key competency for the public health workforce (PHWF). Consequently, emergency preparedness training has become essential. In response to the need for PHEP training, the Public Health Foundation (PHF) established a web-based learning management tool – TRAIN (TrainingFinder Real-time Affiliated Integrated Network).
Research Objective: This study investigated the effects of PHEP training for local health department (LHD) employees on the preparedness and response capacities of their LHDs.
Data Sources: This project used three data sources: (1) the 2005 and 2008 National Profile of Local Health Departments (NACCHO) and (2) training data from the TRAIN database. NACCHO’s local profile surveys core questionnaire contains questions related to what can be termed discretionary emergency preparedness (EP) activities. The TRAIN data set provided individual-level data including course name/ID, zip code, and demographics (age, gender, ethnicity, and education-level)
Analysis: The first analysis is descriptive and cross-sectional measures of participation in discretionary EP activities by local public health agencies in 2005 and 2008. The second analysis includes the longitudinal effects of training using a random effects model with instrumental variables to account for autocorrelation and endogeneity. The longitudinal analysis examined changes in EP and response capacities by local public agencies from 2005 to 2008.
Principal Findings: Four discretionary EP activities were examined; three EP activities (changed/reviewed EP plan, reviewed relevant legal authorities, and participated in drills or exercises) had an approximate 2 percentage point increase from 2005 to 2008. Assessed EP competencies had a dramatic decrease of approximately 25 percentage points from 2005 to 2008. In 2005, approximately 1.3% of the 2300 LHDs completed at least one EP course while almost 45% of the LHDs in 2008 completed at least one EP course. Results from the multivariate analysis demonstrate that for all of the EP activities, a positive, statistically significant correlation exists with frequency/intensity of training.
Conclusions/Implications: The results suggest that a positive relationship exists between training and participation in EP activities, demonstrating the need for additional EP training. However, it is uncertain whether this training-performance relationship exists in other areas of public health activities.
Monica Schoch-Spana, Ph.D., M.A., B.A.
A National Survey on Health Department Capacity for Community Engagement in Emergency Preparedness
Co-Investigators: Fred Selck, Ph.D., Lisa Goldberg, M.P.H
Background: Federal doctrine and national consensus statements assert that government alone cannot effectively manage public health emergencies. Rather, individuals, businesses, and community- and faith-based groups help the nation to withstand and recover from disasters and epidemics. Responsibility for integrating residents and non-governmental entities into the larger public health emergency preparedness (PHEP) enterprise rests with health departments. Little systematic knowledge exists about how public health integrates partners in PHEP and what can strengthen these interactions.
Research Objective: We investigated local health departments’ (LHDs) adoption of federally-recommended participatory approaches to PHEP and identified LHD organizational characteristics associated with more intense community engagement (CE).
Data Sets & Sources: In 2012, a web-based survey was emailed to emergency preparedness coordinators for 754 randomly selected LHDs. Topics included CE-PHEP activities conducted in prior year, anticipated change in CE-PHEP level in coming year, and LHD resources for CE-PHEP.
Study Design: The randomized sample was drawn from the 2,565 LHDs invited to participate in the 2010 NACCHO National Profile. Sample selection was stratified by the size of population served and by geographic location based on DHHS region.
Analysis: Differences in survey responses were examined, and a multivariate analysis was used to test whether LHD organizational characteristics were associated with differences in CE-PHEP intensity.
Principal Findings: Response rate was 61%. The most common reported CE activity was disseminating personal preparedness materials (90%); least common was convening public forums on PHEP planning (22%). LHD characteristics most strongly associated with more intense CE were having a formal CE policy, allocating funds for CE, having strong support from community-based organizations (CBOs), and employing a coordinator with prior CE experience.
Conclusions: LHDs of all sizes are striving to integrate community partners into the PHEP enterprise, and agencies can further intensify their efforts through adopting a formal CE-PHEP policy, hiring staff with prior experience and training inexperienced staff, and strengthening and leveraging CBO ties.
Implications: Federal authorities should examine whether funding and technical support to LHDs are commensurate with the national value now placed on CE-PHEP and the task of improving the present baseline of CE-PHEP activity.