Regional public health preparedness teams in North Carolina: An analysis of their structural capacity and impact on services provided

Authors

  • Jennifer A. Horney, PhD, MPH
  • Milissa Markiewicz, MPH
  • Anne Marie Meyer, PhD
  • Julie Casani, MD, MPH
  • Jennifer Hegle, MPH
  • Pia D. M. MacDonald, PhD, MPH

DOI:

https://doi.org/10.5055/ajdm.2011.0050

Keywords:

public health, preparedness, structural capacity

Abstract

In December 2001, the North Carolina Division of Public Health established Public Health Regional Surveillance Teams (PHRSTs) to build local public health capacity to prevent, prepare for, respond to, and recover from public health incidents and events. Seven PHRSTs are colocated at local health departments (LHDs) around the state.
The authors assessed structural capacity of the PHRSTs and analyzed the relationship between structural capacity and the frequency of support and services provided to LHDs by PHRSTs. Five categories of structural capacity were measured: human, fiscal, informational, physical, and organizational resources. In addition, variation in structural capacity among teams was also examined.
The most variation was seen in human resources. Although each team was originally designed to include a physician/epidemiologist, industrial hygienist, nurse/epidemiologist, and administrative support technician, team composition varied such that only the administrative support technician is common to all teams. Variation in team composition was associated with differences in the support and services that PHRSTs provide to LHDs.Teams that reported having a medical doctor or a doctor of osteopathic medicine (χ2 = 9.95; p < 0.01) or an epidemiologist (χ2 = 5.35; p < 0.02) had larger budgets and provided more support and services, and teams that housed a pharmacist reported more partners (χ2 = 52.34; p < 0.01). Teams that received directives from more groups (such as LHDs) also provided more support and services in planning (Z = 21.71; p < 0.01), communication and liaison (Z = 12.11; p < 0.01), epidemiology and surveillance (Z = 5.09; p < 0.01), consultation and technical support (Z = 2.25; p = 0.02), H1N1 outbreak assistance (Z = 10.25; p < 0.01), and public health event response (Z = 2.19; p = 0.03).
In the last 10 years, significant variation in structural capacity, particularly in human resources, has been introduced among PHRSTs. These differences explain much of the variation in support and services provided to LHDs by PHRSTs.

Author Biographies

Jennifer A. Horney, PhD, MPH

Research Assistant Professor, Department of Epidemiology, North Carolina Institute for Public Health, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina.

Milissa Markiewicz, MPH

Research Associate, North Carolina Institute for Public Health, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina.

Anne Marie Meyer, PhD

Research Associate, Sheps Center for Health Services Research, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina.

Julie Casani, MD, MPH

Director, Public Health Preparedness and Response, NC Division of Public Health, Raleigh, North Carolina.

Jennifer Hegle, MPH

Research Associate, North Carolina Institute for Public Health, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina.

Pia D. M. MacDonald, PhD, MPH

Research Associate Professor, Department of Epidemiology, North Carolina Institute for Public Health, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina.

References

Koh HK, Elqura LJ, Judge CM, et al.: Regionalization of local health systems in the era of preparedness. Annu Rev Public Health. 2008; 29: 205-218.

Handler A, Issel M, Turnock B: A conceptual framework to measure performance of the public health system. Am J Public Health. 2001; 91(8): 1235-1239.

Mays GP, Halverson PK, Scutchfield FD: Behind the curve? What we know and need to learn from public health systems research. J Public Health Manag Pract. 2003; 9: 179-182.

Mays GP, McHugh MC, Shim K, et al.: Institutional and economic determinants of public health system performance. Am J Public Health. 2006; 96(3): 523-531.

Turnock BJ: Public Health:What It Is and How It Works. 3rd ed. Sudbury, MA: Jones and Bartlett Publishers, 2004.

Horney JA, Markiewicz M, Meyer AM, et al.: Support and services provided by public health regional surveillance teams to local health departments in North Carolina. J Public Health Manag Pract. 2011; 17(1): E7-E13.

Maldonado G, Greenland S: Simulation study of confounder-selection strategies. Am J Epidemiol. 1993; 138(11): 923-936.

Beitsch LM,Kodolikar S, Stephens T, et al.: A state-based analysis of public health preparedness programs in the United States. Public Health Rep. 2006; 121(6): 737-745.

Bravata DM, McDonald KM, Owens DK, et al.: Regionalization of bioterrorism preparedness and response. Evidence Report/Technology Assessment No. 96. Rockville, MD: Agency for Healthcare Research and Quality, 2004.

Horney JA, Markiewicz M, Meyer AM, et al.: Support and services provided by public health regional surveillance teams to local health departments in North Carolina. J Public Health Manag Pract. 2011; 17(1): E7-E13.

Published

03/01/2011

How to Cite

Horney, PhD, MPH, J. A., M. Markiewicz, MPH, A. M. Meyer, PhD, J. Casani, MD, MPH, J. Hegle, MPH, and P. D. M. MacDonald, PhD, MPH. “Regional Public Health Preparedness Teams in North Carolina: An Analysis of Their Structural Capacity and Impact on Services Provided”. American Journal of Disaster Medicine, vol. 6, no. 2, Mar. 2011, pp. 107-1, doi:10.5055/ajdm.2011.0050.

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