An intervention for enhancing public health crisis response willingness among local health department workers: A qualitative programmatic analysis

Authors

  • Krista L. Harrison, PhD
  • Nicole A. Errett, MSPH
  • Lainie Rutkow, JD, PhD, MPH
  • Carol B. Thompson, MS, MBA
  • Marilyn K. Anderson, MHE
  • Justin L. Ferrell, MS
  • Jennifer M. Freiheit, MA, MCHES
  • Robert Hudson, MSN
  • Michelle M. Koch, PHN, RN
  • Mary McKee, MSW, LCSW
  • Alvaro Mejia-Echeverry, MD, MPH, ARNP
  • James B. Spitzer, MBA, MS, CEM
  • Doug Storey, PhD
  • Daniel J. Barnett, MD, MPH

DOI:

https://doi.org/10.5055/ajdm.2014.0145

Keywords:

emergency preparedness, local health department, willingness to respond, EPPM, self-efficacy

Abstract

Objectives: This study evaluated the impact of a novel multimethod curricular intervention using a trainthe-trainer model: the Public Health Infrastructure Training (PHIT). PHIT was designed to 1) modify perceptions of self-efficacy, response efficacy, and threat related to specific hazards and 2) improve the willingness of local health department (LHD) workers to report to duty when called upon.

Methods: Between June 2009 and October 2010, eight clusters of US LHDs (n = 49) received PHIT. Two rounds of focus groups at each intervention site were used to evaluate PHIT. The first round of focus groups included separate sessions for trainers and trainees, 3 weeks after PHIT. The second round of focus groups combined trainers and trainees in a single group at each site 6 months following PHIT. During the second focus group round, participants were asked to self-assess their preparedness before and after PHIT implementation.

Setting: Focus groups were conducted at eight geographically representative clusters of LHDs.

Participants: Focus group participants included PHIT trainers and PHIT trainees within each LHD cluster.

Main outcome measure(s): Focus groups were used to assess attitudes toward the curricular intervention and modifications of willingness to respond (WTR) to an emergency; self-efficacy; and response efficacy.

Results: Participants reported that despite challenges in administering the training, PHIT was well designed and appropriate for multiple management levels and disciplines. Positive mean changes were observed for all nine self-rated preparedness factors (p < 0.001). The findings show PHIT's benefit in improving self-efficacy and WTR among participants.

Conclusions: The PHIT has the potential to enhance emergency response willingness and related self-efficacy among LHD workers.

Author Biographies

Krista L. Harrison, PhD

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Nicole A. Errett, MSPH

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Lainie Rutkow, JD, PhD, MPH

Assistant Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Carol B. Thompson, MS, MBA

Assistant Scientist, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Marilyn K. Anderson, MHE

Position Training Specialist, Eastern Idaho Public Health District, Idaho Falls, Idaho.

Justin L. Ferrell, MS

Emergency Planner, Lord Fairfax Health District, Virginia Department of Health, Winchester, Virginia.

Jennifer M. Freiheit, MA, MCHES

Graduate Assistant, University of Wisconsin–Milwaukee, Milwaukee, Wisconsin.

Robert Hudson, MSN

Administrator, Butler County Health Department, Poplar Bluff, Missouri.

Michelle M. Koch, PHN, RN

Emergency Preparedness Coordinator, Meeker County Public Health, Litchfield, Minnesota.

Mary McKee, MSW, LCSW

Director, Public Health Practice, Marion County Health Department, Indianapolis, Indiana.

Alvaro Mejia-Echeverry, MD, MPH, ARNP

Advanced Registered Nurse Practitioner, Miami-Dade County Health Department, Doral, Florida.

James B. Spitzer, MBA, MS, CEM

Emergency Preparedness Coordinator (retired), Office of the Director, Multnomah County Health Department, Portland, Oregon.

Doug Storey, PhD

Assistant Professor, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Daniel J. Barnett, MD, MPH

Assistant Professor, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

References

Altevogt BM, Pope AM, Hill MN, et al. (eds.): Committee on Research Priorities in Emergency Preparedness and Response for Public Health Systems. Research Priorities in Emergency Preparedness and Response for Public Health Systems: A Letter Report. Washington, DC: The National Academies Press, 2008.

The National Association of County and City, Health Officials (NACCHO): Local Health Department Job Losses and Program Cuts: Findings from the January 2012 Survey. Washington, DC: NACCHO, 2012.

Errett NA, Barnett DJ, Thompson CB, et al.: Assessment of psychological preparedness and emergency response willingness of local public health department and hospital workers. Int J Emerg Ment Health. 2012; 14(2): 125-133.

Barnett DJ, Thompson CB, Errett NA, et al.: Determinants of emergency response willingness in the local public health workforce by jurisdictional and scenario patterns: A cross-sectional survey. BMC Public Health. 2012; 12(1): 164.

Barnett DJ, Balicer RD, Thompson CB, et al.: Assessment of local public health workers' willingness to respond to pandemic influenza through application of the Extended Parallel Process Model. PLoS ONE. 2009; 4(7): e6365.

Balicer RD, Omer SB, Barnett DJ, et al.: Local public health workers' perceptions toward responding to an influenza pandemic. BMC Public Health. 2006; 6: 99.

Barnett DJ, Semon NL: Johns Hopkins-Public Health Infrastructure Training (JH-PHIT)™ Program Overview. Johns Hopkins Bloomberg School of Public Health. Baltimore, MD: Johns Hopkins Center for Public Health Preparedness, 2012. Available at http://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-publichealth-preparedness/Research/JH-PERRC_Projects/PHIT. Accessed April 10, 2014.

Witte K: Putting the fear back into fear appeals: The Extended Parallel Process Model. Commun Monogr. 1992; 59(4): 329-349.

McMahan S, Witte K, Meyer J: The perception of risk messages regarding electromagnetic fields: Extending the Extended Parallel Process Model to an unknown risk. Health Commun. 1998; 10(3): 247-259.

Smith RA, Ferrara M, Witte K: Social sides of health risks: Stigma and collective efficacy. Health Commun. 2007; 21(1): 55-64.

Witte K, Allen M: A meta-analysis of fear appeals: Implications for effective public health campaigns. Health Educ Behav. 2000; 27(5): 591-615.

Watson CM, Barnett DJ, Thompson CB, et al.: Characterizing public health emergency perceptions and influential modifiers of willingness to respond among pediatric healthcare staff. Am J Disaster Med. 2011; 6(5): 299-308.

Balicer RD, Catlett CL, Barnett DJ, et al.: Characterizing hospital workers' willingness to respond to a radiological event. PLoS ONE. 2011; 6(10): e25327.

Balicer RD, Barnett DJ, Thompson CB, et al.: Characterizing hospital workers' willingness to report to duty in an influenza pandemic through threat- and efficacy-based assessment. BMC Public Health. 2010; 10: 436.

Barnett DJ, Levine R, Thompson CB, et al.: Gauging U.S. Emergency Medical Services workers' willingness to respond to pandemic influenza using a threat- and efficacy-based assessment framework. PLoS ONE. 2010; 5(3): e9856.

Barnett DJ, Thompson CB, Semon NL, et al.: EPPM and willingness to respond: The role of risk and efficacy communication in strengthening public health emergency response systems. Health Commun. 2014; 29(6): 598-609.

QSR International Pty Ltd: NVivo Qualitative Data Analysis Software. Version 10. Burlington, MA. 2012.

StataCorp: Stata Statistical Software: Release 12. College Station, TX: StataCorp LP, 2011.

Marshall C, Rossman GB: Designing Qualitative Research. 4th ed. Thousand Oaks, CA: Sage Publications, Inc., 2006: 157-162.

Miles MB, Huberman AM: Qualitative Data Analysis: An Expanded Sourceboo. 2nd ed. Thousand Oaks, CA: Sage Publications, Inc, 1994: 55-77, 246.

Van Dyke ME, McCormick LC, Bolus NE, et al.: Radiological emergency preparedness: A survey of nuclear medicine technologists in the United States. J Nucl Med Technol. 2013; 41(3): 223-230.

Pillow MT, Stader D, Nguyen M, et al.: Perceptions of basic, advanced, and pediatric life support training in a United States medical school. J Emerg Med. 2013 (in press).

Published

04/01/2014

How to Cite

Harrison, PhD, K. L., N. A. Errett, MSPH, L. Rutkow, JD, PhD, MPH, C. B. Thompson, MS, MBA, M. K. Anderson, MHE, J. L. Ferrell, MS, J. M. Freiheit, MA, MCHES, R. Hudson, MSN, M. M. Koch, PHN, RN, M. McKee, MSW, LCSW, A. Mejia-Echeverry, MD, MPH, ARNP, J. B. Spitzer, MBA, MS, CEM, D. Storey, PhD, and D. J. Barnett, MD, MPH. “An Intervention for Enhancing Public Health Crisis Response Willingness Among Local Health Department Workers: A Qualitative Programmatic Analysis”. American Journal of Disaster Medicine, vol. 9, no. 2, Apr. 2014, pp. 87-96, doi:10.5055/ajdm.2014.0145.

Issue

Section

Articles

Most read articles by the same author(s)