This journal supplement presents highlights of the work of the Preparedness and Response Learning Center (PERLC) program and network and also includes reflections on the importance and challenges of training for public health preparedness. The PERLC program is specifically designed to address the preparedness and response training and education needs of the public health workforce. Begun in 2010 and supported by federal funds, the PERLC network includes 14 centers located in Council on Education for Public Health accredited Schools of Public Health. Additional information about the program's history and activities is presented in the article by Richmond et al in this supplement.
Most of the articles in this supplement feature key activities of the PERLC program. In part, this is to acknowledge the achievements of the many participants and partners in these activities and to articulate the importance and challenges of public health preparedness training. But even more importantly, this supplement was produced with the intent to increase awareness and understanding of the innovative methods and training programs that have been developed so that these achievements can be extended more broadly and can stimulate additional innovations and programs for preparedness training.
Prior to 2001, funding for and attention to public health preparedness were minor. This changed dramatically following the unprecedented terrorist events of 2001, especially the anthrax exposures in 3 regions of the East Coast. For the first few years after those events, for many public health agencies, it was almost as though their most important responsibility was emergency preparedness. There were several years of time-consuming and low-value trainings for the public health workforce that were originally designed for very different audiences, such as the military, or that were unrealistic regarding the public health resources available and that failed to acknowledge the many other ongoing public health programs and responsibilities. Fortunately, other developments soon contributed to advancing the priority and quality of training for public health preparedness.
The Institute of Medicine has noted in many reports since 2001 that all public health professionals should have preparedness skills, and the Institute of Medicine continues to add substantively to the field through the publications and other activities of the Forum on Medical and Public Health Preparedness. Public health professional organizations such as the National Association of City & County Health Officers and the Association of State and Territorial Health Officials have high-profile activities to develop and assess preparedness skills and performance for public health workers and agencies. The Association of Schools of Public Health (now the Association of School and Programs of Public Health), with the Centers for Disease Control and Prevention support, has led the development of 2 sets of competencies related to public health preparedness and response—for the public health workforce (Preparedness & Response Core Competency Model, 2010) and for academic public health programs (Master's Level Public Health Preparedness & Response Competency Model, 2011). These and other initiatives have been, in part, in response to expectations laid out in the federal Pandemic and All-Hazards Preparedness Act legislation, which has identified interrelated national public health and medical preparedness goals and has increased the alignments of key funding sources and activities.
When the PERLC program began in 2010, both the fields of public health training and of public health preparedness had matured somewhat. These fields were becoming more realistic about what was needed, possible, and effective, and the PERLC network has been able to draw from and interact with other major activities and key players during this period. One of the most valuable changes in perspective was the increasing attention to evaluation, research, and building an evidence base of practices that could be implemented by others and also could guide future activities. This is where the contributions of the PERLC network are most significant: in providing methods and programs that incorporate explicit planning processes and evaluations, in the context of strong partnerships between the public health practice communities and public health academic institutions.
The supplement begins with a Guest Editorial by Dr. Ali Khan, who draws from his leadership position at the Centers for Disease Control and Prevention to provide a visionary overview of public health preparedness and related training. The supplement concludes with a joint Commentary by the preparedness directors at the Association of State and Territorial Health Officials and the National Association of City & County Health Officers (Jim Blumenstock and Jack Herrmann), who not only describe the importance of preparedness skills and training for the current and future public health workforce but also note the challenges in an era of eroding funding and smaller workforces.
Articles in the supplement are organized by the general themes of the articles. “Understanding the PERLC Program and Network” includes 2 articles: an overview of the PERLC programs' development and activities is described in the article by Richmond et al., and the evaluation of PERLC program training activities is described by Hites et al.
“Innovative Methods for Public Health Workforce Preparedness Training” comprises 6 articles: training non–mental health public health personnel to provide psychological first aid (Everly et al); presenting lessons about evaluating transfer of training to operations (Renger et al); planning and executing complex exercises (McCormick et al); using adaptive scenarios for training (Uden-Holman et al); using a digital story format to training public health laboratory workforce (Walkner et al); and using gaming simulation to evaluate training (Olson et al).
“Enhancing Public Health Preparedness Planning” comprises 3 articles: innovative models of public health hazard vulnerability and jurisdictional risk (Testa et al); a planning process for public health hazard mitigation (Griffith et al); and leveraging the PERLC to improve other public health activities (Horney et al).
“Training and Preparedness in the Community” comprises 6 articles: leveraging community human service organization for disaster planning for vulnerable populations (Berliner et al); using mini-grants to enhance preparedness capabilities and capacity (Wiebel et al); weaving Latino cultural concepts into preparedness training (Riley-Jacome et al); evidence-based communication strategies for training to reach limited English-speaking populations (D'Ambrosio et al); a partnership between a PERLC and a tribal emergency management coalition (Tallchief et al); and community-based disaster coalition training (Frahm et al).
All of us who have been involved in developing this supplement strongly believe in the importance of strengthening the ability of our communities to successfully plan for, respond to, and recover from public health emergencies. We trust that the thoughts and information in this supplement will further stimulate the development of additional and increasingly effective trainings and tools for the public health workforce and their partners and ultimately to better protect the public health of our communities.