Competency framework, methods, evaluation, and outcomes of natural disaster preparedness and response training: a scoping review protocol

Abstract

Objective: 

This systematic scoping review aims to clarify and map the range of natural disaster preparedness and response training for public health personnel around the world.

Introduction: 

Various preparedness and response training courses, exercises, and drills for public health professionals have been developed for natural disasters. Most of these focus on developing competency. However, there is no overview of the frameworks, methods, evaluation, and outcomes of these disaster preparedness and response training courses, exercises, and drills.

Inclusion criteria: 

This review will consider all studies that focus on the framework, evaluation, and outcome of training in natural disaster preparedness for public health personnel.

Methods: 

The databases and sources to be searched will include MEDLINE (PubMed), CINAHL with Full Text Plus, Academic Search Premier, APA PsycINFO, and Ichushi-Web. Searches for gray literature will be conducted using websites that discuss, introduce, or provide competence-based disaster preparedness and response training. These websites will mainly be for public organizations or universities with a focus on public health. The review will consider studies published in both English and Japanese. Retrieval of full-text studies and data extraction will be performed independently by two reviewers. The findings will be summarized in tabular form and accompanied by narrative text.

Introduction

Natural disasters, including earthquakes, floods, tsunamis, storms, fires, and other extreme weather events, often have a significant impact on people's health.^1,2 Public health personnel such as nurses, physicians, dentists, pharmacists, and other health workers within the community have an important role in protecting community residents’ safety and health during and after natural disasters. In the natural disaster response phase, public health personnel provide physical, psychological, and holistic care for individuals, families, and communities. In the recovery phase, they provide care to help individuals, families, and communities rebuild their lives. They also have knowledge, skills, and abilities used in the mitigation, preparedness, or pre-event phases to help identify risks and plan disaster response guidelines that will direct adequate action rapidly.^3,4 To promote natural disaster preparedness and response, various training programs have been conducted by academics, graduate schools, and public health organizations around the world.⁵

Disaster preparedness and response training for public health personnel is often competency based. Various organizations and universities have developed competencies for health professionals and other emergency responders.⁶ The number of competency-based training programs has increased over the past decade, especially in the United States. The National Disaster Health Consortium has defined some disaster-specific competencies,⁷ such as: “Demonstrate situational awareness of actual/potential health hazards before, during, and after a disaster or public health emergency”^(p.562); “Communicate effectively with others in a disaster or public health emergency”^(p.562); and “Demonstrate knowledge of short-term and long-term considerations for recovery of all ages, populations, and communities affected by a disaster or public health emergency.”^(p.563) The Centers for Disease Control and Prevention (CDC) and the Association of Schools and Programs of Public Health (ASPPH) have developed workforce-level competencies that demonstrate the abilities required for a public health professional involved in preparedness work, and which are recommended for all members of the public health workforce to enhance their readiness to respond to public health disasters and emergencies.^8,9 The competencies are organized into domains that are critical to building and sustaining the capacity to fulfill responsibilities,¹⁰ including model leadership (six competencies), communicate and manage information (five competencies), plan for and improve practice (four competencies), and protect worker health and safety (three competencies).

Other countries have followed the lead of the United States. Public health organizations and universities around the world have clarified disaster-specific competencies for public health personnel and provided competency-based disaster preparedness and response training. In Japan, the National Institute of Public Health provides specialized training to improve and enhance disaster preparedness and response. This includes specialized education based on the CDC competencies for personnel working in public health, including physicians, dentists, pharmacists, veterinarians, public health nurses, midwives, registered dietitians, radiology technicians, medical technologists, and social welfare personnel.¹¹ Miyazaki¹² suggested that there were three domains and 87 specific competences for public health nurses, including knowledge, skills, and attitude. Disaster preparedness and response training is based on the competencies for public health nurses and other public health professionals in several states.¹²

These examples show that there are a number of definitions of competencies, but there is general agreement on the broad knowledge, skills, and attitudes required for public health personnel in natural disaster settings. In the United States, online training is often provided to improve knowledge of competencies.¹³ To improve assessment skills and team functionality, face-to-face lectures, table-top exercises, and simulation training are often provided,¹⁴ which can be combined with self-learning through online or face-to-face lectures, exercises, and simulation training for blended learning.¹⁵ Participants can develop various competencies through lectures, face-to-face meetings, online courses, web seminars, table-top exercises, and simulation training.^13,16 In Japan, most training is provided through face-to-face lectures, table-top exercises, and simulation training. Usually, participants are required to check disaster response guidelines and manuals for their workforce before they join face-to-face lectures, or undertake further activities like simulations or table-top exercises.

To date, there are no reviews focusing on competency frameworks and methods, evaluation, and outcomes for disaster preparedness and response training. This scoping review therefore aims to clarify and map out competency frameworks, methods, and outcomes of disaster preparedness response training for public health professionals around the world. The review will focus on natural disasters, rather than manmade disasters or pandemics.¹⁷ This focus was chosen because public health personnel are responsible for providing care for individuals, families, and communities. Natural disasters usually have a broad effect on communities, and all public health personnel may be required to work as first responders. A preliminary search of PROSPERO, MEDLINE, the Cochrane Database of Systematic Reviews, and JBI Evidence Synthesis was carried out, and identified no current systematic reviews on this topic. It is hoped that this scoping review will contribute to improved and more effective disaster preparedness and response training for public health personnel.

Review questions

• i) What competency frameworks have been used to develop natural disaster preparedness and response training programs for public health personnel?
• ii) What methods have been used to train public health personnel?
• iii) What methods have been used to evaluate the outcomes of natural disaster preparedness and response training?
• iv) What outcomes of disaster preparedness and response training have been identified?"

Inclusion criteria

Participants

The review will consider studies whose participants include public health personnel. Public health personnel will be defined as individuals employed in a public health organization or a non-public health organization. Nurses, physicians, dentists, pharmacists, and other health workers within the community could be included. These public health personnel provide primary care for individuals, families, and communities on a daily basis, and act as first responders during natural disasters. Undergraduate students will be excluded because they learn more general competencies than those required by public health personnel. Health professionals employed by military facilities or emergency departments will also be excluded to enable the review to focus on the specific competencies required by public health personnel who usually provide primary care for individuals, families, and communities.

Concept

This review aims to map frameworks, methods, evaluations, and outcomes of disaster preparedness and response training for public health personnel. It will consider studies that focus on any or all of these four concepts. Frameworks are defined as specific disaster competency lists, guidelines, or manuals, such as those issued by CDC, ASPPH, or any other public health organization, or by universities. Methods will include types of training such as online learning, face-to-face lectures, table-top exercises, and simulations. Evaluation covers activities such as pre-post-tests, self-reported outcomes, and focus group discussion designed to evaluate the effectiveness of training. The review will also cover how outcomes and evaluations are explained in each study.

Context

This review will consider studies that describe competence-based disaster preparedness and response training from anywhere around the world. Studies that describe disaster preparedness and response training based on competencies will be included. However, studies that describe training based on other sorts of framework (not competency based) will be excluded. This review will also focus on preparedness and response training for natural disasters including earthquakes, floods, tsunamis, storms, fires, and other extreme weather events. These disasters can have a significant impact on people's health and affect whole communities, often requiring all public health personnel to work as first responders. Studies may be included that cover training for manmade disasters and pandemics as well as natural disasters; however, studies that cover training only for manmade disasters or pandemics will be excluded.

Types of sources

This scoping review will consider all studies, including primary research studies, systematic reviews, case studies, and short reports. Editorial comment, rapid communications, letters to the editor, and opinion papers will also be considered for inclusion. The review will also draw on websites that discuss, introduce or provide competence-based disaster preparedness and response training, as provided by public organizations or universities.

Methods

The proposed scoping review will be conducted in accordance with JBI methodology.¹⁸

Search strategy

The search strategy will aim to identify both published and unpublished studies. An initial limited search of CINAHL with Full Text Plus and MEDLINE was undertaken to locate articles on the topic. The text words contained in the titles and abstracts of relevant articles and the index terms used to describe the articles will be used to develop a full search strategy. A full search strategy for MEDLINE (PubMed) is presented in Appendix I. The search strategy, including keywords and index terms, will be adapted as necessary for each information source. The reference lists of all studies selected for critical appraisal will be screened for additional studies.

The databases to be searched will include MEDLINE (PubMed), CINAHL with Full Text Plus, Academic Search Premier, APA PsycINFO, Ichushi-Web. The sources of unpublished studies and gray literature to be searched will include, for example, The British Library website, Centers for Disease Control and Prevention website by public organizations and Open Dissertations (EBSCOhost). Searches for unpublished gray literature will be conducted using websites that discuss, introduce, or provide competence-based disaster preparedness and response training. Studies published in either English or Japanese will be included because all authors are able to critique in both languages. The review will consider all studies published to date. All sources will be listed, and the review will also include a comprehensive list of variations of the keywords.

Study selection

Following the search, all identified records will be collated and uploaded into EndNote X.9. (Clarivate Analytics, PA, USA) and duplicates removed. Two independent reviewers will then screen the titles and abstracts and assess them against the inclusion criteria for the review. Potentially relevant studies will be retrieved in full and their citation details will be imported into the JBI System for the Unified Management, Assessment and Review of Information (JBI SUMARI; JBI, Adelaide, Australia). Two separate independent reviewers will assess the full text of selected articles against the inclusion criteria. Reasons for excluding full-text studies that do not meet the inclusion criteria will be recorded and reported in the scoping review. Any disagreements that arise between the reviewers at each stage of the study selection process will be resolved through discussion or with a third reviewer. The search results will be reported in full in the final scoping review, and presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.^19,20

Data extraction

Data will be extracted from papers included in the scoping review by two independent reviewers using a data extraction tool developed by the reviewers. The data extracted will include authors, year of publication, origin or country of origin (where the study was published or conducted), aims or purpose, study population, framework or theory, methodology or methods, evaluation methods, and outcomes relevant to the review objective. A draft extraction tool is included in Appendix II. The provisional data extraction tool will be modified and revised as necessary during the process of extracting data from each study included in the review. Modifications will be detailed in the full scoping review. Any disagreements that arise between the reviewers will be resolved through discussion or with a third reviewer. Where required, authors of papers will be contacted with a request to supply missing or additional data.

Data analysis and presentation

The extracted data will be presented in diagrammatic or tabular form in a manner that aligns with the objective of this scoping review. A narrative summary will accompany the tabulated or charted results and will describe how the results relate to the review's objective and questions.

Funding

MM is supported by the Health and Labor Sciences Research Grant in Japan for Misako Miyazaki.