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A National Survey on Health Department Capacity for Community Engagement in Emergency Preparedness

Schoch-Spana, Monica PhD; Selck, Frederic W. PhD; Goldberg, Lisa A. MPH

Journal of Public Health Management and Practice: March/April 2015 - Volume 21 - Issue 2 - p 196–207
doi: 10.1097/PHH.0000000000000110
Original Articles

Context: Limited systematic knowledge exists about how public health practitioners and policy makers can best strengthen community engagement in public health emergency preparedness (“CE-PHEP”), a top priority for US national health security.

Objectives: To investigate local health department (LHD) adoption of federally recommended participatory approaches to PHEP and to identify LHD organizational characteristics associated with more intense CE-PHEP.

Design: National survey in 2012 of LHDs using a self-administered Web-based questionnaire regarding LHD practices and resources for CE-PHEP (“The Community Engagement for Public Health Emergency Preparedness Survey”). 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.

Setting: A randomized sample of 754 LHDs drawn from the 2565 LHDs that had been invited to participate in the 2010 National Profile of LHDs. Sample selection was stratified by the size of population served and geographic location.

Participants: Emergency preparedness coordinators reporting on their respective LHDs.

Main Outcome Measure: CE-PHEP intensity as measured with a scoring system that rated specific CE-PHEP practices by LHD according to the relative degrees of public participation and community capacity they represented.

Results: Survey response rate was 61%. The most common reported CE-PHEP activity was disseminating personal preparedness materials (90%); the least common was convening public forums on PHEP planning (22%). LHD characteristics most strongly associated with more intense CE-PHEP were having a formal CE-PHEP policy, allocating funds for CE-PHEP, having strong support from community-based organizations, and employing a coordinator with prior CE experience.

Conclusions: Promising ways to engage community partners more fully in the PHEP enterprise are institutionalizing CE-PHEP objectives, employing sufficient and skilled staff, leveraging current community-based organization support, and aligning budgets with the value of CE-PHEP to US national health security.

Supplemental Digital Content is Available in the Text.This article describes adoption by local health departments (LHDs) of federally recommended participatory approaches to public health emergency preparedness and LHD organizational characteristics associated with more intense community engagement in emergency preparedness, a top priority for US national health security.

Texas State University (Dr Schoch-Spana); and UPMC Center for Health Security, Baltimore, Maryland (Dr Selck and Ms Goldberg).

Correspondence: Monica Schoch-Spana, PhD, Texas State University, Department of Anthropology, 601 University Drive, San Marcos, TX 78666 (

This study was supported by the UPMC Center for Health Security and by the US Department of Homeland Security and Federal Emergency Management Agency through the National Consortium for the Study of Terrorism and Responses to Terrorism (START), cooperative agreement no. 2008-TH-T8-K006 and grant no. 2008-ST-061-ST0004. The authors thank NACCHO staff, including Jack Herrmann, Carolyn Leep, Laura Biesadecki, Justin Snair, and Scott Fisher, for their feedback on the survey instrument, sampling strategy, and study findings. The authors also thank anonymous practitioners who piloted the survey instrument as well as Nidhi Bouri, Elaine Hughes, Tanna Liggins, Sanjana Ravi, and Kate Gilles, who helped with survey administration. The findings are those of the authors and do not necessarily represent the views of the funders.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

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