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Lessons Learned From an Epidemiologist-Led Countywide Community Assessment for Public Health Emergency Response (CASPER) in Oregon

Repp, Kimberly K. PhD, MPH; Hawes, Eva MPH, CHES; Rees, Kathleen J. MSPH; Vorderstrasse, Beth PhD, MPH; Mohnkern, Sue MPH, RN

Journal of Public Health Management and Practice: June 07, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHH.0000000000000804
Practice Full Report: PDF Only

Context: Conducting a large-scale Community Assessment for Public Health Emergency Response (CASPER) in a geographically and linguistically diverse county presents significant methodological challenges that require advance planning.

Program: The Centers for Disease Control and Prevention (CDC) has adapted methodology and provided a toolkit for a rapid needs assessment after a disaster. The assessment provides representative data of the sampling frame to help guide effective distribution of resources.

Implementation: This article describes methodological considerations and lessons learned from a CASPER exercise conducted by Washington County Public Health in June 2016 to assess community emergency preparedness. The CDC's CASPER toolkit provides detailed guidance for exercises in urban areas where city blocks are well defined with many single family homes. Converting the exercise to include rural areas with challenging geographical terrain, including accessing homes without public roads, required considerable adjustments in planning. Adequate preparations for vulnerable populations with English linguistic barriers required additional significant resources. Lessons learned are presented from the first countywide CASPER exercise in Oregon.

Evaluation: Approximately 61% of interviews were completed, and 85% of volunteers reported they would participate in another CASPER exercise. Results from the emergency preparedness survey will be presented elsewhere.

Discussion: This experience indicates the most important considerations for conducting a CASPER exercise are oversampling clusters, overrecruiting volunteers, anticipating the actual cost of staff time, and ensuring timely language services are available during the event.

Research, Analytics, Informatics and Data (RAID) Program (Drs Repp and Vorderstrasse and Mss Hawes and Rees) and Public Health Emergency Preparedness Program (Ms Mohnkern), Washington County Public Health, Hillsboro, Oregon.

Correspondence: Kimberly K. Repp, PhD, MPH, Research, Analytics, Informatics and Data (RAID) Program, Washington County Public Health, 155 N First Ave, MS 23A, Hillsboro, OR 97124 (

The authors thank the following interns and staff volunteers who dedicated considerable time and effort supporting this exercise: Whitney Juszczak, Sharon Coryell, Kendra Bunker, Alisa Bruno, Cynthia Valdivia, and Casey Thomas Repp. The authors also thank Roger Livingston and the Washington County Assessment and Taxation Department for providing a cleaned census of all residential addresses; Amy Schnall of the CDC CASPER team for providing methodological suggestions and Dr Jeff Bethel (Oregon State University) for helpful discussion; Texas Department of State Health Services for its guidance and Dr Katie Kurkjian at the Virginia Department of Health for sharing CASPER documents; the many community volunteers who participated in this exercise including Tigard and Beaverton Community Emergency Response Team, Medical Reserve Corps, Community Participation Organization, Neighborhood Watch, Virginia Garcia Memorial Health Center, Oregon State University, Portland Community College, Oregon Health & Science University, and Portland State University; and volunteers from Washington County: Public Health, Mental Health, Sheriff's Office, and Disability, Aging, and Veterans Services, the Oregon Health Authority, Clackamas County Public Health, Clark County Public Health, and Multnomah County Public Health. The authors also acknowledge the support of Undersheriff Jeff Mori, Washington County Sherriff's Office, for his dedication to keeping their CASPER exercise and volunteers safe.

There are no conflict of interest disclosures and no resources to report for any author.

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