Addressing Community Needs During the Hurricane Response and Recovery Efforts Through Community Assessments for Public Health Emergency Response (CASPER)—United States Virgin Islands, 2017-2018

ABSTRACTObjectivesTwo category 5 storms hit the US Virgin Islands (USVI) within 13 days of each other in September 2017. This caused an almost complete loss of power and devastated critical infrastructure such as the hospitals and airportsMethodsThe USVI Department of Health conducted 2 response Community Assessments for Public Health Emergency Response (CASPERs) in November 2017 and a recovery CASPER in February 2018. CASPER is a 2-stage cluster sampling method designed to provide household-based information about a community’s needs in a timely, inexpensive, and representative manner.ResultsAlmost 70% of homes were damaged or destroyed, 81.2% of homes still needed repair, and 10.4% of respondents felt their home was unsafe to live in approximately 5 months after the storms. Eighteen percent of individual respondents indicated that their mental health was “not good” for 14 or more days in the past month, a significant increase from 2016.ConclusionThe CASPERs helped characterize the status and needs of residents after the devastating hurricanes and illustrate the evolving needs of the community and the progression of the recovery process. CASPER findings were shared with response and recovery partners to promote data-driven recovery efforts, improve the efficiency of the current response and recovery efforts, and strengthen emergency preparedness in USVI. (Disaster Med Public Health Preparedness. 2019;13:53-62)

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Use of Community Assessments for Public Health Emergency Response (CASPERs) to Rapidly Assess Public Health Issues — United States, 2003-2012

Prehospital and Disaster Medicine ◽

10.1017/s1049023x15004938 ◽

2015 ◽

Vol 30 (4) ◽

pp. 374-381 ◽

Cited By ~ 15

Author(s):

Tesfaye M. Bayleyegn ◽

Amy H. Schnall ◽

Shimere G. Ballou ◽

David F. Zane ◽

Sherry L. Burrer ◽

...

Keyword(s):

Public Health ◽

Emergency Response ◽

Disaster Preparedness ◽

Public Health Emergency ◽

Cluster Sampling ◽

Health Issues ◽

Public Health Action ◽

Sampling Methodology ◽

Health Action ◽

Public Health Emergency Response

AbstractIntroductionCommunity Assessment for Public Health Emergency Response (CASPER) is an epidemiologic technique designed to provide quick, inexpensive, accurate, and reliable household-based public health information about a community’s emergency response needs. The Health Studies Branch at the Centers for Disease Control and Prevention (CDC) provides in-field assistance and technical support to state, local, tribal, and territorial (SLTT) health departments in conducting CASPERs during a disaster response and in non-emergency settings. Data from CASPERs conducted from 2003 through 2012 were reviewed to describe uses of CASPER, ascertain strengths of the CASPER methodology, and highlight significant findings.MethodsThrough an assessment of the CDC’s CASPER metadatabase, all CASPERs that involved CDC support performed in US states and territories from 2003 through 2012 were reviewed and compared descriptively for differences in geographic distribution, sampling methodology, mapping tool, assessment settings, and result and action taken by decision makers.ResultsFor the study period, 53 CASPERs were conducted in 13 states and one US territory. Among the 53 CASPERS, 38 (71.6%) used the traditional 2-stage cluster sampling methodology, 10 (18.8%) used a 3-stage cluster sampling, and two (3.7%) used a simple random sampling methodology. Among the CASPERs, 37 (69.9%) were conducted in response to specific natural or human-induced disasters, including 14 (37.8%) for hurricanes. The remaining 16 (30.1%) CASPERS were conducted in non-disaster settings to assess household preparedness levels or potential effects of a proposed plan or program. The most common recommendations resulting from a disaster-related CASPER were to educate the community on available resources (27; 72.9%) and provide services (18; 48.6%) such as debris removals and refills of medications. In preparedness CASPERs, the most common recommendations were to educate the community in disaster preparedness (5; 31.2%) and to revise or improve preparedness plans (5; 31.2%). Twenty-five (47.1%) CASPERs documented on the report or publications the public health action has taken based on the result or recommendations. Findings from 27 (50.9%) of the CASPERs conducted with CDC assistance were published in peer-reviewed journals or elsewhere.ConclusionThe number of CASPERs conducted with CDC assistance has increased and diversified over the past decade. The CASPERs’ results and recommendations supported the public health decisions that benefitted the community. Overall, the findings suggest that the CASPER is a useful tool for collecting household-level disaster preparedness and response data and generating information to support public health action.BayleyegnTM, SchnallAH, BallouSG, ZaneDF, BurrerSL, NoeRS, WolkinAF. Use of Community Assessments for Public Health Emergency Response (CASPERs) to rapidly assess public health issues — United States, 2003-2012. Prehosp Disaster Med. 2015;30(4):1-8.

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Developing an instrument to measure household radiological emergency preparedness using the Community Assessment for Public Health Emergency Response (CASPER) methodology: An evidence-informed approach

Journal of Emergency Management ◽

10.5055/jem.0583 ◽

2021 ◽

Vol 19 (3) ◽

pp. 293-305

Author(s):

Rennie W. Ferguson, DrPH, MHS ◽

Daniel J. Barnett, MD, MPH ◽

Ryan David Kennedy, PhD ◽

Tara Kirk Sell, PhD, MA ◽

Jessica S. Wieder ◽

...

Keyword(s):

Public Health ◽

Emergency Management ◽

Emergency Response ◽

Emergency Preparedness ◽

Survey Instrument ◽

Public Health Emergency ◽

Community Assessment ◽

Radiological Emergency ◽

Preparedness Planning ◽

Public Health Emergency Response

Introduction: Community assessments to measure emergency preparedness can inform policies, planning, and communication to the public to improve readiness and response if an emergency was to occur. Public health and emergency management officials need an effective assessment tool to measure community preparedness for a radiological emergency. Methods: The authors created a survey instrument to collect data on household radiological emergency preparedness that could be implemented using the Community Assessment for Public Health Emergency Response (CASPER) methodology, developed by the US Centers for Disease Control and Prevention. To inform the development of the tool, the authors examined existing CASPER surveys, focusing on identifying best practices for creating a survey instrument, as well as analyzing the results of a survey of radiation preparedness experts and state/local health and emergency management officials. Results: The developed survey tool includes 32 questions covering four domains: communication in an emergency, preparedness planning, physical/behavioral health, and demographics. The instrument captures information related to identified barriers in communicating in a radiological emergency as well as self-reported behaviors that could potentially be influenced through awareness and education.Discussion: Using the proposed survey instrument and following the existing rapid assessment methodology provided by CASPER, public health and emergency management agencies can collect valuable information on the radiation preparedness needs of their communities, which can then be used to improve household readiness for an emergency.

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Principles of public health emergency response for acute environmental, chemical, and radiation incidents

10.1093/med/9780198816805.003.0105 ◽

2021 ◽

pp. 739-750

Author(s):

Virginia Murray ◽

Thomas Waite ◽

Paul Sutton

Keyword(s):

Public Health ◽

Risk Assessment ◽

Health Risk ◽

Emergency Response ◽

Emergency Preparedness ◽

Public Health Emergency ◽

Environmental Chemical ◽

Public Health Risk ◽

International Obligations ◽

Public Health Emergency Response

In recent years there have been many environmental, chemical, and radiation disasters that have challenged the emergency preparedness of countries around the globe. This chapter on the principles of public health emergency response for acute environmental, chemical, and radiation incidents summarizes the stages of response to emergencies using a generic ‘all hazards’ framework and a ‘source–pathway–receptor’ risk assessment model which is adaptable to any situation and conforms with international obligations. The stages identified address incident management arrangements for emergency response including international obligations; public health risk assessment; public health risk management techniques and countermeasures; public reassurance in emergencies and incidents and finally the need to identify and publish the lessons from incidents Remembering that before any response can be mounted, the event has to be detected and identified as requiring special action. Detection requires early warning and forecasting to clinical awareness, timely surveillance, and intelligence. A significant number of evidence gaps remain and so detailed documentation and follow-up of future incidents will continue to be needed to fill those gaps and improve emergency preparedness and response in the future. By the use of case studies of some significant environmental, chemical, and radiological incidents and processes the stages of the emergency response are illustrated to facilitate an all hazards approach.

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Assessing Radiation Emergency Preparedness Planning by Using Community Assessment for Public Health Emergency Response (CASPER) Methodology

Prehospital and Disaster Medicine ◽

10.1017/s1049023x14000491 ◽

2014 ◽

Vol 29 (3) ◽

pp. 262-269 ◽

Cited By ~ 9

Author(s):

Mawuli K. Nyaku ◽

Amy F. Wolkin ◽

Jevon McFadden ◽

Jim Collins ◽

Michelle Murti ◽

...

Keyword(s):

Public Health ◽

Emergency Response ◽

Emergency Preparedness ◽

Sampling Design ◽

Public Health Emergency ◽

Community Assessment ◽

Preparedness Planning ◽

Oakland County ◽

Radiation Emergency ◽

Public Health Emergency Response

AbstractIntroductionApproximately 1.2 million persons in Oakland County, Michigan (USA) reside less than 50 miles from the Fermi Nuclear Power Plant, Unit 2, but information is limited regarding how residents might react during a radiation emergency. Community Assessment for Public Health Emergency Response (CASPER) survey methodology has been used in disaster and nondisaster settings to collect reliable and accurate population-based public health information, but it has not been used to assess household-level emergency preparedness for a radiation emergency. To improve emergency preparedness plans in Oakland County, including how residents might respond during a radiation emergency, Oakland County Health Division (OCHD), with assistance from the Centers for Disease Control and Prevention (CDC) and the Michigan Department of Community Health (MDCH), conducted a CASPER survey.MethodsDuring September 2012, a 2-stage cluster sampling design was used to select 210 representative households in Oakland County. By using in-person surveys, the proportion of households with essential needs and supplies, how residents might respond to public health authorities’ instructions, and their main source for obtaining information during a radiation emergency were assessed. Data were weighted to account for the complex sampling design.ResultsOf the goal of 210 households, 192 (91.4%) surveys were completed: 64.7% and 85.4% of respondents indicated having 3-day supplies of water and of nonperishable food, respectively; 62.8% had a 7-day supply of prescription medication for each person who needed it. Additionally, 64.2% had a working carbon monoxide detector; 67.1% had a first-aid kit; and 52% had an alternative heat source. In response to instructions from public health officials during a radiation emergency, 93.3% of all respondents would report to a radiation screening center; 96% would evacuate; and 91.8% would shelter-in-place. During a radiation emergency, 55.8% of respondents indicated their main information source would be television, 18.4% radio, and 13.6% the Internet. The most trusted source for information would be the local public health department (36.5%), local news (23%), a physician (11.2%), and family members (11.1%). Including completed and incomplete interviews, refusals, and nonrespondents, 517 total households were contacted.ConclusionsCASPER data regarding how residents might react during a radiation emergency provided objective and quantifiable information that will be used to develop Oakland County's radiation emergency preparedness plans. Survey information demonstrates the feasibility and usefulness of CASPER methodology for radiation emergency preparedness planning.NyakuMK, WolkinAF, McFaddenJ, CollinsJ, MurtiM, SchnallA, BiesS, StanburyM, BeggsJ, BayleyegnTM. Assessing radiation emergency preparedness planning by using Community Assessment for Public Health Emergency Response (CASPER) methodology. Prehosp Disaster Med. 2014;29(3):1-9.

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State of public health emergency response leadership training: A multitiered organizational perspective

American Journal of Disaster Medicine ◽

10.5055/ajdm.2021.0399 ◽

2021 ◽

Vol 16 (3) ◽

pp. 167-177

Author(s):

Anthony Salerno, MSc ◽

Yang Li, MPH, MS ◽

Xiaohong M. Davis, PhD, MS, MA ◽

Gail Stennies, MD, MPH ◽

Daniel J. Barnett, MD, MPH ◽

...

Keyword(s):

Public Health ◽

Emergency Response ◽

Leadership Training ◽

Emergency Preparedness ◽

Common Factor ◽

Public Health Emergency ◽

Organizational Level ◽

Local Health ◽

Health Departments ◽

Public Health Emergency Response

Objective: To capture organizational level information on the current state of public health emergency response leadership training.Design: A web-based questionnaire.Participants: This multitiered assessment of health departments included two distinct respondent groups: (1) Public Health Emergency Preparedness (PHEP) Cooperative Agreement recipients (n = 34) and (2) local health departments (LHDs) (n = 169) representative of different agency sizes and populations served.Results: Overall, PHEP and LHD respondents expressed a clear preference for participatory learning with practical drills/exercises and participatory workshops as the preferred training delivery modes. Compared with technical and role-specific training, leadership training was less available. For both PHEP and LHD respondents, staff availability for training is most notably limited due to lack of time. For PHEP respondents, a common factor limiting agency ability to offer training is lack of mentors/instructors, whereas for LHD respondents, it is limited funding.Conclusions: Efforts should focus on increasing accessibility and the continued development of rigorous and effective training based on practical experience in all aspects of multitiered public health emergency response leadership.

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