Local public health agencies (LPHAs) are at the heart of the public health emergency preparedness system, and their workers play critical roles in all disaster phases - including recovery. Despite this, LPHA workers'perceptions of efficacy toward disaster recovery challenges remain poorly understood. Of note, a substantial body of research has found perceived efficacy to be determinative of positively adaptive individual and collective behaviors in the face of challenges. It is therefore essential to understand LPHA workers'efficacy perceptions toward disaster recovery public health challenges, to identify relevant deficits in their perceived recovery-phase efficacy, and to develop evidence-based curricular approaches to address these deficits. Our proposed mixed-methods study will accomplish these goals in the context of Hurricane Sandy recovery, from the critical perspectives of LPHA workers whose jurisdictions were impacted by this disaster. Consonant with this goal, our aims are to: 1) Characterize the nature of operational challenges that LPHA workers face in Hurricane Sandy recovery efforts by investigating potential barriers to communicating and receiving needed information in recovery activities;impediments to recovery surveillance efforts, and how these impediments differ by types of surveillance activities;and hurdles to effective integration and coordination of recovery efforts between LPHAs and other organizations across the public health emergency preparedness system;2) Apply a threat- and efficacy-based model to assess LPHA workers'perceptions and related beliefs toward Hurricane Sandy recovery operational challenges identified in Specific Aim 1, including: whether and how LPHA workers'perceived levels of efficacy toward Hurricane Sandy recovery activities differ by recovery phases per the National Disaster Recovery Framework;the roles, if any, that jurisdictional- and agency-level policies, legal authorities, and personal and household preparedness play in modifying LPHA workers'perceptions of threat and efficacy toward Hurricane Sandy recovery efforts;and whether LPHA workers perceive that their individual participation in Hurricane Sandy recovery activities meaningfully impacts their agencies'success in disaster recovery efforts;and 3) Gauge the effectiveness of a novel curricular intervention for boosting LPHA workers'efficacy perceptions toward the identified recovery challenges and for enhancing their motivation toward ongoing preparedness efforts. The value of this project to the public health emergency preparedness system is both practical and substantial, as it will provide much- needed data-driven insights and novel evidence-based approaches to optimize LPHA recovery and ongoing public health preparedness in the wake of Hurricane Sandy.

Public Health Relevance

The proposed research is directly relevant to public health recovery in the aftermath of Hurricane Sandy, and its novel focus on local public health agency (LPHA) workers'perceptions toward disaster recovery will shed critical new light on leading public health recovery phase challenges from the perspectives of those on the front lines. These insights will, in turn, inform first-of-its-kind curricular intervention to address identified deficits in LPHA workers'recovery-phase efficacy - thus benefiting population health and welfare in the wake of this disaster. This study will yield generalizable knowledge to not only address post-Hurricane Sandy public health recovery challenges, but also to enhance public health preparedness and recovery for future disasters.

National Institute of Health (NIH)
Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZTP1-SXQ (01))
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Williams-Johnson, Mildred M
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Johns Hopkins University
United States
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