Willingness of public health workers to report to duty during emergencies: Barriers and risk perceptions modifiers

Since 9/11, public health has seen a progressive cultural change toward a 24/7 emergency response organizational model, requiring readiness and willingness to report to duty in emergencies. A growing body of research has suggested that willingness to respond to health emergencies is scenario-dependent, rooted in risk perception theory, distinct from ability to respond, and may be alarmingly low in dreadful scenarios. In a pre-Katrina pilot study in three local health departments in Maryland, nearly half of the surveyed workers reported they would be unlikely to report to duty in an influenza pandemic.

An anonymous online instrument (Johns Hopkins~ Public Health Infrastructure Response Survey Tool) was developed, and used to survey public health workers in multiple U.S. jurisdictions (several hundreds surveyed- survey ongoing). This self-administered survey, which applies risk perception theories and a behavioral model (the Extended Parallel Processing Model), explores workers' self-perceptions of their efficacy in responding to four distinct scenarios within an all-hazards framework: a weather-related disaster; an influenza pandemic; a “dirty” bomb; and an inhalational anthrax bioterrorism event.

We will discuss the results of this survey currently being directed at a variety of scenarios. From these results we will derive suggestions for public health preparedness training that address constraining attitudes and perceptions, and promote a more favorable response of the public health workforce during an emergency. These data will not only provide important programmatic insights for emergency planning and communication, but also serve as a critical basis for training interventions that address the willingness-to-respond gaps in health departments.