Using a community based participatory approach to develop environmental health emergency resilience

An inequitable distribution of resources and education leaves those isolated by geography, language, culture, or socioeconomic factors ill prepared and at risk for poor health outcomes during and after emergencies. In this mixed methods, quasi-experimental systems efficacy study, the conventional expert-driven, top-down approach to environmental health emergency preparedness (EHEP) will be compared to a community-based participatory approach in vulnerable communities of two inland Southern California counties. First, county environmental health (EH) employees from the intervention and control counties received standardized EHEP training to establish an EHEP knowledge baseline. Collective efficacy for community involvement in EHEP and EH employees' readiness to engage the community in implementing EHEP were also measured. Next, a needs and assets assessment was conducted in the intervention county using theory-based semi-structured key informant interviews and validation focus groups. The findings from this baseline assessment will be used to develop a community involved approach to readiness. Meanwhile, the control county was encouraged to proceed with their usual plans for readiness. Process evaluation findings from the initial assessments of employee knowledge of EHEP, readiness to engage the community in EHEP capacity building, and collective efficacy for effectively performing EHEP will be presented. Key barriers and facilitating factors related to community involvement with EHEP will be identified as will the communities' choice of approach to readiness. The results of the initial assessment provide the evidence base for determining whether the CBPR-approach to EHEP is superior to the traditional, expert-driven approach.