Developing Environmental Health Emergency Resilience in Vulnerable Populations: A Community Based Participatory Research (CBPR) Approach

An inequitable distribution of resources and education leaves those isolated by geography, language, culture, or socioeconomic factors vulnerable and at risk for poor health outcomes during and after emergencies. In this mixed methods, quasi-experimental study, the conventional expert-driven 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 control county proceeded EHEP as usual. The findings from this baseline assessment will be used to inform implementation of CBPR approach to EHEP. The goal is to empower and mobilize vulnerable communities to establish partnerships with local health departments and CBOs and, thus, move toward environmental justice. 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 and the communities' approach to readiness will be identified. 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.