Development of a Local Public Health Preparedness Survey: Results of the Pilot Study

Local public health departments (LPHDs) occupy pivotal positions within their communities' emergency preparedness system; however, measuring their abilities to perform and coordinate preparedness and response capacities have been problematic. When viewed through the classic “structure-process-outcome” framework several conceptual differences for measuring public health emergency preparedness (PHEP) exist including a lack of widely accepted standards for preparedness and a weak evidence-base linking structures and processes to outcomes. As a result, a number of survey instruments have been created to collect self-reported measures of preparedness among local and state public health agencies, but relatively few have been subjected to formal validity and reliability testing. Formal validity and reliability testing can involve significant amounts of money and time

This instrument was developed using selected items from existing instruments to help achieve a balance among structural and process measures and among different domains of activity within the preparedness and response continuum. An external panel process was used to select items from each instrument using a four-cycle Delphi method. The consensus set of items were organized into a web-based, self-administered instrument for pilot testing with a diverse set of local PH agencies outside of North Carolina. Cognitive interviews were conducted with 11 local PH agencies in three states (Missouri, Kentucky, and Tennessee) with a total of 28 individual participants including health directors, epidemiologists, emergency preparedness coordinators, and others involved in local emergency preparedness.

According to the results approximately 43% of the individuals completing the survey were emergency preparedness coordinators, 21% were health directors, and 14% were epidemiologist. Interestingly, approximately 90% of the respondents indicated that their LPHD completed an after action report in response to a real event. Several key PHEP domains are measured including surveillance (10 measures), case reporting and investigation (7 measures), community partnerships (14 measures), and workforce preparedness (5 measures).