Quantitative Impact of Mental Health Preparedness Training for Public Health Professionals

Developing Public Health Emergency Response Leaders in Incident Management: A Scoping Review of Educational Interventions

During emergency responses, public health leaders frequently serve in incident management roles that differ from their routine job functions. Leaders' familiarity with incident management principles and functions can influence response outcomes. Therefore, training and exercises in incident management are often required for public health leaders. To describe existing methods of incident management training and exercises in the literature, we queried 6 English language databases and found 786 relevant articles. Five themes emerged: (1) experiential learning as an established approach to foster engaging and interactive learning environments and optimize training design; (2) technology-aided decision support tools are increasingly common for crisis decision-making; (3) integration of leadership training in the education continuum is needed for developing public health response leaders; (4) equal emphasis on competency and character is needed for developing capable and adaptable leaders; and (5) consistent evaluation methodologies and metrics are needed to assess the effectiveness of educational interventions.These findings offer important strategic and practical considerations for improving the design and delivery of educational interventions to develop public health emergency response leaders. This review and ongoing real-world events could facilitate further exploration of current practices, emerging trends, and challenges for continuous improvements in developing public health emergency response leaders.

Utilization of Functional Exercises to Build Regional Emergency Preparedness among Rural Health Organizations in the US

Rural communities face barriers to disaster preparedness and considerable risk of disasters. Emergency preparedness among rural communities has improved with funding from federal programs and implementation of a National Incident Management System. The objective of this project was to design and implement disaster exercises to test decision making by rural response partners to improve regional planning, collaboration, and readiness. Six functional exercises were developed and conducted among three rural Nebraska (USA) regions by the Center for Preparedness Education (CPE) at the University of Nebraska Medical Center (Omaha, Nebraska USA). A total of 83 command centers participated. Six functional exercises were designed to test regional response and command-level decision making, and each 3-hour exercise was followed by a 3-hour regional after action conference. Participant feedback, single agency debriefing feedback, and regional After Action Reports were analyzed. Functional exercises were able to test command-level decision making and operations at multiple agencies simultaneously with limited funding. Observations included emergency management jurisdiction barriers to utilization of unified command and establishment of joint information centers, limited utilization of documentation necessary for reimbursement, and the need to develop coordinated public messaging. Functional exercises are a key tool for testing command-level decision making and response at a higher level than what is typically achieved in tabletop or short, full-scale exercises. Functional exercises enable evaluation of command staff, identification of areas for improvement, and advancing regional collaboration among diverse response partners.

ObaidJM, BaileyG, WheelerH, MeyersL, MedcalfSJ, HansenKF, SangerKK, LoweJJ. Utilization of functional exercises to build regional emergency preparedness among rural health organizations in the US. Prehosp Disaster Med. 2017;32(2):224–230.

Feasibility of disaster mental health preparedness training for black communities

OBJECTIVES

To test the feasibility of developing evidence-based mental health training to build capacity to respond to natural disasters in black communities and the adaptation of a train-the-trainer (TTT) model for black community leaders and clinical providers in distressed areas at risk of natural disasters.

METHODS

A core curriculum was developed based on a training needs assessment and resource review. Participants were recruited using network sampling in eastern North Carolina. The core curriculum was tested for usability, revised, and then pilot tested among five mental health providers. Three of the five were trained to lead one-day workshops tailored for black community leaders and clinical providers. Process data were collected, and workshop participants completed posttraining knowledge tests, evaluation forms, and debriefing focus groups.

RESULTS

Ten providers and 13 community leaders pilot tested the training. Posttest knowledge scores were generally higher among clinical providers. Perceived effectiveness of training was higher among community-based organization leaders than clinical providers. Evaluations indicated that the workshop components were culturally relevant and well received by all participants. We identified ways to facilitate recruitment, provide optional e-learning, evaluate effectiveness, and extend trainer support in future field trials.

CONCLUSION

The curriculum and TTT model provide culturally competent disaster mental health preparedness training for black communities.

Prioritizing "psychological" consequences for disaster preparedness and response: a framework for addressing the emotional, behavioral, and cognitive effects of patient surge in large-scale disasters

While information for the medical aspects of disaster surge is increasingly available, there is little guidance for health care facilities on how to manage the psychological aspects of large-scale disasters that might involve a surge of psychological casualties. In addition, no models are available to guide the development of training curricula to address these needs. This article describes 2 conceptual frameworks to guide hospitals and clinics in managing such consequences. One framework was developed to understand the antecedents of psychological effects or "psychological triggers" (restricted movement, limited resources, limited information, trauma exposure, and perceived personal or family risk) that cause the emotional, behavioral, and cognitive reactions following large-scale disasters. Another framework, adapted from the Donabedian quality of care model, was developed to guide appropriate disaster response by health care facilities in addressing the consequences of reactions to psychological triggers. This framework specifies structural components (internal organizational structure and chain of command, resources and infrastructure, and knowledge and skills) that should be in place before an event to minimize consequences. The framework also specifies process components (coordination with external organizations, risk assessment and monitoring, psychological support, and communication and information sharing) to support evidence-informed interventions.