Getting actionable about community resilience: the Los Angeles County Community Disaster Resilience project

Urban Flood Resilience Evaluation Based on Heterogeneous Data and Group Decision-Making

In recent years, urban floods have occurred frequently in China. Therefore, there is an urgent need to strengthen urban flood resilience. This paper proposed a hybrid multi-criteria group decision-making method to assess urban flood resilience based on heterogeneous data, group decision-making methodologies, the pressure-state-response model, and social-economic-natural complex ecosystem theory (PSR-SENCE model). A qualitative and quantitative indicator system is formulated using the PSR-SENCE model. Additionally, a new weighting method for indicators, called the synthesis weighting-group analytic hierarchy process (SW-GAHP), is proposed by considering both intrapersonal consistency and interpersonal consistency of decision-makers. Furthermore, an extensional group decision-making technology (EGDMT) based on heterogeneous data is proposed to evaluate qualitative indicators. The flexible parameterized mapping function (FPMF) is introduced for the evaluation of quantitative indicators. The normal cloud model is employed to handle various uncertainties associated with heterogeneous data. The evaluations for Beijing from 2017 to 2021 reveal a consistent annual improvement in urban flood resilience, with a 14.1% increase. Subsequently, optimization recommendations are presented not only for favorable indicators such as regional economic status, drainability, and public transportation service capacity but also for unfavorable indicators like flood risk and population density. This provides a theoretical foundation and a guide for making decisions about the improvement of urban flood resilience. Finally, our proposed method shows superiority and robustness through comparative and sensitivity analyses.

Parasitic Resilience: The Next Phase of Public Health Preparedness Must Address Power Imbalances Between Communities

Community resilience, a system's ability to maintain its essential functions despite disturbance, is a cornerstone of public health preparedness. However, as currently practiced, community resilience generally focuses on defined neighborhood characteristics to describe factors such as vulnerability or social capital. This ignores the way that residents of some neighborhoods (as "essential workers") were required during the COVID-19 pandemic to sacrifice their wellbeing for the sake of others staying at home in more affluent neighborhoods. Using the global care chain theory, we analyze the way that the resilience of affluent neighborhoods depends on siphoning off the labor of other, less affluent neighborhoods, creating what we call the parasitic nature of resilience. We argue that understanding this neighborhood interdependence-and accounting for its parasitic nature-should be prioritized by public health authorities to prevent unintentional harm in future pandemics. Otherwise, any public health emergency response that relies on this labor (as did the COVID-19 pandemic response) depends on exploitative practices that produce the very disparities the response is trying to address. We explore the theoretical grounding and practical effects of this idea to provide the preparedness enterprise with an initial set of theoretical tools to move from a model of community resilience to one of community renewal. The community renewal model is based on an underlying ethics of care, in which systems are redesigned to become more prosocial during a public health response. We believe this model can more successfully address the tragic inequities in labor and health outcomes that we see during public health emergencies.

Relationships are everything: The underpinnings of grassroots community action in the COVID-19 pandemic in Toronto

Most government emergency/pandemic response plans feature top-down decision making and communication strategies and a focus on 'hard' (physical) infrastructure. There is nothing about the importance of the ideas and communications originating from communities, the social infrastructure that supports their impact locally and their contribution to the central administration. In this study, we found that the 'soft' (social) infrastructure within communities and between communities and formal institutions is key to an inclusive and more equitable response to large-scale crises like the COVID-19 pandemic. Grassroots leaders in six Toronto neighbourhoods were interviewed between the first and second waves of the COVID-19 pandemic in Toronto about what helped or hindered community action. Three themes emerged: (1) Grassroots leaders and community organizations were able to act as key connection points in a two-way flow of information and resources with residents and service providers; (2) Grassroots leaders and groups were challenged to engage in this work in a sustained capacity without adequate resourcing; and (3) there was a disconnect between community-centred grassroots approaches and the City's emergency response. We conclude that there needs to be pre-disaster investment in community level planning and preparation that fosters two-way connections between all municipal emergency/disaster and pandemic preparedness plans and community-centred organizations and grassroots leaders working in marginalized communities.

A Socio-Health Approach to Improve Local Disaster Resilience and Contain Secondary Crises: A Case Study in an Agricultural Community Exposed to Bushfires in Australia

Recent large-scale disasters have exposed the interconnected nature of modern societies, exacerbating the risk of cascading impacts. Examining elements of community health status, such as social determinants of health, their perceived health status, and how they relate to disaster resilience, can illuminate alternative actions for cost-effective disaster prevention and management. Moreover, agricultural communities are essential to food security and provide a working example of the importance of mitigation in escalation of crises. To that aim, this research examines perceptions of the relationship between disaster resilience and determinants of health, including health status. Participants also reported their views on perceived vulnerable groups in their community and proposed design characteristics of more effective community disaster plans.Here investigated are these elements in a small agricultural community of Western Australia previously exposed to bushfires. A questionnaire was used based on health elements from the Social Determinants of Health described by the World Health Organization (WHO) and compared this with quantitative data describing the community health status. A mixed methods approach combining qualitative (semi-structured interview) and quantitative (closed questions using a Likert scale) tools was undertaken with a small group of community members.It was found that community connection and social capital were perceived to provide knowledge and support that enhanced individual disaster risk awareness and preparedness and improved an individual's disaster resilience. Stress and social exclusion within a community were perceived to decrease an individual's resilience to disaster. Disaster resilience was reported to be a function of good physical and mental health. To achieve effective disaster planning, community partnership in the development, education, and testing of plans and robust communication were described as essential traits in community emergency plans.

Predicting COVID-19 community infection relative risk with a Dynamic Bayesian Network

As COVID-19 continues to impact the United States and the world at large it is becoming increasingly necessary to develop methods which predict local scale spread of the disease. This is especially important as newer variants of the virus are likely to emerge and threaten community spread. We develop a Dynamic Bayesian Network (DBN) to predict community-level relative risk of COVID-19 infection at the census tract scale in the U.S. state of Indiana. The model incorporates measures of social and environmental vulnerability-including environmental determinants of COVID-19 infection-into a spatial temporal prediction of infection relative risk 1-month into the future. The DBN significantly outperforms five other modeling techniques used for comparison and which are typically applied in spatial epidemiological applications. The logic behind the DBN also makes it very well-suited for spatial-temporal prediction and for "what-if" analysis. The research results also highlight the need for further research using DBN-type approaches that incorporate methods of artificial intelligence into modeling dynamic processes, especially prominent within spatial epidemiologic applications.

What does community resilience mean in the context of trauma-informed communities? A scoping review

Several communities are implementing trauma-informed, community-level approaches focused on addressing/preventing adverse childhood experiences (ACEs), yet most community resilience definitions from published articles are based on acute traumas. This scoping review aims to determine how community resilience is defined and operationalized within the context of chronic/complex traumas.

METHODS

We performed a rigorous, comprehensive literature search using multiple databases.

RESULTS

The 38 included articles addressed multiple types of chronic traumas, including historical trauma, poverty, minority stress, mass incarceration, and ACEs. A variety of definitions of community resilience were cited, several of which stressed the ability to thrive despite risk factors and the safety and wellbeing of residents. Few articles operationalized community resilience within the context of ACEs, suggesting significant gaps in the literature.

CONCLUSION

This review can serve as an important building block to develop expanded definitions of community resilience for chronic traumas and assist communities in promoting community-wide responses to ACEs.

Moderating Effect of Personal and Community Resilience on the Relationship Between Disaster Trauma, Disaster Conflict, Economic Loss, and Post-traumatic Stress Disorder

OBJECTIVE

This study aimed to investigate the effects of disaster trauma, disaster conflict, and economic loss on posttraumatic stress disorder (PTSD), and to verify the moderating effect of personal and community resilience in these relationships. The data of 1914 people, aged 20 or above, who had experienced natural disasters (earthquake, typhoon, flooding) were used.

METHODS

Hayes's (2013) PROCESS macro (Model 1) was conducted to verify the moderation effect of personal and community resilience between PTSD and disaster trauma, disaster conflict, and economic loss.

RESULTS

Disaster trauma, disaster conflict, and economic loss were found to be positively related to PTSD. Personal and community resilience were negatively related to PTSD. Resilience had a moderating effect on the relationship between disaster trauma, economic loss, and PTSD. However, there was no moderating effect on the relationship between disaster conflict and PTSD. Community resilience had a moderating effect on the relationship between economic loss and PTSD. However, there was no moderating effect on the relationship between disaster trauma, disaster conflict, and PTSD.

CONCLUSIONS

The results suggest that personal and community resilience could be used for prevention and therapeutic interventions for disaster victims who experience PTSD.

An Approach to the Unified Conceptualization, Definition, and Characterization of Social Resilience

The purpose of this article is to offer a synthesis of the characteristics of social resilience, integrating the different approaches received from the social sciences. We propose to focus this conceptual framework as a previous and necessary step for the later study of the possible ways of promotion of this social resilience, that will help to strengthen the welfare and public health systems. The paper explores the difficulties in defining these characteristics, identifying their constituent elements. After this, the paper study the challenges to the future development of resilience models, showing the ways that offer some advances. Finally, we conclude that the social resilience must be conceived as a dynamic, multi-level, and evolutionary process if we are to help societies not only cope with adversity but also to adapt and transform themselves.

Building community resilience during COVID‐19: Learning from rural Bangladesh

The COVID‐19 pandemic has brought overwhelming challenges to developing countries which are already resource‐constrained and lack adequate social safety nets. Specifically, lockdown has adversely impacted marginalized communities (e.g., labourer, fish wholesaler and small business owner) and informal sector employees who rely on meager daily wages for their survival. Set in the contested climate of the emergency response to the COVID‐19 outbreak in Phulbari, Dinajpur, Bangladesh, we examine the early response of the community to the pandemic. Drawing on 24 in‐depth interviews with members of this community, we find that the existing central and regional government structure has failed to deal with the crisis. Yet, we show how collective effort at the local community level, led by volunteers and community leaders, is crucial in the fight against hardship during lockdown.

Community Disaster Resilience and Risk Perception in Earthquake-Stricken Areas of China

OBJECTIVE

The purpose of this study is to further deepen our understanding of the relationship between community resilience and disaster risk perception of residents, so as to provide beneficial enlightenment for the construction of community resilience disaster prevention system and disaster risk management.

METHODS

This study surveyed 327 rural households in four counties of Sichuan Province, China, that were affected by the Wenchuan and Lushan earthquakes. Community disaster resilience was divided into five dimensions: connection and caring, resources, transformative potential, disaster management, and information and communication. Residents' disaster risk perception was divided into three dimensions: possibility, threat, and worry. This study analyzed the characteristics of community disaster resilience and residents' disaster risk perceptions. Ordinary least squares (OLS) methods were used to explore the correlations between these factors.

RESULTS

The results show that (1) Residents' overall disaster risk perception was at a moderate level, and the community's overall disaster resilience were above the moderate level. (2) Community connection and caring has a positive significant correlation with the possibility perception of disaster occurrence; transformative potential has a negative significant correlation with the possibility perception of disaster occurrence; the overall community disaster resilience has negative significant correlations with the possibility and the overall residents' perception of disaster risk occurrence.

CONCLUSIONS

The implication for the local government is that the government should appropriately increase its contact with external institutions/organizations, especially some Non-Governmental Organization, to strengthen the resilience and disaster prevention capacity of the community. Establish and improve information and communication networks to ensure the timely and effective transmission of effective disaster information, and strengthen the supervision of the dissemination of false information to reduce the losses caused by false information to residents. Attention should be paid to psychological counseling for people in disaster-hit areas to reduce the psychological trauma of the disaster.

Using ARC-D Toolkit for Measuring Community Resilience to Disasters

Increased levels of resilience will reduce the negative consequences of any disaster and develop the capacities of communities to mitigate future disasters. The main objective of this study was to measure the level of resilience of two different communities in two different study areas and compare the resilience levels in terms of a flood. The study used the Analysis of Resilience of Communities to Disasters (ARC-D) toolkit. The study was conducted in two different areas to compare the level of community resilience. Both quantitative and qualitative methods were used in the study. A structured questionnaire was developed by using the toolkit. Results of the study indicated that communities in study area 1 were more resilient than communities in study area 2. Communities from study area 1 were more aware of their risk(s) and problem(s) and ensured proper strategies and actions to solve problems. On the other hand, communities in study area 2 were less aware of their risk(s). The strategies and actions implemented by the communities of study area 1 focused on the short-term problem(s), which reduced their level of resilience. Measuring resilience is very important in terms of developing disaster risk reduction (DRR) plans and incorporating DRR in the development process in lower-income countries and developing countries. As data scarcity is one of the major issues in developing countries, introducing a community resilience assessment mechanism can be a great help to reduce gaps in the planning and implementation process.

Environmental Changed, Capacity of Adaptation, and The Levels of Community Resilience Post-Earthquake in Lombok, Indonesia: A Cross-Sectional study

BACKGROUND: Natural disasters led to environmental destruction, casualties, and fatality. Disasters have been associated with post-traumatic disorders among affected community, thus, it is important to understand capability and resilience level post-disasters. AIM: This study aims to determine the degree of environmental change and the capacity of adaptation associate to the levels of community resilience among earthquake victims in Lombok, Indonesia. METHODS: A number of 129 respondents were recruited using clustered random sampling design. Data were collected using the adaptation capacity framework and the resilience brief scale questionnaire by face-to-face interviews. Significant level was set as p = 0.05 with 95% confidence interval. A Chi-square statistical test and logistic regression were used to test hypothesis. RESULTS: A number of 129 respondents included in the study. Bivariate analysis indicated a significant correlation between environmental changed, adaptation capacity, and community resilience. Environmental changed was predictor that statistically significant predicted community resilience (ß = 2.425, p < 0.001). CONCLUSION: The level of environmental destruction was significantly predicted the level of community resilience.

The community resilience measurement throughout the COVID-19 pandemic and beyond -an empirical study based on data from Shanghai, Wuhan and Chengdu

Against the backdrop of the COVID-19 pandemic, there is widespread agreement in the field of public health that community resilience should be maintained and strengthened. However, there are significant differences in the pandemic prevention effects between different communities in different areas. To explore the main influencing factors on community resilience and the magnitude of their impact during the pandemic, this study collected 650 valid questionnaires from Shanghai, Wuhan and Chengdu by using the Communities Advancing Resilience Toolkit Assessment Survey (CART). Data collection was conducted from February to March 2020 when this three cities activated a Level One public health emergency response. The data were analyzed by using multiple linear regression analysis and structural equation model. Results indicate that: (1) Domains such as Information and Communication, and Connection and Caring scored higher, while Disaster Management, Resources and Transformative Potential scored lower; (2) A community got higher resilience scores if it took more effective measures to prevent and control the pandemic(Shanghai > Chengdu > Wuhan), people within the community participated more actively in disaster risk reduction activities and activities of volunteer responder groups, and people were more closely connected with the community; (3) Variables such as the participation in affiliated volunteer responder groups, and community disaster risk reduction activities exerted the biggest impact on community resilience. Therefore, it is urgent to establish a community-based, resilience-centered framework of community resilience in the post-pandemic era. This framework will strengthen a community's capacity to cope with disasters and risks.

Risk Perception, Risk Communication, and Mitigation Actions of Flash Floods: Results from a Survey in Three Types of Communities

In order to improve the decision-making of risk management and enhance community resilience to flash floods, the perception of risks, communication of warnings, and mitigation actions concerning flash floods were investigated in this study. The survey involves 280 participants from three types of communities in flash flood-prone areas. Results show that: (i) About 55.4% of community participants misperceived or underestimated the risk of flash floods, especially in the suburban communities, and people had misconceptions about the safety of crossing fast-flowing water, even though most of them had experienced flash flood hazards. (ii) In total, 67.9% of participants indicated that they had at some point received a flash flood warning. The perception of accuracy was related to trust in flash flood warnings, but they were different constructs for some individuals. Moreover, residents in the rural community and suburban community reported a closer social communication with neighbors, which would greatly influence inhabitants’ attitudes and behaviors towards the flash flood warnings and mitigation actions. (iii) Most of the participants indicated they would take some protective action when they received a warning. Risk perceptions and risk communications influence the mitigation actions in the community. Significant variables in the rural community and non-rural community were explored, and some important suggestions are highlighted. These findings suggest that risk perception and risk communication in neighborhoods help people to decide what action to take in the given scenarios, contribute to enhancing the community resilience, and contribute to coping with future flash floods in a more specific and effective way.

A Connected Community Approach: Citizens and Formal Institutions Working Together to Build Community-Centred Resilience

Urban resilience research is recognizing the need to complement a mainstream preoccupation with “hard” infrastructure (electrical grid, storm sewers, etc.) with attention to the “soft” (social) infrastructure issues that include the increased visibility of and role for civil society, moving from (top-down, paternalistic) government to (participatory) governance. Analyses of past shock events invariably point to the need for more concerted efforts in building effective governance and networked relations between civil society groupings and formal institutions before, during, and after crisis. However, the literature contains little advice on how to go about this. In this paper, we advance a Connected Community Approach (CCA) to building community resilience with a specific focus on the relationship between community and formal institutions. In the literature review that informs this work, we assess the current, limited models for connecting communities to formal institutions, as well as the emerging role of community-based organizations in this work, and we offer our own assessment of some of the key tensions, lacunae, and trends in the community resilience field. Principally, we explore the potential of the CCA model, as spearheaded by the East Scarborough Storefront and the Centre for Connected Communities in Toronto, Canada, as a promising approach for building the relational space between civil society and the state that is so often called for in the literature. The paper concludes with future directions for research and practice.

What Do You Mean by Community Resilience? More Assets or Better Prepared?

OBJECTIVES

Understanding people's perception of community resilience to disaster is important. This study explores the correlations of household livelihood assets, the adopted household disaster preparedness activities, and individuals' assessment of community resilience.

METHODS

The data was collected in 2018 by surveying a group of survivors affected by the 2008 Wenchuan earthquake in China. The CART (Community Advancing Resilience Toolkit) was used to measure individuals' perception of community resilience, while the livelihood assets included financial, physical, natural, human, and social capitals owned by the family, and the preparedness contained 13 activities. Ordinary least squares (OLS) regression models were used to test our hypotheses.

RESULTS

Social capital is consistently and positively associated with the overall individuals' perceived community resilience, while the natural, human, and financial capitals' effects are not significant. The awareness and participation preparedness activities are positively correlated with the perceived community resilience, but the material preparedness activities are not.

CONCLUSIONS

Social capital and disaster preparedness activities are critical in building community resilience. Community resilience can be achieved by making the community more connected and by providing disaster preparedness interventions.

Community engagement in public health: a bibliometric mapping of global research

Background

Community engagement (CE) has been regarded as a critical element of successful health programs to achieve “the health for all” goals. Numerous studies have shown that it plays a significant role in reducing inequalities, improving social justice, enhancing benefits, and sharing responsibility towards public health. Despite this, the extant literature of community engagement in public health (CEPH) has topic-focused boundaries and is scattered across disciplinary. Large-scale studies are needed to systematically identify current status, hotspots, knowledge structure, dynamic trends, and future developments in this field.

Methods

The bibliometric techniques were applied in the analysis of publications on CEPH in Web of Science Core Collection from Thomson Reuters. One thousand one hundred two papers out of 70.8 million publications over the period of 1980 to 2020 and their 15,116 references were retrieved as the sample set. First, basic characteristics of publications, including distributions of geography, journals and categories, productive authors and frequently cited articles, etc. were obtained. Then, four bibliometric methods, i.e. social network analysis, co-citation analysis, co-occurrence clustering, and burst detection, were further conducted to sketch the contours of the structure and evolution of CEPH.

Results

Between Jan 1, 1980, and Apr 25, 2020, CEPH has attracted a sharp increase in interest all over the world. Total 117 countries or regions have participated in the field of CEPH and the contributions are geographically and institutionally distinct. The United States is the key region performing such research, which accounts for more than half of the total number of publications. Developing countries, such as South Africa, India, Brazil and China also contributed a lot. The advancements of CEPH are marked by historically momentous public health events and evolved from macroscopic strategies to mesoscopic and microscopic actions. Based on keyword clustering and co-citation clustering, we propose a 4O (i.e. orientation, object, operation, and outcome) framework of CEPH to facilitate a better understanding of the current global achievements and an elaborate structuring of developments in the future.

Conclusion

This study draws an outline of the global review on the contemporary and cross-disciplinary research of CEPH which might present an opportunity to take stock and understand the march of knowledge as well as the logical venation underlying research activities which are fundamental to inform policy making.

A Rapid Assessment of Disaster Preparedness Needs and Resources during the COVID-19 Pandemic

Background: This year has seen the emergence of two major crises, a significant increase in the frequency and severity of hurricanes and the COVID-19 pandemic. However, little is known as to how each of these two events have impacted the other. A rapid qualitative assessment was conducted to determine the impact of the pandemic on preparedness and response to natural disasters and the impact of past experiences with natural disasters in responding to the pandemic. Methods: Semi-structured interviews were conducted with 26 representatives of 24 different community-based programs in southern Louisiana. Data were analyzed using procedures embedded in the Rapid Assessment Procedure-Informed Community Ethnography methodology, using techniques of immersion and crystallization and focused thematic analysis. Results: The pandemic has impacted the form and function of disaster preparedness, making it harder to plan for evacuations in the event of a hurricane. Specific concerns included being able to see people in person, providing food and other resources to residents who shelter in place, finding volunteers to assist in food distribution and other forms of disaster response, competing for funds to support disaster-related activities, developing new support infrastructures, and focusing on equity in disaster preparedness. However, several strengths based on disaster preparedness experience and capabilities were identified, including providing a framework for how to respond and adapt to COVID and integration of COVID response with their normal disaster preparedness activities. Conclusions: Although prior experience has enabled community-based organizations to respond to the pandemic, the pandemic is also creating new challenges to preparing for and responding to natural disasters.

Examining the role of ageing-in-place organisations in building older adults’ disaster resilience

Older adults are more susceptible to adverse health outcomes during and after a disaster compared with their younger counterparts. Ageing-in-place organisations such as senior centres and Villages provide social services and programming for older adults and may support older adults’ resilience to disasters. This study examines the role of ageing-in-place organisations in building disaster resilience for older adults. Semi-structured interviews were conducted with a purposive sample of 14 ageing-in-place organisation leaders in King County, Washington in the United States of America. The sample included representatives of five government-run senior centres, seven non-profit senior centres and two Villages. Interviews were audio-recorded and professionally transcribed. We used a combined inductive and deductive approach to code and thematically analyse the data. Ageing-in-place organisation leadership recognise disasters as a threat to older adults’ health and safety, and they see opportunities to provide disaster-related support for older adults, though the type and extent of participation in resilience-building activities reflected each organisation's unique local context. Organisations participate in a variety of disaster-related activities, though respondents emphasised the importance of collaborative and communication-focused efforts. Findings suggest that ageing-in-place organisations may be best equipped to support older adults’ disaster resilience by serving as a trusted source of disaster-related information and providing input on the appropriateness of disaster plans and messages for the unique needs of older adults ageing-in-place.

Household preparedness for emergency events: a cross-sectional survey on residents in four regions of China

OBJECTIVE

This study aimed to assess household preparedness for emergency events and its determinants in China.

DESIGN

A cross-sectional questionnaire survey was conducted on 3541 households in China in 2015.

PARTICIPANTS

Households were selected using a stratified cluster sampling strategy, representing central, eastern, western and southern regions of China. The designed questionnaires were administered through face-to-face interviews.

OUTCOME MEASURES

Household emergency preparedness was measured with 14 indicators, tapping into the supply of nine emergency necessities (food and water, extra batteries, battery-powered radio, battery-operated torch, first-aid kit, gas mask, fire extinguisher, escape ropes, whistle), coverage of accident insurance, knowledge of local emergency response systems (emergency numbers, exit routes and shelters) and availability of a household evacuation plan. If an individual acted on 9 of the 14 indicators, they were deemed well prepared. Logistic regression models were established to identify predictors of well preparedness based on 3541 returned questionnaires containing no missing values.

RESULTS

Only 9.9% of households were well prepared for emergencies: 53.6% did not know what to do and 31.6% did not want to think about it. A higher level of preparedness was found in the respondents who have attained higher education (adjusted OR=0.826 compared with the higher level), participated in emergency training activities (adjusted OR=2.299), had better emergency knowledge (adjusted OR=2.043), reported less fate-submissiveness (adjusted OR=1.385) and more self-reliance (adjusted OR=1.349), prior exposure to emergency events (adjusted OR=1.280) and held more positive attitudes towards preparedness (adjusted OR=1.286).

CONCLUSION

Household preparedness for emergency events is poor in China. Lack of motivation, negative attitude to preparedness and knowledge shortfall are major but remediable barriers for household preparedness.

High-Performing Local Health Departments Relate Their Experiences at Community Engagement in Emergency Preparedness

CONTEXT

Local health departments (LHDs) are implementing a national mandate to engage community partners, including individuals, businesses, and community- and faith-based organizations in the larger public health emergency preparedness (PHEP) enterprise.

OBJECTIVE

Investigate how LHDs of varying size and resource levels successfully engage the community in PHEP to help uncover "best practices" that aspiring agencies can replicate, particularly in low-resource environments.

DESIGN

In-depth, semistructured qualitative interviews with practitioners from 9 highly performing LHDs.

SETTING

Participating agencies comprised equal amounts of small (serving <50 000 residents), medium (serving 50 000-500 000 residents), and large (serving >500 000 residents) LHDs and were diverse in terms of geographic region, rural-urban environment, and governance structure.

PARTICIPANTS

A cross section of LHD staff (n = 34) including agency leaders, preparedness coordinators, public information officers, and health educators/promoters.

MAIN OUTCOME MEASURE

Local health department performance at community engagement as determined by top scores in 2 national LHD surveys (2012, 2015) regarding community engagement in PHEP.

RESULTS

Based on key informant accounts, high-performing LHDs show a holistic, organization-wide commitment to, rather than discrete focus on, community engagement. Best practices clustered around 5 domains: administration (eg, top executive who models collaborative behavior), organizational culture (eg, solicitous rather than prescriptive posture regarding community needs), social capital (eg, mining preexisting community connections held by other LHD programs), workforce skills (eg, cultural competence), and methods/tactics (eg, visibility in community events unrelated to PHEP).

CONCLUSIONS

For LHDs that wish to enhance their performance at community engagement in PHEP, change will entail adoption of evidence-based interventions (the technical "what") as well as evidence-based administrative approaches (the managerial "how"). Smaller, rural LHDs should be encouraged that, in the case of PHEP community engagement, they have unique social assets that may help offset advantages that larger, more materially resourced metropolitan health departments may have.

The Local Health Department Mandate and Capacity for Community Engagement in Emergency Preparedness: A National View Over Time

CONTEXT

Local health departments (LHDs) perform the highly valued, yet time- and staff-intensive work of community engagement in public health emergency preparedness (CE-PHEP) when the Great Recession has had lingering effects on their organizational capacity.

OBJECTIVE

Track the extent to which LHDs still embrace collaborative, whole community approaches to PHEP in a historically low resource environment.

DESIGN

National survey in 2015 of LHDs using a self-administered online questionnaire regarding LHD practices and resources for CE-PHEP first fielded in 2012 ("The Community Engagement for Public Health Emergency Preparedness Survey"). Differences in 2015 survey responses were reviewed, and comparisons made between 2012 and 2015 responses.

SETTING

Randomized sample of 811 LHDs drawn from 2565 LHDs that were invited to participate in the 2010 National Profile of LHDs and participated in the 2012 CE-PHEP survey. Sample selection was stratified by geographic location and size of population served.

PARTICIPANTS

Emergency preparedness coordinators reporting on the LHDs they serve.

MAIN OUTCOME MEASURE

Community engagement in public health emergency preparedness intensity as measured by a scoring system that valued specific practices on the basis of the community capacity and public participation they represented.

RESULTS

Survey response was 30%; 243 LHDs participated. The CE-PHEP activities and intensity scores remained unchanged from 2012 to 2015. Local health departments that reported having an explicit CE-PHEP policy and experienced CE-PHEP staff member--2 of the top 3 predictors of CE-PHEP intensity--have dropped between 2012 and 2015. The numbers of LHDs with a CE-PHEP budget, also an important predictor of intensity, have not increased in a statistically significant way during that same period.

CONCLUSIONS

Local health departments appear to be in a CE-PHEP holding pattern, presumably pushed forward by the doctrinal focus on partner-centered preparedness but held back by capacity issues, in particular, limited staff and partner support. Local health departments operating in low-resource environments are encouraged to formalize their CE-PHEP policy to advance performance in this arena.

Who Is Happier in China? Exploring Determinant Factors Using Religion as a Moderator

The relationship between religion and happiness has been seriously understudied in non-Western and non-Islamic societies. Taking religious identity and religious practice as strata, the 2015 Chinese General Social Survey (CGSS) data were used to examine the predicting power of health, politics, and social relationships with regard to happiness in four different groups, as follows: People with a religious identity and practice, people with no religious identity but with a practice, people with a religious identity but no practice, and people with neither a religious identity nor practice. Multiple regression analyses were conducted using the Ordinary Least Squares method. The results demonstrate the influence of the independent variables in the four groups, thus confirming the expectation that different religious practices, as well as identities, play a vital role in moderating the degree of happiness. Physical and mental health are significant predictors of happiness regardless of different religious situations, with the effect of mental health here found to be greater in magnitude on happiness than that of physical health. Political participation was not found to be related to happiness, but having a left-wing political attitude did emerge as strongly predicting happiness. The results concerning social relationships further consolidate the hypothesis that religious practice should be taken into consideration separately from religious identity. This study indicates the importance of further investigating religious practice as an independent factor in religious studies in the context of Chinese society.

"We All Have Strengths": A Retrospective Qualitative Evaluation of a Resilience Training for Latino Immigrants in Philadelphia, PA

Background: Limited research has explored sources of resilience for Latino immigrants or the potential of resilience-based interventions to promote Latino immigrant health and well-being.

Purpose: To evaluate Latino immigrants' experiences with a resilience training and application of the training to participants' personal lives and their communities among Latino immigrants.

Methods: We conducted a retrospective, qualitative study in Philadelphia, PA from 2017 to 2018. We completed semi-structured, key informant interviews with nine participants who had taken the resilience training, and one facilitator (N=10). Transcripts were analyzed via interpretive content analysis.

Results: The training resonated deeply with participants because of their personal traumas and immigration-related adversity. Participants were primed by past experiences of violence, as well as by daily struggles they encounter as Latino immigrants in the United States amid worsening anti-immigrant rhetoric and policy. The training was found to be transformative by allowing participants to discover and tap into their own inherent resilience. Participants utilized the knowledge and skills acquired from the training to better manage daily situations, as well as worked to strengthen others within their networks.

Conclusions: Resilience-based interventions can help to strengthen communities against adversity. Cultivating resilience in Latino immigrants can have positive effects on psychosocial health. Resilience-building approaches could be implemented as stand-alone or enhancing components of more complex health promotion interventions. More research is needed on resilience, as well as its utility in community-based interventions to promote the health and well-being of Latino immigrants.

Proximal and distal determinants of community resilience under threats of terror

Community resilience (CR) is a positive trajectory of adaptation of a commune after a disturbance, stress, or adversity. Previous studies have successfully predicted CR in times of stress by distal factors, such as demographic characteristics of the community members and by their psychological attributes. We submit that since all these variables are distal predictors, which are not directly related to the actual stressful condition, CR would be predicted more readily by proximal factors, which portray people's responses to the investigated adversity (i.e., trust in the community emergency team). A sample of 1,515 adults, living in terror-stricken border communities in northern Israel has been examined. Their perceived CR has been predicted concurrently by distal and by proximal factors. Results have supported the research hypotheses, indicating the importance of proximal variables in determining and promoting CR.

Confidence in Health-Services Availability during Disasters and Emergency Situations-Does it Matter?-Lessons Learned from an Israeli Population Survey

The association between health and community resilience is well established in the literature. However, maintaining continuity of healthcare services during emergencies, and their contribution in the context of community resiliency have not been sufficiently studied. This study aims to explore the relationship between the public's confidence in the availability of healthcare services during and following emergencies, and community resilience. A cross-sectional study was conducted among 3478 Israeli adults, using the Conjoint Community Resilience Assessment Measurement (CCRAM) tool. Associations between confidence in health services availability during emergencies, socio-demographic variables, and community resilience as measured by the CCRAM score were analyzed. The results revealed that confidence in the availability of health services positively correlated with community resilience score (r(3377) = 0.580, p < 0.001), and that it contributed significantly to increasing resilience (OR = 2.67, 95% CI (2.4-2.9), p < 0.001). Maintaining continuity of healthcare services during emergencies has effects beyond the provision of medical treatment. For instance, the confidence of the population in the availability of these services contributes to community resilience. In turn, this finding can be translated into practical resilience building actions and to facilitate community health.

Breaking Through Barriers and Building Disaster Mental Resilience: A Case Study in the Aftermath of the 2015 Nepal Earthquakes

Introduction: Nepal was hit by two devastating earthquakes in 2015 that disrupted its socio-economic system and shattered many lives, resulting in increased mental health issues during the post-earthquake phase. Disasters can have severe mental health impacts on the affected population, making it necessary to enhance resilience within communities and to help them to adapt well in the face of adversities. From these earthquakes, this study looks to identify measures needed to develop community mental resilience for disaster preparedness in Nepal. Method: We conducted this research using the qualitative case study method and thematic analysis (TA). Result: Several activities were carried out by organizations to support the psycho-social aspects of communities, but were challenged by existing barriers. After considering the present context, this study presents five recommendations for mental resilience and also suggests the utilization of existing resources, such as faith-based organizations and teachers in the communities. Despite the considerable impact, communities demonstrate their own resilience, to some extent, through the culture of sharing and helping each other. Conclusions: A firm commitment is required from the government to enhance resilience by mainstreaming mental health in all areas of disaster management and planning.

Hybrid Resiliency-Stressor Conceptual Framework for Informing Decision Support Tools and Addressing Environmental Injustice and Health Inequities

While structural factors may drive health inequities, certain health-promoting attributes of one's "place" known as salutogens may further moderate the cumulative impacts of exposures to socio-environmental stressors that behave as pathogens. Understanding the synergistic relationship between socio-environmental stressors and resilience factors is a critical component in reducing health inequities; however, the catalyst for this concept relies on community-engaged research approaches to ultimately strengthen resiliency and promote health. Furthermore, this concept has not been fully integrated into environmental justice and cumulative risk assessment screening tools designed to identify geospatial variability in environmental factors that may be associated with health inequities. As a result, we propose a hybrid resiliency-stressor conceptual framework to inform the development of environmental justice and cumulative risk assessment screening tools that can detect environmental inequities and opportunities for resilience in vulnerable populations. We explore the relationship between actual exposures to socio-environmental stressors, perceptions of stressors, and one's physiological and psychological stress response to environmental stimuli, which collectively may perpetuate health inequities by increasing allostatic load and initiating disease onset. This comprehensive framework expands the scope of existing screening tools to inform action-based solutions that rely on community-engaged research efforts to increase resiliency and promote positive health outcomes.

Theory and Metrics of Community Resilience: A Systematic Literature Review Based on Public Health Guidelines

A systematic literature review on quantitative methods to assess community resilience was conducted following Institute of Medicine and Patient-Centered Outcomes Research Institute standards. Community resilience is the ability of a community to bounce back or return to normal after a disaster strikes, yet there is no agreement on what this actually means. All studies reviewed addressed natural disasters, but the methodological approaches can be applied to technological disasters, epidemics, and terrorist attacks. Theoretical frameworks consider the association between vulnerability, resilience, and preparedness, yet these associations vary across frameworks. Because of this complexity, indexes based on composite indicators are the predominant methodological tool used to assess community resilience. Indexes identify similar dimensions but observe resilience at both the individual and geographical levels, reflecting a lack of agreement on what constitutes a community. A consistent, cross-disciplinary metric for community resilience would allow for identifying areas to apply short-term versus long-term interventions. A comparable metric for assessing geographic units in multiple levels and dimensions is an opportunity to identify regional strengths and weaknesses, develop timely targeted policy interventions, improve policy evaluation instruments, and grant allocation formulas design. (Disaster Med Public Health Preparedness. 2017;11:756-763).

Community Resilience Learning Collaborative and Research Network (C-LEARN): Study Protocol with Participatory Planning for a Randomized, Comparative Effectiveness Trial

This manuscript presents the protocol and participatory planning process for implementing the Community Resilience Learning Collaborative and Research Network (C-LEARN) study. C-LEARN is designed to determine how to build a service program and individual client capacity to improve mental health-related quality of life among individuals at risk for depression, with exposure to social risk factors or concerns about environmental hazards in areas of Southern Louisiana at risk for events such as hurricanes and storms. The study uses a Community Partnered Participatory Research (CPPR) framework to incorporate community priorities into study design and implementation. The first phase of C-LEARN is assessment of community priorities, assets, and opportunities for building resilience through key informant interviews and community agency outreach. Findings from this phase will inform the implementation of a two-level (program-level and individual client level) randomized study in up to four South Louisiana communities. Within communities, health and social-community service programs will be randomized to Community Engagement and Planning (CEP) for multi-sector coalition support or Technical Assistance (TA) for individual program support to implement evidence-based and community-prioritized intervention toolkits, including an expanded version of depression collaborative care and resources (referrals, manuals) to address social risk factors such as financial or housing instability and for a community resilience approach to disaster preparedness and response. Within each arm, the study will randomize individual adult clients to one of two mobile applications that provide informational resources on services for depression, social risk factors, and disaster response or also provide psychoeducation on Cognitive Behavioral Therapy to enhance coping with stress and mood. Planned data collection includes baseline, six-month and brief monthly surveys for clients, and baseline and 12-month surveys for administrators and staff.

A systematic review of components of community-based organisation engagement

Community-based organisations (CBOs) are important for eliminating health disparities globally and translating research findings to inform interventions. Engagement is an integral part of partnerships between CBOs and community health researchers and impacts the quality and quantity of any desired outcome. Despite the acknowledged benefits of community-based organisation engagement (CBOE), there are variations in its operationalisation and paucity in the understanding of its use in community-scientific partnerships. To further understand CBOE, the aim of this study was to synthesise published literature relevant to the definitions and applications of CBOE and identify its key components. A systematic search was conducted in March 2017, and updated in June 2017. Keywords were varied to account for international differences in spelling and word usage. Five major databases, MEDLINE, PubMed, CINAHL, PsycINFO and Google Scholar, were used to identify potential research studies. A total of 32 studies were included in this review. Following the analysis of the literature, four salient themes emerged as components of CBOE: (1) Need (a consensus between all the parties in a partnership on the importance of a specified project and its proposed benefits to a target community); (2) Partnership Dynamics (the workings of a relationship between a CBO and a scientific/academic stakeholder); (3) Resources (include but are not limited to: personnel, money, work space, expertise and equipment); and (4) Outcomes (products of the partnership). This review provides a foundation for future research in applying CBOE to translational research and interventions. This analysis will assist community health researchers in planning partnerships with CBOs, and make necessary adjustments to improve study outcomes. Appropriate application of the components of CBOE in partnerships will assist researchers in addressing health disparities.

Training Community Health Workers to Enhance Disaster Resilience

Community health workers (CHWs) have significant potential to contribute to public health in the United States by promoting disaster preparedness, speeding postdisaster recovery, and building disaster resilience in their communities. To maximize this potential, however, they must undergo rigorous and relevant training. As part of the Gulf Region Health Outreach Program, an appropriate curriculum was developed and delivered in several training sessions conducted from 2013 to 2016. This article provides insights into the primary issues associated with such training and offers a detailed elaboration of the basic and specialized curricula as presented and adapted over the course of the program. We present lessons learned from these training experiences, as reflected in participants' initial ratings and comments, training staff debriefings, and feedback from CHWs working in the field. Informed by this feedback, as well as additional research and conceptual development, we offer recommendations aimed at expanding and refining CHW training curricula in the areas of chronic disease, psychosocial symptoms, community resilience, and environmental health. In addition to curriculum changes, we review policy implications aimed at promoting and facilitating the inclusion of CHWs in disaster response and recovery teams.

Case Study of Resilient Baton Rouge: Applying Depression Collaborative Care and Community Planning to Disaster Recovery

BACKGROUND

Addressing behavioral health impacts of major disasters is a priority of increasing national attention, but there are limited examples of implementation strategies to guide new disaster responses. We provide a case study of an effort being applied in response to the 2016 Great Flood in Baton Rouge.

METHODS

Resilient Baton Rouge was designed to support recovery after major flooding by building local capacity to implement an expanded model of depression collaborative care for adults, coupled with identifying and responding to local priorities and assets for recovery. For a descriptive, initial evaluation, we coupled analysis of documents and process notes with descriptive surveys of participants in initial training and orientation, including preliminary comparisons among licensed and non-licensed participants to identify training priorities.

RESULTS

We expanded local behavioral health service delivery capacity through subgrants to four agencies, provision of training tailored to licensed and non-licensed providers and development of advisory councils and partnerships with grassroots and government agencies. We also undertook initial efforts to enhance national collaboration around post-disaster resilience.

CONCLUSION

Our partnered processes and lessons learned may be applicable to other communities that aim to promote resilience, as well as planning for and responding to post-disaster behavioral health needs.

Evaluating Community Partnerships Addressing Community Resilience in Los Angeles, California

Community resilience has grown in importance in national disaster response and recovery efforts. However, measurement of community resilience, particularly the content and quality of relationships aimed at improving resilience, is lacking. To address this gap, we used a social network survey to measure the number, type, and quality of relationships among organizations participating in 16 coalitions brought together to address community resilience in the Los Angeles Community Disaster Resilience project. These coalitions were randomized to one of two approaches (community resilience or preparedness). Resilience coalitions received training and support to develop these partnerships and implement new activities. Both coalition types received expert facilitation by a public health nurse or community educator. We also measured the activities each coalition engaged in and the extent to which partners participated in these activities at two time points. We found that the community resilience coalitions were initially larger and had lower trust among members than the preparedness communities. Over time, these trust differences dissipated. While both coalitions grew, the resilience community coalitions maintained their size difference throughout the project. We also found differences in the types of activities implemented by the resilience communities; these differences were directly related to the trainings provided. This information is useful to organizations seeking guidance on expanding the network of community-based organizations that participate in community resilience activities.

Resilience of an Earthquake-Stricken Rural Community in Southwest China: Correlation with Disaster Risk Reduction Efforts

Disaster risk reduction (DRR) activities have given growing attention to building community resilience, but the effects of such efforts on community resilience are still under-investigated, especially in China where the concept of community resilience has only just emerged. Using the Communities Advancing Resilience Toolkit Assessment Survey, data on self-perceived community resilience were collected in 2017 from a post-disaster Chinese rural community in Yingxiu Town, which was the epicenter of the Wenchuan earthquake (Magnitude = 8.0) in the year 2008. Linear regression analyses were conducted to explore the correlations between residents’ DRR behaviors and perceived community resilience with the control of their socio-demographic characteristics including age, ethnicity, gender, education, income level, employment status and marital status. Results indicate that residents who volunteered for DRR activities, received geological disaster education, participated in evacuation drills, and reported higher income levels had a perception of higher community resilience. Practice research is suggested to help clarify the cause and effect of DRR work on the enhancement of community resilience to disasters in China and abroad. Attention is also called to the development of a Chinese indigenous community resilience concept and assessment instrument.

Who Participates in Building Disaster Resilient Communities: A Cluster-Analytic Approach

CONTEXT

The Los Angeles County Community Disaster Resilience project is a community-based program to improve disaster resilience. We collected baseline measures of resilience-related attitudes and practices among targeted communities prior to the implementation of the intervention.

OBJECTIVES

This study identified community disaster resilience behavior patterns and assessed their associations with sociodemographic and social cognitive characteristics.

DESIGN

Telephone surveys during summer 2013.

SETTING

Sixteen communities in Los Angeles County (2 per service planning area).

PARTICIPANTS

The address-based sample of adults (≥18) was selected to be representative of 2010 census tracts in each of the communitiesMAIN OUTCOME MEASURES:: We examined relationships between sociodemographic characteristics, social cognitive factors, and participation in community disaster resilience activities.

RESULTS

Three clusters of community resilience behavior patterns emerged. Cluster distribution significantly differed across several sociodemographic and social cognitive factors. Participants who were African American, Hispanic, had higher education, income, self-efficacy, trust in the public health department, civic engagement, and social capital were significantly associated with being in the cluster most active in resilience-building activities.

CONCLUSIONS

The results confirm that there are distinct community resilience behavior patterns. These patterns vary according to population characteristics, which supports audience segmentation approaches and developing a range of emergency preparedness programs targeted to the strengths and weaknesses of the different audience segments.

How Community and Public Health Partnerships Contribute to Disaster Recovery and Resilience

OBJECTIVE

To summarize ways that networks of community-based organizations (CBO), in partnership with public health departments, contribute to community recovery from disaster.

METHODS

The study was conducted using an online survey administered one and 2 years after Hurricane Sandy to the partnership networks of 369 CBO and the New York Department of Health and Mental Hygiene. The survey assessed the structure and durability of networks, how they were influenced by storm damage, and whether more connected networks were associated with better recovery outcomes.

RESULTS

During response and recovery, CBOs provide an array of critical public health services often outside their usual scope. New CBO partnerships were formed to support recovery, particularly in severely impacted areas. CBOs that were more connected to other CBOs and were part of a long-term recovery committee reported greater impacts on the community; however, a partnership with the local health department was not associated with recovery impacts.

CONCLUSION

CBO partners are flexible in their scope of services, and CBO partnerships often emerge in areas with the greatest storm damage, and subsequently the greatest community needs. National policies will advance if they account for the dynamic and emergent nature of these partnerships and their contributions, and clarify the role of government partners. (Disaster Med Public Health Preparedness. 2018;12:635-643).

COPEWELL: A Conceptual Framework and System Dynamics Model for Predicting Community Functioning and Resilience After Disasters

OBJECTIVE

Policy-makers and practitioners have a need to assess community resilience in disasters. Prior efforts conflated resilience with community functioning, combined resistance and recovery (the components of resilience), and relied on a static model for what is inherently a dynamic process. We sought to develop linked conceptual and computational models of community functioning and resilience after a disaster.

METHODS

We developed a system dynamics computational model that predicts community functioning after a disaster. The computational model outputted the time course of community functioning before, during, and after a disaster, which was used to calculate resistance, recovery, and resilience for all US counties.

RESULTS

The conceptual model explicitly separated resilience from community functioning and identified all key components for each, which were translated into a system dynamics computational model with connections and feedbacks. The components were represented by publicly available measures at the county level. Baseline community functioning, resistance, recovery, and resilience evidenced a range of values and geographic clustering, consistent with hypotheses based on the disaster literature.

CONCLUSIONS

The work is transparent, motivates ongoing refinements, and identifies areas for improved measurements. After validation, such a model can be used to identify effective investments to enhance community resilience. (Disaster Med Public Health Preparedness. 2018;12:127-137).

Resilience as a double-edged health promotion goal: examples from Lao PDR

Individual and community resilience are undoubtedly important targets for health enhancement and invaluable aspirational outcomes in the health promotion endeavour especially in disaster contexts. However, overreliance on resilience as a proxy for positive well-being has serious personal and political implications in many contexts, as illustrated in research findings on women's quality of life in southern Lao PDR. Case studies derived from focus group interviews with ethnic minority Lao women about their quality of life are used to exemplify how overt signs of resilience may mask, rather than mirror, covert existential reality leaving women without a voice. The political implications of this silencing are profound. Private troubles remain hidden rather than being identified as public issues subject to public policy. This conundrum is not confined to third world countries. Structural limitations to achieving profound fulfilment abound in affluent countries also, yet neo-liberal governments rely heavily on the resilience of populations to minimize public spending. The challenge for health promotion researchers, policy makers and practitioners is to explore the nexus between individual agency and structural change in each specific context to ensure that health promotion initiatives do not inadvertently perpetuate disparities in access to power and resources.

A coupled human-natural systems framework of community resilience

This article compares and contrasts resilience frameworks to identify commonalities and gaps. It proposes use of a coupled human-natural systems framework (CHNS) to analyze community resilience to disasters. CHNS builds on the human ecosystem model that analyzes how institutions and social order shape fluxes and flows of resources between and within social and environmental systems. It expands on the model by including anthropological concepts of culture, agency, power, and discourse. The framework covers environmental and social legacies, pre-disaster trends and conditions, resilience measures, and system changes provoked by a disaster. The article proposes eleven categories of variables that affect resilience and discusses research steps for putting the framework into action. The CHNS framework can be used to predict system changes and identify resilience measures that allow communities to articulate and achieve their resilience goals.

Beyond Disaster Preparedness: Building a Resilience-Oriented Workforce for the Future

Enhancing citizens' and communities' resilience is critical to adapt successfully to ongoing challenges faced by communities, as well as acute shocks resulting from disasters. While significant progress has been made in this area, several research and practice gaps remain. A crucial next step to advance resilience is the development of a resilience-oriented workforce. This narrative review examines existing literature to determine key components of a resilience-oriented workforce, with a focus on organizational structures, training and education, and leadership models. Reviewed articles spanned a variety of study types, including needs assessments of existing workforce, program evaluations, and reviews/commentaries. A resilience-oriented workforce spans many disciplines and training programs will need to reflect that. It requires a collaborative organizational model that promotes information sharing structures. Leadership models should foster a balance between workforce autonomy and operation as a collective entity. Optimal strategies to develop a resilience-oriented workforce have yet to be realized and future research will need to collect and synthesize data to promote and evaluate the growth of this field.

How Do Communities Use a Participatory Public Health Approach to Build Resilience? The Los Angeles County Community Disaster Resilience Project

Community resilience is a key concept in the National Health Security Strategy that emphasizes development of multi-sector partnerships and equity through community engagement. Here, we describe the advancement of CR principles through community participatory methods in the Los Angeles County Community Disaster Resilience (LACCDR) initiative. LACCDR, an initiative led by the Los Angeles County Department of Public Health with academic partners, randomized 16 community coalitions to implement either an Enhanced Standard Preparedness or Community Resilience approach over 24 months. Facilitated by a public health nurse or community educator, coalitions comprised government agencies, community-focused organizations and community members. We used thematic analysis of data from focus groups (n = 5) and interviews (n = 6 coalition members; n = 16 facilitators) to compare coalitions’ strategies for operationalizing community resilience levers of change (engagement, partnership, self-sufficiency, education). We find that strategies that included bidirectional learning helped coalitions understand and adopt resilience principles. Strategies that operationalized community resilience levers in mutually reinforcing ways (e.g., disseminating information while strengthening partnerships) also secured commitment to resilience principles. We review additional challenges and successes in achieving cross-sector collaboration and engaging at-risk groups in the resilience versus preparedness coalitions. The LACCDR example can inform strategies for uptake and implementation of community resilience and uptake of the resilience concept and methods.

Promoting Community Preparedness and Resilience: A Latino Immigrant Community-Driven Project Following Hurricane Sandy

As community residents and recovery workers, Latino immigrants play important roles after disasters, yet are rarely included in preparedness planning. A community-university-labor union partnership created a demonstration project after Hurricane Sandy to strengthen connections to disaster preparedness systems to increase community resilience among Latino immigrant communities in New York and New Jersey. Building ongoing ties that connect workers and community-based organizations with local disaster preparedness systems provided mutual benefits to disaster planners and local immigrant communities, and also had an impact on national disaster-related initiatives.

A New Framework for Addressing Adverse Childhood and Community Experiences: The Building Community Resilience Model

OBJECTIVE

We propose a transformative approach to foster collaboration across child health, public health, and community-based agencies to address the root causes of toxic stress and childhood adversity and to build community resilience.

METHODS

Physicians, members of social service agencies, and experts in toxic stress and adverse childhood experiences (ACEs) were interviewed to inform development of the Building Community Resilience (BCR) model. Through a series of key informant interviews and focus groups, we sought to understand the role of BCR for child health systems and their partners to reduce toxic stress and build community resilience to improve child health outcomes.

RESULTS

Key informants indicated the intentional approach to ACEs and toxic stress through continuous quality improvement (data-driven decisions and program development, partners testing and adapting to changes to their needs, and iterative development and testing) which provides a mechanism by which social determinants or a population health approach could be introduced to physicians and community partners as part of a larger effort to build community resilience. Structured interviews also reveal a need for a framework that provides guidance, structure, and support for child health systems and community partners to develop collective goals, shared work plans, and a means for data-sharing to reinforce the components that will contribute to community resilience.

CONCLUSIONS

Key informant interviews and focus group dialogues revealed a deep understanding of the factors related to toxic stress and ACEs. Respondents endorsed the BCR approach as a means to explore capacity issues, reduce fragmented health care delivery, and facilitate integrated systems across partners in efforts to build community resilience. Current financing models are seen as a potential barrier, because they often do not support restructured roles, partnership development, and the work to sustain upstream efforts to address toxic stress and community resilience.

Facilitating Partnerships With Community- and Faith-Based Organizations for Disaster Preparedness and Response: Results of a National Survey of Public Health Departments

OBJECTIVE

We identify characteristics of local health departments, which enhance collaborations with community- and faith-based organizations (CFBOs) for emergency preparedness and response.

METHODS

Online survey data were collected from a sample of 273 disaster preparedness coordinators working at local health departments across the United States between August and December 2011.

RESULTS

Using multiple linear regression models, we found that perceptions of CFBO trust were associated with more successful partnership planning (β=0.63; P=0.02) and capacity building (β=0.61; P=0.01). Employee layoffs in the past 3 years (β=0.41; P=0.001) and urban location (β=0.41; P=0.005) were positively associated with higher ratings of resource sharing between health agencies and CFBOs. Having 1-3 full-time employees increased the ratings of success in communication and outreach activities compared with health departments having less than 1 full-time employee (β=0.33; P=0.05). Positive attitudes toward CFBOs also enhanced communication and outreach (β=0.16; P=0.03).

CONCLUSIONS

Staff-capacity factors are important for quick dissemination of information and resources needed to address emerging threats. Building the trust of CFBOs can help address large-scale disasters by improving the success of more involved activities that integrate the CFBO into emergency plans and operations of the health department and that better align with federal-funding performance measures. (Disaster Med Public Health Preparedness. 2018;12:57-66).

What Do We Mean by 'Community Resilience'? A Systematic Literature Review of How It Is Defined in the Literature

Background:

Government, industry and charitable organisations have an increasing focus on programs intended to support community resilience to disasters. But has consensus been reached as to what defines 'community resilience' and what its core characteristics are?

Methods:

We undertook a systematic literature review of definitions of community resilience related to disasters. We conducted an inductive thematic analysis of the definitions and descriptions that we identified, in order to determine the proposed characteristics of community resilience prior to, during and after a disaster.

Results:

We identified 80 relevant papers. There was no evidence of a common, agreed definition of community resilience. In spite of this, evidence was found of nine core elements of community resilience that were common among the definitions. The core elements were: local knowledge, community networks and relationships, communication, health, governance and leadership, resources, economic investment, preparedness, and mental outlook. Within these core elements, we identified 19 sub-elements linked to community resilience.

Conclusion:

Our findings show that community resilience remains an amorphous concept that is understood and applied differently by different research groups. Yet in spite of the differences in conception and application, there are well-understood elements that are widely proposed as important for a resilient community. A focus on these individual elements may be more productive than attempting to define and study community resilience as a distinct concept.