Health Department Capacity for Community Engagement in Preparedness

By Monica Schoch-Spana, PhD, and Jennifer Nuzzo, DrPH, UPMC Center for Health Security 

crosswalkIn 2012, the UPMC Center for Health Security and NACCHO fielded the Community Engagement for Public Health Emergency Preparedness (CEPHEP) survey to provide the first comprehensive nationwide picture of local health department (LHD) efforts to integrate individuals and community- and faith-based groups into emergency preparedness – the results of which we published in the Journal of Public Health Management and Practice.[1] Prior to this national survey, knowledge of how LHDs integrate partners into PHEP and which organizational factors predict their success was confined to a few local case studies.

In summary, the results of the original survey in 2012 are very encouraging. LHDs of all sizes actively and successfully involve community partners in the PHEP enterprise. While large LHDs often benefit from economies of scale and scope, smaller LHDs may have their own CEPHEP advantages such as practitioners who are already well known, trusted, and influential in a tight-knit community. One-way engagement techniques such as publishing personal preparedness pamphlets are very common among LHDs, but more “intense” two-way CEPHEP activities are also occurring in field. These include standing up neighbor-to-neighbor disaster assistance networks and holding formal public deliberations about difficult decisions anticipated in a health emergency, such as how best to use scarce medical resources.

An LHD’s budget does influence the level and intensity of CEPHEP, but it is not the only significant factor. The 2012 survey also found that more intense CEPHEP is strongly associated with the following factors: having an explicit CEPHEP policy and intending to conduct CEPHEP in the future, employing personnel with prior community engagement experience, and having material and moral support from community-based organizations (CBOs). These three factors suggest that even in a period of scarcity, LHDs may still be able to take budget-neutral steps that help intensify their community engagement efforts for preparedness. Engaging in formal planning to set milestones and solidify CEPHEP as an institutional objective, for example, may reduce the chances that community involvement work does not dissipate with staff turnover or irregular budgets. Moreover, leveraging CBO connections may provide access to other CBOs, to facilities for hosting preparedness trainings, and to pools of volunteers who can be enlisted in preparedness.

This summer, NACCHO, the de Beaumont Foundation, and the UPMC Center for Health Security have partnered to field the same survey to give PHEP practitioners an opportunity to document their diverse and continued achievements since 2012 and to identify with greater fidelity the organizational predictors of successful community engagement. A comparison between the 2012 and 2015 snapshots will also help to uncover how steady reductions in LHD staff and budgets as well as competing preparedness duties amidst scarce resources may have affected community engagement efforts.

Emergency preparedness coordinators (EPCs) should be on the lookout for the invitation to participate in the 2015 CEPHEP survey in the coming weeks. Response rates were high in 2012 since two-thirds of EPCs contacted completed the survey, and the research team is eager to enlist the same level of support in 2015. A longitudinal survey approach can harden the data about what fuels top performance in CEPHEP. Ultimately, the information gathered can help LHD officials to fine tune change in their agencies’ current operations and to advocate more aggressively for the infrastructure that supports excellence in this work.

When you receive the survey invitation, please share your personal success stories about engaging your community in the critical work of public health emergency preparedness. In doing so, your responses will help generate national data about which policy and practice shifts could enable more LHD frontrunners to emerge in this arena. For more information, please contact Ms. Sanjana Ravi, the project manager, at sravi@upmc.edu.

About the Authors
Monica Schoch-Spana, PhD, and Jennifer Nuzzo, DrPH, are co-principal investigators for the 2015 CEPHEP survey and Senior Associates with the UPMC Center for Health Security.


  1. Schoch-Spana, M., Selck, F.W., & Goldberg, L.A. (2015). A national survey on health department capacity for community engagement in emergency preparedness. Journal of Public Health Management Practice 21(2): 196-207.

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