Balicer Ran D, Omer Saad B, Barnett Daniel J, Everly George S
Epidemiology Department, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
BMC Public Health. 2006 Apr 18;6:99. doi: 10.1186/1471-2458-6-99.
Current national preparedness plans require local health departments to play an integral role in responding to an influenza pandemic, a major public health threat that the World Health Organization has described as "inevitable and possibly imminent". To understand local public health workers' perceptions toward pandemic influenza response, we surveyed 308 employees at three health departments in Maryland from March-July 2005, on factors that may influence their ability and willingness to report to duty in such an event.
The data suggest that nearly half of the local health department workers are likely not to report to duty during a pandemic. The stated likelihood of reporting to duty was significantly greater for clinical (Multivariate OR: 2.5; CI 1.3-4.7) than technical and support staff, and perception of the importance of one's role in the agency's overall response was the single most influential factor associated with willingness to report (Multivariate OR: 9.5; CI 4.6-19.9).
The perceived risk among public health workers was shown to be associated with several factors peripheral to the actual hazard of this event. These risk perception modifiers and the knowledge gaps identified serve as barriers to pandemic influenza response and must be specifically addressed to enable effective local public health response to this significant threat.
当前的国家应急计划要求地方卫生部门在应对流感大流行中发挥不可或缺的作用。流感大流行是世界卫生组织形容为“不可避免且可能迫在眉睫”的重大公共卫生威胁。为了解地方公共卫生工作者对流感大流行应对措施的看法,我们在2005年3月至7月间对马里兰州三个卫生部门的308名员工进行了调查,了解可能影响他们在这种情况下报到上班的能力和意愿的因素。
数据表明,近一半的地方卫生部门工作人员在流感大流行期间可能不会报到上班。临床工作人员报到上班的既定可能性(多变量比值比:2.5;可信区间1.3 - 4.7)显著高于技术和支持人员,并且认为自己在机构整体应对中的角色重要性是与报到意愿相关的最具影响力的单一因素(多变量比值比:9.5;可信区间4.6 - 19.9)。
公共卫生工作者所感知的风险与该事件实际危害之外的几个因素相关。这些风险认知调节因素和所发现的知识差距成为流感大流行应对的障碍,必须加以具体解决,以使地方公共卫生部门能够有效应对这一重大威胁。