Barnett Daniel J, Thompson Carol B, Semon Natalie L, Errett Nicole A, Harrison Krista L, Anderson Marilyn K, Ferrell Justin L, Freiheit Jennifer M, Hudson Robert, McKee Mary, Mejia-Echeverry Alvaro, Spitzer James, Balicer Ran D, Links Jonathan M, Storey J Douglas
a Johns Hopkins Preparedness and Emergency Response Research Center , Johns Hopkins Bloomberg School of Public Health.
Health Commun. 2014;29(6):598-609. doi: 10.1080/10410236.2013.785474. Epub 2013 Jun 25.
This study examines the attitudinal impact of an Extended Parallel Process Model (EPPM)-based training curriculum on local public health department (LHD) workers' willingness to respond to representative public health emergency scenarios. Data are from 71 U.S. LHDs in urban and rural settings across nine states. The study explores changes in response willingness and EPPM threat and efficacy appraisals between randomly assigned control versus intervention health departments, at baseline and 1 week post curriculum, through an EPPM-based survey/resurvey design. Levels of response willingness and emergency response-related attitudes/beliefs are measured. Analyses focus on two scenario categories that have appeared on a U.S. government list of scenarios of significant concern: a weather-related emergency and a radiological "dirty" bomb event (U.S. Department of Homeland Security, 2007). The greatest impact from the training intervention on response willingness was observed among LHD workers who had low levels of EPPM-related threat and efficacy perceptions at baseline. Self-efficacy and response efficacy and response willingness increased in intervention LHDs for both scenarios, with greater response willingness increases observed for the radiological "dirty" bomb terrorism scenario. Findings indicate the importance of building efficacy versus enhancing threat perceptions as a path toward greater response willingness, and suggest the potential applicability of such curricular interventions for boosting emergency response willingness among other cadres of health providers.
本研究考察了基于扩展平行过程模型（EPPM）的培训课程对地方公共卫生部门（LHD）工作人员应对典型公共卫生紧急情况意愿的态度影响。数据来自美国九个州城乡地区的71个地方公共卫生部门。该研究通过基于EPPM的调查/重新调查设计，探讨了在基线时以及课程结束后1周，随机分配的对照卫生部门与干预卫生部门之间在应对意愿以及EPPM威胁和效能评估方面的变化。测量了应对意愿水平以及与应急响应相关的态度/信念。分析聚焦于美国政府一份高度关注情景清单中出现的两类情景：与天气相关的紧急情况和放射性“脏弹”事件（美国国土安全部，2007年）。在基线时EPPM相关威胁和效能认知水平较低的LHD工作人员中，观察到培训干预对应对意愿的影响最大。在干预的LHD中，两种情景下自我效能、响应效能和应对意愿均有所提高，放射性“脏弹”恐怖主义情景下的应对意愿提高幅度更大。研究结果表明，增强效能而非提高威胁认知作为提高应对意愿的途径具有重要意义，并表明此类课程干预措施在提高其他卫生服务人员应急响应意愿方面具有潜在适用性。
