Davis Mary V, Mays Glen P, Bellamy James, Bevc Christine A, Marti Cammie
University of North Carolina at Chapel Hill Gillings School of Global Public Health, North Carolina Preparedness and Emergency Response Research Center, Chapel Hill, North Carolina.
University of Arkansas for Medical Sciences College of Public Health, Little Rock, Arkansas.
Disaster Med Public Health Prep. 2013 Dec;7(6):578-84. doi: 10.1017/dmp.2013.108. Epub 2013 Dec 16.
To address limitations in measuring the preparedness capacities of health departments, we developed and tested the Local Health Department Preparedness Capacities Assessment Survey (PCAS).
Preexisting instruments and a modified 4-cycle Delphi panel process were used to select instrument items. Pilot test data were analyzed using exploratory factor analysis. Kappa statistics were calculated to examine rater agreement within items. The final instrument was fielded with 85 North Carolina health departments and a national matched comparison group of 248 health departments.
Factor analysis identified 8 initial domains: communications, surveillance and investigation, plans and protocols, workforce and volunteers, legal infrastructure, incident command, exercises and events, and corrective action. Kappa statistics and z scores indicated substantial to moderate agreement among respondents in 7 domains. Cronbach α coefficients ranged from 0.605 for legal infrastructure to 0.929 for corrective action. Mean scores and standard deviations were also calculated for each domain and ranged from 0.41 to 0.72, indicating sufficient variation in the sample to detect changes over time.
The PCAS is a useful tool to determine how well health departments are performing on preparedness measures and identify opportunities for future preparedness improvements. Future survey implementation will incorporate recent Centers for Disease Control and Prevention's Public Health Preparedness Capabilities: National Standards for State and Local Planning.
为解决卫生部门应急准备能力测量方面的局限性，我们开发并测试了地方卫生部门应急准备能力评估调查（PCAS）。
使用现有的工具和经过改进的四轮德尔菲专家小组流程来选择工具项目。使用探索性因素分析对试点测试数据进行分析。计算卡帕统计量以检验项目内评分者间的一致性。最终工具在北卡罗来纳州的85个卫生部门以及由248个卫生部门组成的全国匹配对照组中进行了实地调查。
因素分析确定了8个初始领域：通信、监测与调查、计划与预案、工作人员与志愿者、法律基础设施、事件指挥、演习与活动以及纠正措施。卡帕统计量和z分数表明，在7个领域中，受访者之间的一致性为实质性到中等程度。克朗巴赫α系数范围从法律基础设施领域的0.605到纠正措施领域的0.929。还计算了每个领域的平均分和标准差，范围从0.41到0.72，表明样本中有足够的差异以检测随时间的变化。
PCAS是一种有用的工具，可用于确定卫生部门在应急准备措施方面的表现，并识别未来应急准备改进的机会。未来的调查实施将纳入疾病控制与预防中心最近发布的《公共卫生应急准备能力：州和地方规划国家标准》。
