Rutkow Lainie, Paul Amy, Taylor Holly A, Barnett Daniel J
Departments of Health Policy and Management (Drs Rutkow and Taylor) and Environmental Health and Engineering (Dr Barnett), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland (Drs Paul and Taylor).
J Public Health Manag Pract. 2017 Nov/Dec;23(6):644-650. doi: 10.1097/PHH.0000000000000574.
Local health departments play a key role in emergency preparedness and respond to a wide range of threats including infectious diseases such as seasonal influenza, tuberculosis, H1N1, Ebola virus disease, and Zika virus disease. To successfully respond to an infectious disease outbreak, local health departments depend upon the participation of their workforce; yet, studies indicate that sizable numbers of workers would not participate in such a response. The reasons why local health department workers participate, or fail to participate, in infectious disease responses are not well understood.
To understand why local health department workers are willing, or not willing, to report to work during an infectious disease response.
From April 2015 to January 2016, we conducted 28 semistructured interviews with local health department directors, preparedness staff, and nonpreparedness staff.
Interviews were conducted with individuals throughout the United States.
We interviewed 28 individuals across 3 groups: local health department directors (n = 8), preparedness staff (n = 10), and nonpreparedness staff (n = 10).
Individuals' descriptions of why local health department workers are willing, or not willing, to report to work during an infectious disease response.
Factors that facilitate willingness to respond to an infectious disease emergency included availability of vaccines and personal protective equipment; flexible work schedule and childcare arrangements; information sharing via local health department trainings; and perceived commitments to one's job and community. Factors that hinder willingness to respond to an infectious disease emergency included potential disease exposure for oneself and one's family; logistical considerations for care of children, the elderly, and pets; and perceptions about one's role during an infectious disease response.
Our findings highlight opportunities for local health departments to revisit their internal policies and engage in strategies likely to promote willingness to respond among their staff. As LHDs face the persistent threat of infectious diseases, they must account for response willingness when planning for and fielding emergency responses. Our findings highlight opportunities for local health departments to revisit their internal policies and engage in strategies likely to promote response willingness to infectious disease emergencies among their staff.
地方卫生部门在应急准备中发挥着关键作用，应对包括季节性流感、结核病、甲型H1N1流感、埃博拉病毒病和寨卡病毒病等传染病在内的广泛威胁。为了成功应对传染病疫情，地方卫生部门依赖其工作人员的参与；然而，研究表明，相当数量的工作人员不会参与此类应对行动。地方卫生部门工作人员参与或不参与传染病应对行动的原因尚不清楚。
了解地方卫生部门工作人员在传染病应对期间愿意或不愿意报到上班的原因。
2015年4月至2016年1月，我们对地方卫生部门主管、应急准备人员和非应急准备人员进行了28次半结构化访谈。
在美国各地与个人进行访谈。
我们对3组共28人进行了访谈：地方卫生部门主管（n = 8）、应急准备人员（n = 10）和非应急准备人员（n = 10）。
个人对地方卫生部门工作人员在传染病应对期间愿意或不愿意报到上班原因的描述。
促进应对传染病紧急情况意愿的因素包括疫苗和个人防护装备的供应；灵活的工作时间表和儿童保育安排；通过地方卫生部门培训进行信息共享；以及对工作和社区的感知承诺。阻碍应对传染病紧急情况意愿的因素包括自身和家人可能接触疾病；照顾儿童、老人和宠物的后勤考虑；以及对个人在传染病应对期间角色的认知。
我们的研究结果突出了地方卫生部门重新审视其内部政策并采取可能提高工作人员应对意愿的策略的机会。由于地方卫生部门面临传染病的持续威胁，他们在规划和实施应急响应时必须考虑应对意愿。我们的研究结果突出了地方卫生部门重新审视其内部政策并采取可能提高工作人员对传染病紧急情况应对意愿的策略的机会。
