Bromley Elizabeth, Eisenman David P, Magana Aizita, Williams Malcolm, Kim Biblia, McCreary Michael, Chandra Anita, Wells Kenneth B
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA.
West Los Angeles VA Healthcare Center, Los Angeles, CA 90073, USA.
Int J Environ Res Public Health. 2017 Oct 21;14(10):1267. doi: 10.3390/ijerph14101267.
Community resilience is a key concept in the National Health Security Strategy that emphasizes development of multi-sector partnerships and equity through community engagement. Here, we describe the advancement of CR principles through community participatory methods in the Los Angeles County Community Disaster Resilience (LACCDR) initiative. LACCDR, an initiative led by the Los Angeles County Department of Public Health with academic partners, randomized 16 community coalitions to implement either an Enhanced Standard Preparedness or Community Resilience approach over 24 months. Facilitated by a public health nurse or community educator, coalitions comprised government agencies, community-focused organizations and community members. We used thematic analysis of data from focus groups ( = 5) and interviews ( = 6 coalition members; = 16 facilitators) to compare coalitions' strategies for operationalizing community resilience levers of change (engagement, partnership, self-sufficiency, education). We find that strategies that included bidirectional learning helped coalitions understand and adopt resilience principles. Strategies that operationalized community resilience levers in mutually reinforcing ways (e.g., disseminating information while strengthening partnerships) also secured commitment to resilience principles. We review additional challenges and successes in achieving cross-sector collaboration and engaging at-risk groups in the resilience versus preparedness coalitions. The LACCDR example can inform strategies for uptake and implementation of community resilience and uptake of the resilience concept and methods.
社区恢复力是《国家卫生安全战略》中的一个关键概念，该战略强调通过社区参与发展多部门伙伴关系和公平性。在此，我们描述了在洛杉矶县社区灾难恢复力（LACCDR）倡议中，通过社区参与方法推进社区恢复力原则的情况。LACCDR是一项由洛杉矶县公共卫生部与学术伙伴牵头的倡议，将16个社区联盟随机分组，在24个月内实施强化标准备灾方法或社区恢复力方法。在公共卫生护士或社区教育工作者的协助下，联盟由政府机构、以社区为重点的组织和社区成员组成。我们对焦点小组（n = 5）和访谈（6名联盟成员；16名协助人员）的数据进行了主题分析，以比较各联盟在将社区恢复力变革杠杆（参与、伙伴关系、自给自足、教育）付诸实践方面的策略。我们发现，包括双向学习的策略有助于联盟理解和采用恢复力原则。以相互强化的方式（例如，在加强伙伴关系的同时传播信息）将社区恢复力杠杆付诸实践的策略，也确保了对恢复力原则的承诺。我们回顾了在实现跨部门合作以及让弱势群体参与恢复力联盟与备灾联盟方面的其他挑战和成功经验。LACCDR的例子可为社区恢复力的推广和实施策略以及恢复力概念和方法的采用提供参考。
