Johns Hopkins Center for Health Security, Baltimore, Maryland (Dr Schoch-Spana and Mss Ravi and Meyer); and Public Health Preparedness Program, National Association of County & City Health Officials, Washington, District of Columbia (Ms Biesiadecki and Mr Mwaungulu).
J Public Health Manag Pract. 2018 Jul/Aug;24(4):360-369. doi: 10.1097/PHH.0000000000000685.
Local health departments (LHDs) are implementing a national mandate to engage community partners, including individuals, businesses, and community- and faith-based organizations in the larger public health emergency preparedness (PHEP) enterprise.
Investigate how LHDs of varying size and resource levels successfully engage the community in PHEP to help uncover "best practices" that aspiring agencies can replicate, particularly in low-resource environments.
In-depth, semistructured qualitative interviews with practitioners from 9 highly performing LHDs.
Participating agencies comprised equal amounts of small (serving <50 000 residents), medium (serving 50 000-500 000 residents), and large (serving >500 000 residents) LHDs and were diverse in terms of geographic region, rural-urban environment, and governance structure.
A cross section of LHD staff (n = 34) including agency leaders, preparedness coordinators, public information officers, and health educators/promoters.
Local health department performance at community engagement as determined by top scores in 2 national LHD surveys (2012, 2015) regarding community engagement in PHEP.
Based on key informant accounts, high-performing LHDs show a holistic, organization-wide commitment to, rather than discrete focus on, community engagement. Best practices clustered around 5 domains: administration (eg, top executive who models collaborative behavior), organizational culture (eg, solicitous rather than prescriptive posture regarding community needs), social capital (eg, mining preexisting community connections held by other LHD programs), workforce skills (eg, cultural competence), and methods/tactics (eg, visibility in community events unrelated to PHEP).
For LHDs that wish to enhance their performance at community engagement in PHEP, change will entail adoption of evidence-based interventions (the technical "what") as well as evidence-based administrative approaches (the managerial "how"). Smaller, rural LHDs should be encouraged that, in the case of PHEP community engagement, they have unique social assets that may help offset advantages that larger, more materially resourced metropolitan health departments may have.
地方卫生部门（LHDs）正在执行一项国家任务，即让包括个人、企业以及社区和信仰组织在内的社区合作伙伴参与到更广泛的公共卫生应急准备（PHEP）工作中。
调查不同规模和资源水平的 LHD 如何成功地让社区参与到 PHEP 中，以帮助发现有志机构可以复制的“最佳实践”，尤其是在资源匮乏的环境中。
对来自 9 个表现出色的 LHD 的从业者进行深入的半结构化定性访谈。
参与的机构包括数量相等的小型（服务居民人数少于 50000 人）、中型（服务居民人数为 50000-500000 人）和大型（服务居民人数超过 500000 人）LHD，并且在地理区域、城乡环境和治理结构方面都具有多样性。
LHD 工作人员的一个横截面（n=34），包括机构领导、准备协调员、公共信息官员和健康教育者/促进者。
根据 2 项全国 LHD 调查（2012 年和 2015 年）中关于 PHEP 中社区参与情况的最高得分，确定地方卫生部门在社区参与方面的表现。
根据关键信息提供者的说法，表现出色的 LHD 显示出对社区参与的整体、全组织的承诺，而不是对社区参与的离散关注。最佳实践集中在 5 个领域：行政（例如，具有协作行为模式的最高执行官）、组织文化（例如，对社区需求持关怀而非规定性的态度）、社会资本（例如，挖掘其他 LHD 项目持有的既有社区联系）、劳动力技能（例如，文化能力）和方法/策略（例如，在与 PHEP 无关的社区活动中保持可见度）。
对于希望提高 PHEP 社区参与绩效的 LHD 而言，变革将需要采用基于证据的干预措施（技术“是什么”）以及基于证据的管理方法（管理“怎么做”）。应该鼓励较小的、农村地区的 LHD 认识到，在 PHEP 社区参与方面，他们拥有独特的社会资产，这可能有助于弥补更大、物质资源更丰富的大都市卫生部门可能拥有的优势。
