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公共卫生残疾专家项目的最佳实践与经验教训:在新冠疫情期间满足残疾人需求

Best Practices and Lessons Learned From the Public Health Disability Specialists Program: Addressing the Needs of People With Disabilities During COVID-19.

作者信息

Cree Robyn A, Wray Allison, Evans Adrianna, Lyons Sara, Burrous Haley, Nilz Margaret, Clarke Cendra, Li Jennifer, Baio Jon

机构信息

Author Affiliations: National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Cree and Mr Baio); Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee (Ms Wray); Preparedness and Disability Integration, Association of State and Territorial Health Officials, Arlington, VA (Mss Evans, Burrous, Nilz, and Clark); and Health and Disability Program, National Association of County and City Health Officials, Washington, District of Columbia (Mss Lyons and Li).

出版信息

J Public Health Manag Pract. 2025;31(1):5-19. doi: 10.1097/PHH.0000000000001958. Epub 2024 Aug 1.

Abstract

CONTEXT

The Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO) applied funding issued by the US Centers for Disease Control and Prevention (CDC) to implement the Public Health Disability Specialists Program, part of a project to address the needs of people with disabilities during the COVID-19 pandemic. Disability specialists (subject matter experts) were embedded within state, territorial, and city/county health departments to help ensure disability inclusion in emergency planning, mitigation, and recovery efforts.

OBJECTIVE

To evaluate the success of the Disability Specialists Program in improving emergency response planning, mitigation, and recovery efforts for people with disabilities within participating jurisdictions.

DESIGN

Disability specialists worked with their assigned jurisdictions to conduct standardized baseline health department needs assessments to identify existing gaps and inform development and implementation of improvement plans. CDC, ASTHO, and NACCHO implemented a mixed methods framework to evaluate specialists' success.

SETTING

State, territorial, and local health departments across 28 jurisdictions between January 2021 and July 2022.

MAIN OUTCOME MEASURES

Average number of categories of gaps addressed and qualitative documentation of strategies, barriers, and promising practices.

RESULTS

Specialists identified 1010 gaps (approximately 36 per jurisdiction) across eight needs assessment categories, most related to mitigation, recovery, resilience, and sustainability efforts (n = 213) and communication (n = 193). Specialists addressed an average of three categories of gaps identified; common focus areas included equitable COVID-19 vaccine distribution and accessible communications. Specialists commonly mentioned barriers related to limited health agency capacity (eg, resources) and community mistrust. Promising practices to address barriers included sharing best practices through peer-to-peer networks and building and strengthening partnerships between health departments and the disability community.

CONCLUSIONS

Embedding disability specialists within state, territorial, and local health departments improved jurisdictional ability to meet evolving public health needs for the entire community, including people with disabilities.

摘要

背景

州和领地卫生官员协会(ASTHO)以及全国县市卫生官员协会(NACCHO)申请了美国疾病控制与预防中心(CDC)发放的资金,以实施公共卫生残疾专家项目,该项目是在新冠疫情期间满足残疾人需求的一个项目的一部分。残疾专家(主题专家)被安置在州、领地以及市/县卫生部门内,以帮助确保在应急规划、缓解措施及恢复工作中纳入对残疾人的考量。

目的

评估残疾专家项目在改善参与管辖区内针对残疾人的应急响应规划、缓解措施及恢复工作方面的成效。

设计

残疾专家与他们所负责的管辖区合作,开展标准化的基线卫生部门需求评估,以识别现有差距,并为改进计划的制定和实施提供依据。疾控中心、ASTHO和NACCHO实施了一个混合方法框架来评估专家的成效。

地点

2021年1月至2022年7月期间,28个管辖区的州、领地和地方卫生部门。

主要结局指标

解决的差距类别平均数量以及策略、障碍和有前景做法的定性记录。

结果

专家们在八项需求评估类别中识别出1010个差距(每个管辖区约36个),其中大部分与缓解措施、恢复、复原力和可持续性工作(n = 213)以及沟通(n = 193)有关。专家们平均解决了所识别出的三类差距;常见的重点领域包括公平的新冠疫苗分发和无障碍沟通。专家们普遍提到了与卫生机构能力有限(如资源)和社区不信任相关的障碍。解决障碍的有前景做法包括通过同行网络分享最佳实践,以及建立和加强卫生部门与残疾人群体之间的伙伴关系。

结论

在州、领地和地方卫生部门内安置残疾专家提高了管辖区满足包括残疾人在内的整个社区不断变化的公共卫生需求的能力。

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