Friday, October 27, 11:00
a.m.-12:30 p.m.
Moderator
RADM Ronald Banks, M.D., M.P.H.
Regional Health Administrator, Region IX, Office of the Secretary
Presentations
LONGITUDINAL ISSUES OF POST-TRAUMATIC STRESS DISORDER, SUBSTANCE ABUSE, AND DISASTERS
Deborah M. Galvin, Ph.D.1; William E. Schlenger, Ph.D.2
1Center for Substance Abuse Prevention, Substance Abuse and Mental Health
Services Administration;
2Abt Associates, Inc., Research Triangle Park, NC
Post-traumatic stress disorder (PTSD) is a highly prevalent and often a chronic condition
following man-made or human disaster. The relationship between PTSD and substance abuse, including
ability to function and quality of life, remains a complex issue in developing a culture of preparedness.
This talk will provide the audience with a longitudinal review of current, state-of-the-art knowledge
and response outcomes of a variety of national and international studies, which serve to help policymakers
identify best and promising practices in reducing PTSD and associated substance abuse, as well as enhancing
the ability of first responders and disaster victims to obtain appropriate and effective services early-on
with well-prepared resources. The presentation will focus on first responder and victim variabilities such
as physical limitations, not working, compromised physical or mental health, and diminished well-being.
With early detection and pre-prepared resources, there is a higher probability of unimpaired functioning
and stabilized quality of life frequently attributable to PTSD and to later related substance abuse.
BLENDING LOCAL AND STATE PUBLIC HEALTH EFFORTS THROUGH ONLINE INFORMATION SHARING: EXPERIENCE FROM
IOWA'S COMMUNITY HEALTH NEEDS ASSESSMENT AND HEALTH IMPROVEMENT PLAN (CHNA/HIP) INITIATIVE
Simon Geletta, Ph.D.1; Juan Carlos Cadenillas, M.S.1; Louise Lex, Ph.D.2
1Des Moines University, Des Moines, IA;
2Iowa Department of Public Health, Des Moines, IA
The Iowa Department of Public Health (IDPH) initiated the Community Health Needs Assessment and
Health Improvement Plan (CHNA/HIP) to enable communities across Iowa to ensure the health of
their citizens. The initiative tied local planning to the state health plan,
Healthy Iowans 2010. Through community planning groups, Iowa's 99 counties
assessed their health status and developed a health improvement plan. The CHNA/HIP
reports provide uniform information on needs, resources, problems, and actions for
each county. A vast amount of program information in these reports touches on all
aspects of statewide health status and program activities, including local health
priorities and health improvement strategies. To make this vast information readily
available to state and local planners, policymakers, and researchers, IDPH recently
initiated a collaborative effort with Des Moines University's Public Health Program to
design, develop, and deploy some of the data that are gathered into an interactive online presentation.
This presentation will detail the results of this collaborative experience. The presentation
also will demonstrate how systematic organization of local and state public health program
information and the use of online Geographic Information Systems technology can result in
better information dissemination and usage of public health data.
MOVING THE NEEDLE TOWARD INCREASED PERSONAL ALL-HAZARDS PREPAREDNESS: A BEHAVIOR CHANGE MODEL
Stephanie L. Kamin, M.P.H.1;
Carol Freeman2
1ORC Macro, Atlanta, GA;
2ORC Macro, Calverton, MD
Since 9/11, the more recent hurricanes that devastated the Gulf Coast region, and an increased focus
on the inevitable threat of a flu pandemic, disaster preparedness has remained at the forefront of the
Nation's public health priorities. Numerous national, state, and local surveys have been conducted to
assess the public's level of preparedness to respond to multiple hazards. Among these are two surveys
that contributed to the U.S. Department of Homeland Security's (DHS) Citizen Corps initiative: the 2003
and 2005 (post-Katrina) national Household Preparedness Surveys (n = 2,002; n = 1,071, respectively).
Results from these and other national surveys indicate that very little improvement has been made in
personal preparedness, in spite of increased concern, increased media and social attention, and
increased preparedness promotion activities.
In an effort to understand and articulate what is required to "move the needle" toward increased
preparedness on a national scale, DHS is examining the socio-behavioral factors affecting people's
motivation to engage in preparedness activities. Building on theoretical constructs that have been
successfully applied to other health topics, such as injury and disease prevention, ORC Macro and
Citizen Corps staff developed a model of all-hazards preparedness behavior change. The model presents
an interplay of socio-structural factors; psychological factors including perceived threat; efficacy
(self- and response); and extrinsic factors with a particular emphasis on opportunities for targeted
messaging themes based on motivational "profiles."
The development and testing of the model through future national Household Preparedness Surveys is
intended to (1) spark discussion and innovation within the field; (2) increase people's understanding
of contributing factors to preparedness and intervention tactics; (3) help government agencies,
Citizen Corps Councils, and non-government organizations better facilitate and promote preparedness
behaviors and foster a culture of preparedness among U.S. citizens; and (4) set the stage for assessing
real changes in levels of personal preparedness across the United States.
IS PRIMARY CARE PREPARED: CAN NEW PRACTICE MODELS FOR PRIMARY CARE BE USED
FOR COMMUNITY PREPAREDNESS?
Sally Phillips, Ph.D., R.N.; Helen Burstin, M.D., M.P.H.; Tricia Trinite, N.P.;
Therese Miller, Dr.P.H.
Agency for Healthcare Research and Quality, Rockville, MD
Threats to public health, including natural and man-made disasters, pose a critical challenge to the
organization and delivery of primary care. Rather than designing and building new systems to meet
these challenges, public health programs should leverage existing innovative models of primary care.
In 2001, the Institute of Medicine (IOM) issued a report,
Crossing the Quality Chasm, which called for a change in healthcare delivery
systems. The Chasm report proposed six goals for improvement: that health care be safe,
effective, patient-centered, timely, efficient, and equitable. To realize these goals,
innovative models of primary care practice promote advanced access (e.g., same-day scheduling);
use the Chronic Care Model components to improve health outcomes; feature patient self-management
support; and facilitate linkages between clinical practice and public health programs.
Innovative models of primary care can support preparedness strategies to address threats imposed by
natural and man-made disasters. Efficiencies that exist today in these models could be maximized by
public health preparedness strategies.
This presentation will focus on how these models/processes would support public health preparedness
and describe how the activities of primary care, prevention, and preparedness are similar. The
presenters will provide examples of how innovative models of primary care delivery could be leveraged
to support public health preparedness. Examples include the following: patient self-management support
as designed for chronic illness could be used for self-triaging; current computerized registries for
preventive health could be used to support preparedness activities; and effective clinical-community
linkages could be used to deploy clinical personnel to high-priority community settings.
For questions or more information, please contact
summit@hhs.gov.
