Sharing our successes

In October 2008, the North Carolina Preparedness and Emergency Response Research Center (NCPERRC) began work on 4 main projects based at the University of North Carolina at Chapel Hill (UNC) Gillings School of Global Public Health and the School of Medicine as well as our research partners at the University of Arkansas for Medical Sciences and North Carolina State University. Now, at the mid-point of the 5-year grant, we are taking stock of our successes. In this issue of NCPERRC news we share 8 stories that illustrate the work we have done. The common theme is the key role our partners play in our success!

Administrative core

Between January and September 2010, all 85 North Carolina health departments participated in at least one NCPERRC research study and 10 departments participated in all 4 studies conducted during this period. Several of these studies achieved a 100% response rate. This level of engagement in research will help ensure the translation to practice in North Carolina as practitioners can see that the findings and recommendations are based on input provided by a broad base of peers.

Dr. Pia MacDonald, the NCPERRC director and Principal Investigator (PI) of the regional workforce project, participated in the North Carolina Division of Public Health (NC DPH) strategic planning process for public health preparedness and emergency response. She was the only academic partner invited to participate in the process that will define the priorities for the next 3 to 5 years, including priority uses of the federal Public Health Emergency Preparedness (PHEP) cooperative agreement funds.

Accreditation Systems and Public Health Preparedness project:

National public health accreditation

The results from the H1N1 After-Action Review (AAR) accreditation study have drawn a great deal of attention. After NCPERRC presented results from this study at American Public Health Association conference, the national Public Health Accreditation Board convened a special workgroup to consider how best to incorporate measures of preparedness capacity and competency into the national accreditation standards. These results also were used by national public health stakeholders, including the Trust for America’s Health, to secure funding for state and local accreditation efforts as part of the federal health reform legislative package that was signed into law by President Obama in March 2010.

The Preparedness Capabilities Assessment

This instrument is the first known preparedness survey available that has been extensively validated via pilot testing and psychometric evaluations to examine internal consistency, inter-rater reliability, and discriminatory power. In December 2010 participating health departments received a customized report that benchmarks their health department against similar participating health departments in their region and the state, as well as a matched comparison group of health departments around the country. Health departments have revealed that they look forward to using the customized report to implement changes in preparedness activities as necessary.

Public Health Surveillance Systems project:

Changes to North Carolina syndromic surveillance system

Findings from the Public Health Surveillance Systems Project survey conducted in the first year identified several valuable improvements to North Carolina’s syndromic surveillance system. The need for more efficient filtering of the large amount of available syndromic surveillance data was identified by many survey respondents. In the second year, changes have been made to North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) programming to allow users to carry out customized searches of emergency department records, allowing more efficient access to these data. The survey also identified a lack of knowledge and training in the use of syndromic surveillance data. In the second year, plans were developed for the creation of trainings using new modalities and new distribution methods. Finally, NCPERRC findings continue to support the development of protocols and reports that broaden the distribution and increase the usefulness of syndromic surveillance data statewide. Syndromic surveillance improvements have been presented at national conferences and are part of national discussions on improving syndromic surveillance.

Regionalization of Public Health Preparedness Workforce Infrastructure project:

Public Health Regional Surveillance Teams (PHRST) study for state-level strategic planning

In the first 2 years, this research project submitted reports to NC DPH/Office of Public Health Preparedness and Response (PHP&R) presenting the following study findings: 1) support and services PHRST provide to LHDs; 2) structural capacity of the PHRSTs; and 3) lessons learned from the PHRSTs’ regional all-hazards exercises. All reports have been shared with key preparedness partners and have provided information to inform the state’s 3 to 5-year strategic planning process (initiated in August 2010) for public health preparedness and response. Findings from this research will provide information for NC DPH to assist with evidence-based decision-making. The PI and co-PI of the project, Dr. Pia MacDonald and Dr. Jennifer Horney, are actively participating in the NC DPH strategic planning process, using the findings from the research to support system modifications and improve public health preparedness workforce infrastructure in North Carolina.

Recommendations for regional exercises

The 9 PERRCs are presenting at the Public Health Preparedness Summit in Atlanta February 23-25. Visit the UNC Center for Public Health Preparedness booth to learn more about NCPERRC.

A main recommendation resulting from the PHRST exercise study conducted in NCPERRC’s first grant year focused on expanding strategies to effectively identify and train exercise evaluators. Through collaboration with the PHP&R Evaluator and Planner, this recommendation was highlighted as a priority activity for PHP&R. PHP&R obtained funding and is currently initiating a project to train exercise evaluators for 2011 and 2012 exercises. Additionally, the PHP&R Evaluator and Planner reports that this study prompted PHP&R to implement an exercise improvement planning process for future regionally planned and conducted exercises.

Engineering the North Carolina Health Alert Network (NCHAN) project:

Increased interdisciplinary collaboration

This project increased the interdisciplinary collaboration between industrial and systems engineering (ISE) faculty and students and members of the state and local public health community. Examples of collaboration include:

  1. the participation of public health officials in the ISE department seminar series to learn about engineering systems approach and modeling techniques;
  2. the involvement of the NC DPH information technology manager and the communicable-disease physician in the development of the report on NCHAN findings and recommendations;
  3. the development of a partnership with an 11-county consortium of local health departments to use locally available data from their recently implemented H1N1 vaccination clinics to develop models of their vaccination clinics and, ultimately, tools to plan clinics more efficiently;
  4. the interdisciplinary research collaboration between the ISE faculty and students, other NCPERRC researchers with epidemiology expertise, officials from NC DPH’s Epidemiology Section, and a member of the faculty of the University of Oklahoma School of Public Health to validate a model representing the dynamics of pertussis outbreaks in a realistic manner; and
  5. the ability of ISE students to become familiar with public health culture and language, learn how to translate ISE modeling techniques for public health audiences, and successfully give oral and poster presentations to many public health audiences. One graduate student interviewed for a position at the CDC based on his research associated with this project; another student’s master’s thesis on H1N1 simulation model for determining optimal mitigation strategies was recently published as a book based on his research.

For more information visit NCPERRC Research or contact the Principal Investigators or Co-Investigators.

NCPERRC component Contact information
Administrative Core Edward Baker (PI) ed_baker@unc.edu
Carol Gunther-Mohr (Program Manager) cgm@email.unc.edu
Accreditation project Glen Mays (PI) gpmays@uams.edu
Mary Davis (Co-PI) mvdavis@email.unc.edu
Surveillance project Anna Waller (PI) awaller@med.unc.edu
Pia MacDonald (Co-PI) pia@email.unc.edu
Regionalization project Pia MacDonald (PI) pia@email.unc.edu
Jennifer Horney (Co-PI) jen.horney@unc.edu
NCHAN project Julie Ivy (PI) jsivy@ncsu.edu
Edward Baker (Co-PI) ed_baker@unc.edu