Enhancing Communication and Effective Response in the Event of a Pandemic: Evaluating a Social Work Prevention Program for Government, Community and Spiritual First Responders during Crisis and Disaster

Background and Purpose: Local officials and community leaders serve a critical role before, during and after a community disaster or public health emergency. Leaders provide information, education, access to services and mental health resources in the midst of overwhelming fear, chaos and uncertainty. Because trust and confidence in authorities strongly influence community mental health response to disaster, attention to cultural subtleties, language, community resilience, and local resources is paramount. Plans for risk communication and management must be steeped in an on-going multi-level assessment that accounts for diversity within and across cultures and generations, and changing circumstances over time. In this study we present the findings from a project funded by the New York City Department of Health and Mental Hygiene (DOHMH) to design and evaluate a preventive training for city government, community, and spiritual leaders whose leadership would be called upon in the event of a pandemic or related emergency.

Methods: This social work evaluation project involved three steps. Step 1 was formative, using focus group methodology with 20 government leaders and 20 community/spiritual leaders to develop a collaborative plan. Step 2 focused on development of a preventive training model to increase knowledge and skills related to risk communication and disaster preparation among city and local leaders with their ongoing input. In Step 3, 60 government, community, and spiritual leaders were trained, representing the diversity spectrum of NYC. We used quantitative and qualitative evaluation data to document process and short term impact.

Results: Through a content anaylsis of focus group transcripts we first identified themes to inform the training: 1) barriers to involvement including fear, importance of trust, denial, pressing “daily” disasters at the community level (e.g. poverty, homelessness), and limited knowledge regarding the multifaceted impact of a pandemic, 2) strategies for building alliance between city and community leaders to promote communication and access to resources and 3) strategies to maximize preparedness and risk communication systems and skills for DOHMH and community leaders and their constituencies, and 4) common and unique needs for care across systems, roles and cultures. The outcome evaluation among trainees showed strong satisfaction with the training (94% high or very high), a close to significant increase in knowledge regarding disaster management and risk communication from pre to post test, and suggestions for addressing the diverse needs of a city where 120 languages are represented with a language other than English spoken in 47.6 percent of homes.

Conclusions and Implications: This project provided a platform to increase knowledge and awareness of public health issues related to a pandemic, while simultaneously addressing mental health issues both to reduce the emotional impact immediately and over time, and promote prevention and leaders' capacity. Local leaders and decision makers must rapidly overcome overt and hidden disparities that exist as a result of embedded inequities if fear, trust and access are to be managed constructively. A social work perspective infused the participatory process. Principles of social justice, care and trust, and related implications for disaster preparedness will be discussed.