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Public Health System Research in Public Health Emergency Preparedness in the United States (2009–2015): Actionable Knowledge Base

机译：美国公共卫生应急准备中的公共卫生系统研究（2009-2015年）：可操作的知识库

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Background. In 2008, the Institute of Medicine released a letter report identifying 4 research priority areas for public health emergency preparedness in public health system research: (1) enhancing the usefulness of training, (2) improving timely emergency communications, (3) creating and maintaining sustainable response systems, and (4) generating effectiveness criteria and metrics.Objectives. To (1) identify and characterize public health system research in public health emergency preparedness produced in the United States from 2009 to 2015, (2) synthesize research findings and assess the level of confidence in these findings, and (3) describe the evolution of knowledge production in public health emergency preparedness system research.Search Methods and Selection Criteria. We reviewed and included the titles and abstracts of 1584 articles derived from MEDLINE, EMBASE, and gray literature databases that focused on the organizational or financial aspects of public health emergency preparedness activities and were grounded on empirical studies.Data Collection and Analysis. We included 156 articles. We appraised the quality of the studies according to the study design. We identified themes during article analysis and summarized overall findings by theme. We determined level of confidence in the findings with the GRADE-CERQual tool.Main Results. Thirty-one studies provided evidence on how to enhance the usefulness of training. Results demonstrated the utility of drills and exercises to enhance decision-making capabilities and coordination across organizations, the benefit of cross-sector partnerships for successfully implementing training activities, and the value of integrating evaluation methods to support training improvement efforts. Thirty-six studies provided evidence on how to improve timely communications. Results supported the use of communication strategies that address differences in access to information, knowledge, attitudes, and practices across segments of the population as well as evidence on specific communication barriers experienced by public health and health care personnel. Forty-eight studies provided evidence on how to create and sustain preparedness systems. Results included how to build social capital across organizations and citizens and how to develop sustainable and useful planning efforts that maintain flexibility and rely on available medical data. Twenty-six studies provided evidence on the usefulness of measurement efforts, such as community and organizational needs assessments, and new methods to learn from the response to critical incidents.Conclusions: In the United States, the field of public health emergency preparedness system research has been supported by the US Centers for Disease Control and Prevention since the release of the 2008 Institute of Medicine letter report. The first definition of public health emergency preparedness appeared in 2007, and before 2008 there was a lack of research and empirical evidence across all 4 research areas identified by the Institute of Medicine. This field can be considered relatively new compared with other research areas in public health; for example, tobacco control research can rely on more than 70 years of knowledge production. However, this review demonstrates that, during the past 7 years, public health emergency preparedness system research has evolved from generic inquiry to the analysis of specific interventions with more empirical studies.Public Health Implications: The results of this review provide an evidence base for public health practitioners responsible for enhancing key components of preparedness and response such as communication, training, and planning efforts.
机译：背景。 2008年，医学研究所发布了一封信函报告，确定了公共卫生系统研究中公共卫生应急准备工作的四个研究优先领域：（1）增强培训的有用性，（2）改进及时的应急通信，（3）创建和维护可持续响应系统，以及（4）制定有效性标准和指标。 （1）在2009年至2015年间，对美国进行的公共卫生应急准备工作中的公共卫生系统研究进行识别和表征，（2）综合研究结果并评估对这些发现的置信度，以及（3）描述公共卫生应急准备系统研究中的知识生产。搜索方法和选择标准。我们审查并纳入了MEDLINE，EMBASE和灰色文献数据库中的1584篇文章的标题和摘要，这些文献和文献着重于公共卫生应急准备活动的组织或财务方面，并以实证研究为基础。数据收集和分析。我们收录了156条文章。我们根据研究设计评估了研究质量。我们在文章分析过程中确定了主题，并按主题总结了总体发现。我们使用GRADE-CERQual工具确定了对结果的信心水平。主要结果。 31项研究提供了有关如何增强培训有用性的证据。结果证明了演习和演习在增强组织之间的决策能力和协调方面的效用，跨部门伙伴关系对成功实施培训活动的好处，以及整合评估方法以支持培训改进工作的价值。三十六项研究提供了有关如何改善及时沟通的证据。结果支持使用沟通策略，以解决不同人群在获取信息，知识，态度和实践方面的差异，以及公共卫生和医护人员遇到的特定沟通障碍的证据。四十八项研究提供了有关如何建立和维持备灾系统的证据。结果包括如何在组织和公民之间建立社会资本，以及如何开展可持续且有用的计划工作，以保持灵活性并依赖可用的医疗数据。 26项研究提供了有关衡量工作的有用性的证据，例如社区和组织需求评估，以及从对重大事件的响应中学习的新方法。结论：在美国，公共卫生应急准备系统研究领域已自2008年美国医学研究所的信函报告发布以来，美国疾病控制与预防中心一直提供支持。公共卫生应急准备的第一个定义出现在2007年，而在2008年之前，医学研究所确定的所有4个研究领域都缺乏研究和经验证据。与其他公共卫生研究领域相比，该领域被认为是相对较新的领域。例如，烟草控制研究可以依靠70多年的知识生产。但是，这项审查表明，在过去的7年中，公共卫生应急准备系统研究已从一般性调查演变为通过更多实证研究对特定干预措施进行分析。负责加强准备和响应的关键组成部分（例如沟通，培训和计划工作）的卫生从业人员。

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