Applying Community Engagement to Disaster Planning: Developing the Vision and Design for the Los Angeles County Community Disaster Resilience Initiative

摘要

Community resilience (CR) is a priority for preparedness, but few models exist. A steering council used community-partnered participatory research to support workgroups in developing CR action plans and hosted forums for input to design a pilot demonstration of implementing CR versus enhanced individual preparedness toolkits. Qualitative data describe how stakeholders viewed CR, how toolkits were developed, and demonstration design evolution. Stakeholders viewed community engagement as facilitating partnerships to implement CR programs when appropriately supported by policy and CR resources. Community engagement exercises clarified motivations and informed action plans (e.g., including vulnerable populations). Community input identified barriers (e.g., trust in government) and CR-building strategies. A CR toolkit and demonstration comparing its implementation with individual preparedness were codeveloped. Community-partnered participatory research was a useful framework to plan a CR initiative through knowledge exchange. “We want information about how to identify resilience-building tasks and activities that communities can replicate. How can vulnerable communities fit into these activities to make sure they are also more resilient to disasters?” – Workgroup member Disasters such as wildfires, tropical storms, hurricanes, earthquakes, and epidemics pose temporary and long-term threats to public health. 1,2 Underresourced communities are at high risk for adverse outcomes owing to preexisting disparities in health, access to services, and environmental risks. 3–5 Large-scale events disrupt physical, social, and communication infrastructures posing challenges to response, and creating “surge burdens” that overwhelm care resources and strain social supports. 6 Events such as Hurricane Katrina, the H1N1 epidemic, and the Gulf oil spill have increased public awareness of the impacts of disasters and of gaps in communication, infrastructure, and resources that limit capacities to respond and recover. 3,7,8 One paradigm that has emerged in response is community resilience (CR). 9,10 Based on a community-systems model, 11,12 CR refers to community capabilities that buffer it from or support effective responses to disasters. 13,14 Such capabilities include effective risk communications, organizational partnerships and networks, and community engagement to improve, prepare for, and respond to disasters. These capabilities may improve outcomes such as access to response and recovery resources, or return to functioning and well-being. 15 Yet there are no operational models of how to build CR. 16,17 One potential model is community-partnered participatory research (CPPR), a manualized form of community-based participatory research 18 that emphasizes power sharing and 2-way knowledge exchange following principles of community engagement to support authentic partnerships. 19–21 We define a community as persons who work, share recreation, or live in a given area. A CPPR initiative has 3 stages: vision (planning), valley (implementation), and victory (products, dissemination). 22–24 Each stage involves organizing, action, and feedback. 20 Community-partnered participatory research was used to support post-Katrina mental health recovery in New Orleans 24–28 and to address chronic conditions. 29–33 Following successful application of CPPR in a postdisaster context, we proposed that it could support development of predisaster CR programs. We describe here the use of CPPR for the planning or vision stage of the Los Angeles County Community Disaster Resilience (LACCDR) initiative. As described elsewhere, LACCDR was initiated in 2010 by the Los Angeles County Department of Public Health (LACDPH) in collaboration with key academic and community partners based on principles from the National Health Security Strategy. 10 Representatives of these partners constitute the LACCDR Steering Council. The Council reviewed the policy background for CR 34 and developed a logic model 35 that emphasizes the importance of community engagement in developing organizational partnerships to build CR. This article focuses on how the Council then used community engagement principles and the CPPR model to develop the project’s CR intervention framework, propose and develop a toolkit containing training and other resources to improve CR, and design a demonstration to compare the effectiveness of implementing the CR toolkit with the enhanced standard approach that emphasizes individual or family preparedness. 15,36.

机译：社区应变能力（CR）是备灾工作的重中之重，但很少有模型。指导委员会利用社区合作的参与式研究来支持工作组制定企业责任行动计划，并主持论坛以提供意见，以设计实施企业责任与增强个人准备工具包的试点示范。定性数据描述了利益相关者如何看待CR，工具包如何开发以及演示设计的演变。利益相关者认为，在政策和企业责任资源的适当支持下，社区参与可以促进伙伴关系实施企业责任计划。社区参与活动阐明了动机和知情的行动计划（例如，包括弱势人群）。社区的投入确定了障碍（例如，对政府的信任）和企业责任建设策略。共同开发了一个CR工具包和将其实施与个人准备进行比较的演示。社区参与的参与式研究是通过知识交流来计划企业责任倡议的有用框架。 “我们需要有关如何确定社区可以复制的恢复力建设任务和活动的信息。弱势社区如何适应这些活动，以确保他们也更能抵御灾难？” –工作组成员野火，热带风暴，飓风，地震和流行病等灾难对公共健康构成了暂时和长期的威胁。 1,2资源不足的社区由于存在健康，服务和环境风险方面的先天差异而处于不良后果的高风险中。 3–5大规模事件破坏了物理，社会和通信基础设施，给应对措施带来了挑战，并造成了“激增负担”，使护理资源不堪重负，并给社会支持带来压力。 6诸如卡特里娜飓风，H1N1流行病和墨西哥湾漏油之类的事件使公众更加认识到灾难的影响以及通讯，基础设施和资源的缺口，这些缺口限制了应对和恢复的能力。 3,7,8作为回应出现的一种范例是社区弹性（CR）。 9,10根据社区系统模型，11,12 CR指的是社区功能，可以从灾难中缓冲或支持灾难的有效响应。 13,14这些能力包括有效的风险沟通，组织合作伙伴关系和网络，以及社区参与，以改善，准备和应对灾害。这些功能可以改善结果，例如获得响应和恢复资源，或恢复功能和福祉。 15然而，尚无如何建立企业责任感的运营模型。 16,17一种潜在的模式是社区参与式参与研究（CPPR），这是基于社区的参与式研究18的一种手动形式，强调遵循社区参与原则以支持真正的伙伴关系的权力共享和双向知识交流。 19–21我们将社区定义为在给定地区工作，共享娱乐或生活的人。 CPPR计划分为三个阶段：远景（规划），低谷（实施）和胜利（产品，传播）。 22–24每个阶段都涉及组织，行动和反馈。 20社区参与的参与性研究被用来支持新奥尔良24-28年卡特里娜飓风之后的精神健康恢复并解决慢性病。 29–33在灾难后环境中成功应用CPPR之后，我们建议该计划可以支持灾难前CR计划的开发。我们在这里描述了CPPR在洛杉矶县社区抗灾能力（LACCDR）计划的规划或愿景阶段的使用。如其他地方所述，LACCDR由洛杉矶县公共卫生部（LACDPH）于2010年根据国家卫生安全策略的原则与主要的学术和社区合作伙伴合作发起。这些合作伙伴的10名代表组成了LACCDR指导委员会。理事会审查了CR 34的政策背景，并制定了逻辑模型35，该模型强调了社区参与在发展组织伙伴关系以建立CR中的重要性。本文重点讨论理事会随后如何使用社区参与原则和CPPR模型来开发项目的CR干预框架，提出并开发一个包含培训和其他资源以改善CR的工具包，并设计一个演示来比较实施CR的有效性带有增强的标准方法的工具包，强调个人或家庭的准备。 15,36。

Applying Community Engagement to Disaster Planning: Developing the Vision and Design for the Los Angeles County Community Disaster Resilience Initiative

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