EPPM and Willingness to Respond: The Role of Risk and Efficacy Communication in Strengthening Public Health Emergency Response Systems

Abstract

This study examines the attitudinal impact of an Extended Parallel Process Model (EPPM)-based training curriculum on local public health department (LHD) workers' willingness to respond to representative public health emergency scenarios. Data are from 71 U.S. LHDs in urban and rural settings across nine states. The study explores changes in response willingness and EPPM threat and efficacy appraisals between randomly assigned control versus intervention health departments, at baseline and 1 week post curriculum, through an EPPM-based survey/resurvey design. Levels of response willingness and emergency response-related attitudes/beliefs are measured. Analyses focus on two scenario categories that have appeared on a U.S. government list of scenarios of significant concern: a weather-related emergency and a radiological "dirty" bomb event (U.S. Department of Homeland Security, 2007). The greatest impact from the training intervention on response willingness was observed among LHD workers who had low levels of EPPM-related threat and efficacy perceptions at baseline. Self-efficacy and response efficacy and response willingness increased in intervention LHDs for both scenarios, with greater response willingness increases observed for the radiological "dirty" bomb terrorism scenario. Findings indicate the importance of building efficacy versus enhancing threat perceptions as a path toward greater response willingness, and suggest the potential applicability of such curricular interventions for boosting emergency response willingness among other cadres of health providers.

Willingness of the Local Health Department Workforce to Respond to Infectious Disease Events: Empirical, Ethical, and Legal Considerations

“…4,6 This in turn highlights the need for efficacy-focused strategies and interventions to boost response willingness among this occupational cohort. 21 Healthcare providers have a generally accepted duty to treat individuals in need of medical attention. The duty of a healthcare provider to treat an individual in need is based on the provider's expert training and commitment to upholding the professional code of conduct.…”

“…The presence of such laws provides opportunities for training and other advance preparations for a response among local health departments, improving workers' response-related skills and making them more comfortable with the parameters of their response roles and responsibilities. 21,65 Many elements contribute to legal conceptions of a duty to respond, or report to work, during an infectious disease emergency. As noted above, for members of the public health workforce, a key concern is whether liability protections, beyond those included in the PREP Act relative to countermeasures, will apply to their response efforts.…”

Perceived Facilitators and Barriers to Local Health Department Workers' Participation in Infectious Disease Emergency Responses

“…Prior research has found that LHD workers’ response willingness increases when their sense of efficacy (i.e., ability to understand and execute their response role) improves. 21 …”

Evaluation and improvement of emergency capacity of medical staff for the COVID-19: A cross-sectional study in China

“…The higher the score, the stronger the core emergency response capability. Targeted training in response to the lack of emergency capacity can enhance the self-e cacy of medical staff in response to public health emergencies, thereby enhancing their willingness to participate in rescue [16]. Therefore, at the end of the questionnaire, the content of medical staff's self-e cacy was added.…”