title: Vaccine-related standard of care and willingness to respond to public health emergencies: a cross-sectional survey of California vaccine providers.
abstract: BACKGROUND
  Responding to a vaccine-related public health emergency involves a broad spectrum of provider types, some of whom may not routinely administer vaccines including obstetricians, pharmacists and other specialists. These providers may have less experience administering vaccines and thus less confidence or self-efficacy in doing so. Self-efficacy is known to have a significant impact on provider willingness to respond in emergency situations.
  
  
  METHODS
  We conducted a survey of 800 California vaccine providers to investigate standard of care, willingness to respond, and how vaccine-related standard of care impacts willingness to respond among these providers. We used linear regression to examine how willingness to respond was impacted by vaccine-related standard of care.
  
  
  RESULTS
  Forty percent of respondents indicated that they had participated in emergency preparedness training, actual disaster response, or surge capacity initiatives with significant differences among provider types for all measures (p=0.007). When asked to identify barriers to responding to a public health emergency, respondents indicated that staff size or capacity, training and resources were the top concerns. Respondents in practices with a higher vaccine-related standard of care had a higher willing to respond index (β=0.190, p=0.001). Respondents who had participated in emergency training or actual emergency response had a higher willing to respond index (β=1.323, p<0.0001).
  
  
  CONCLUSIONS
  Our study suggests that concerns about staff size and surge capacity need to be more explicitly addressed in current emergency preparedness training efforts. In the context of boosting response willingness, larger practice environments stand to benefit from self-efficacy focused training and exercise efforts that also incorporate standard of care.
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States. kseib@emory.edu
authors.forename: Katherine
authors.initials: K
authors.lastname: Seib
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Barnett
authors.forename: Paul S
authors.initials: PS
authors.lastname: Weiss
authors.forename: Saad B
authors.initials: SB
authors.lastname: Omer
mesh_terms: D003430:Cross-Sectional Studies; D004189:Disaster Planning; D004632:Emergency Medical Services; D006801:Humans; D011634:Public Health / Q000592:standards*; D014612:Vaccines / Q000592:standards*
chemical_list: D014612:Vaccines