title: Improving public health preparedness capacity measurement: development of the local health department preparedness capacities assessment survey.
abstract: OBJECTIVE
  To address limitations in measuring the preparedness capacities of health departments, we developed and tested the Local Health Department Preparedness Capacities Assessment Survey (PCAS).
  
  
  METHODS
  Preexisting instruments and a modified 4-cycle Delphi panel process were used to select instrument items. Pilot test data were analyzed using exploratory factor analysis. Kappa statistics were calculated to examine rater agreement within items. The final instrument was fielded with 85 North Carolina health departments and a national matched comparison group of 248 health departments.
  
  
  RESULTS
  Factor analysis identified 8 initial domains: communications, surveillance and investigation, plans and protocols, workforce and volunteers, legal infrastructure, incident command, exercises and events, and corrective action. Kappa statistics and z scores indicated substantial to moderate agreement among respondents in 7 domains. Cronbach α coefficients ranged from 0.605 for legal infrastructure to 0.929 for corrective action. Mean scores and standard deviations were also calculated for each domain and ranged from 0.41 to 0.72, indicating sufficient variation in the sample to detect changes over time.
  
  
  CONCLUSIONS
  The PCAS is a useful tool to determine how well health departments are performing on preparedness measures and identify opportunities for future preparedness improvements. Future survey implementation will incorporate recent Centers for Disease Control and Prevention's Public Health Preparedness Capabilities: National Standards for State and Local Planning.
authors: University of North Carolina at Chapel Hill Gillings School of Global Public Health, North Carolina Preparedness and Emergency Response Research Center, Chapel Hill, North Carolina.
authors: Mary V
authors: MV
authors: Davis
authors: University of Arkansas for Medical Sciences College of Public Health, Little Rock, Arkansas.
authors: Glen P
authors: GP
authors: Mays
authors: University of Arkansas for Medical Sciences College of Public Health, Little Rock, Arkansas.
authors: James
authors: J
authors: Bellamy
authors: University of North Carolina at Chapel Hill Gillings School of Global Public Health, North Carolina Preparedness and Emergency Response Research Center, Chapel Hill, North Carolina.
authors: Christine A
authors: CA
authors: Bevc
authors: University of Arkansas for Medical Sciences College of Public Health, Little Rock, Arkansas.
authors: Cammie
authors: C
authors: Marti
mesh_terms: D057191:Capacity Building / Q000379:methods / Q000592:standards*; D003697:Delphi Technique; D004189:Disaster Planning / Q000379:methods / Q000458:organization & administration*; D005163:Factor Analysis, Statistical; D006801:Humans; D020380:Needs Assessment; D009657:North Carolina; D015397:Program Evaluation / Q000379:methods; D015980:Public Health Practice / Q000592:standards*; D015203:Reproducibility of Results; D014481:United States