title: An intervention for enhancing public health crisis response willingness among local health department workers: a qualitative programmatic analysis.
abstract: OBJECTIVE
  This study evaluated the impact of a novel multimethod curricular intervention using a train-the-trainer model: the Public Health Infrastructure Training (PHIT). PHIT was designed to 1) modify perceptions of self-efficacy, response efficacy, and threat related to specific hazards and 2) improve the willingness of local health department (LHD) workers to report to duty when called upon.
  
  
  METHODS
  Between June 2009 and October 2010, eight clusters of US LHDs (n = 49) received PHIT. Two rounds of focus groups at each intervention site were used to evaluate PHIT. The first round of focus groups included separate sessions for trainers and trainees, 3 weeks after PHIT. The second round of focus groups combined trainers and trainees in a single group at each site 6 months following PHIT. During the second focus group round, participants were asked to self-assess their preparedness before and after PHIT implementation.
  
  
  METHODS
  Focus groups were conducted at eight geographically representative clusters of LHDs.
  
  
  METHODS
  Focus group participants included PHIT trainers and PHIT trainees within each LHD cluster.
  
  
  METHODS
  Focus groups were used to assess attitudes toward the curricular intervention and modifications of willingness to respond (WTR) to an emergency; self-efficacy; and response efficacy.
  
  
  RESULTS
  Participants reported that despite challenges in administering the training, PHIT was well designed and appropriate for multiple management levels and disciplines. Positive mean changes were observed for all nine self-rated preparedness factors (p < 0.001). The findings show PHIT's benefit in improving self-efficacy and WTR among participants.
  
  
  CONCLUSIONS
  The PHIT has the potential to enhance emergency response willingness and related self-efficacy among LHD workers.
authors: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Krista L
authors: KL
authors: Harrison
authors: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Nicole A
authors: NA
authors: Errett
authors: Assistant Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Lainie
authors: L
authors: Rutkow
authors: Assistant Scientist, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Carol B
authors: CB
authors: Thompson
authors: Position Training Specialist, Eastern Idaho Public Health District, Idaho Falls, Idaho.
authors: Marilyn K
authors: MK
authors: Anderson
authors: Emergency Planner, Lord Fairfax Health District, Virginia Department of Health, Winchester, Virginia.
authors: Justin L
authors: JL
authors: Ferrell
authors: Graduate Assistant, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin.
authors: Jennifer M
authors: JM
authors: Freiheit
authors: Administrator, Butler County Health Department, Poplar Bluff, Missouri.
authors: Robert
authors: R
authors: Hudson
authors: Emergency Preparedness Coordinator, Meeker County Public Health, Litchfield, Minnesota.
authors: Michelle M
authors: MM
authors: Koch
authors: Director, Public Health Practice, Marion County Health Department, Indianapolis, Indiana.
authors: Mary
authors: M
authors: McKee
authors: Advanced Registered Nurse Practitioner, Miami-Dade County Health Department, Doral, Florida.
authors: Alvaro
authors: A
authors: Mejia-Echeverry
authors: Emergency Preparedness Coordinator (retired), Office of the Director, Multnomah County Health Department, Portland, Oregon.
authors: James B
authors: JB
authors: Spitzer
authors: Assistant Professor, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Doug
authors: D
authors: Storey
authors: Assistant Professor, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Daniel J
authors: DJ
authors: Barnett
mesh_terms: D001291:Attitude of Health Personnel; D002959:Civil Defense / Q000193:education*; D003479:Curriculum; D060731:Emergency Responders / Q000193:education* / Q000523:psychology*; D017144:Focus Groups; D006801:Humans; D011634:Public Health / Q000193:education*; D020377:Self Efficacy; D014836:Volition