title: Interlocal collaboration and emergency preparedness: a qualitative analysis of the impact of the Urban Area Security Initiative program.
abstract: OBJECTIVE
  Horizontal intergovernmental coordination, or interlocal collaboration, is an ongoing strategy to enhance public health emergency preparedness in the United States. This study aims to understand the impact of interlocal collaboration on emergency preparedness, and how the Urban Area Security Initiative (UASI) program, a federally administered grant program to promote regional preparedness capability development, has influenced perceptions of this relationship.
  
  
  METHODS
  Semistructured interviews were conducted and recorded in early 2014. Transcribed data were coded and iteratively analyzed. A purposive and snowball sampling strategy was used.
  
  
  METHODS
  Interviews were conducted in person or by phone.
  
  
  METHODS
  Twenty-eight key informants were interviewed during 24 interviews. Individuals were selected as key informants due to their knowledge of a UASI region(s) and its governance structures, investment strategies, and challenges, as well as knowledge of the UASI program&s history and goals.
  
  
  METHODS
  Interviews were used to identify, describe, and characterize perceptions of interlocal collaboration, national emergency preparedness, and the UASI grant.
  
  
  RESULTS
  Impacts, challenges, incentives, facilitators, and disadvantages to interlocal collaboration were identified. Interlocal collaboration was found to impact preparedness by promoting the perceived dissolution of geopolitical boundaries; developing self-reliant regions; developing regional capabilities; promoting regional risk identification; and creating an appreciation of interlocal collaboration importance. The UASI program was thought to have a profound and unique impact on the development of interlocal collaboration infrastructure and on national preparedness.
  
  
  CONCLUSIONS
  Interlocal collaborations contribute to overall national preparedness. Grant programs, such as the UASI, can incentivize and foster interlocal collaboration in preparedness.
authors: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Nicole A
authors: NA
authors: Errett
authors: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Shannon
authors: S
authors: Frattaroli
authors: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Beth A
authors: BA
authors: Resnick
authors: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Daniel J
authors: DJ
authors: Barnett
authors: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Lainie
authors: L
authors: Rutkow
mesh_terms: D003299:Cooperative Behavior; D004189:Disaster Planning / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D009111:Local Government; D011635:Public Health Administration; D036301:Qualitative Research; D012637:Security Measures; D014504:Urban Health