Exposure to extreme heat events increases the risk for negative birth outcomes, including preterm birth. This study sought to determine the presence and content of web-based heat health information for pregnant people provided by federal, state, and local government public health websites.

This website content analysis consisted of 17 federal, 50 state, and 21 city websites, and noted which of 25 recognized pregnancy heat health data elements were included. Data for the analysis were collected from March 12, 2022, through March 16, 2022.

The search identified 17 federal websites, 38 state websites, and 19 city websites with heat health information. Within these, only seven websites listed pregnant people as a vulnerable or at-risk population, and only six websites provided information related to heat health specifically for pregnancy. Of the 25 themes recognized as important for pregnancy risk during extreme heat exposure, only 11 were represented within these 6 websites.

The presence of web-based pregnancy heat health information is infrequent and limited in content. Boosting web-based publication of extreme heat and pregnancy risks could mitigate negative maternal and child health outcomes.

Little is known about how flood risk of health-care facilities (HCFs) is evaluated by emergency preparedness professionals and HCFs administrators. This study assessed knowledge of emergency preparedness and HCF management professionals regarding locations of floodplains in relation to HCFs. A Web-based interactive map of floodplains and HCF was developed and users of the map were asked to evaluate it.

An online survey was completed by administrators of HCFs and public health emergency preparedness professionals in Illinois, before and after an interactive online map of floodplains and HCFs was provided.

Forty Illinois HCFs located in floodplains were identified, including 12 long-term care facilities. Preparedness professionals have limited knowledge of whether local HCFs were in floodplains, and few reported availability of geographic information system (GIS) resources at baseline. Respondents intended to use the interactive map for planning and stakeholder communications.

Given that HCFs are located in floodplains, this first assessment of using interactive maps of floodplains and HCFs may promote a shift to reliable data sources of floodplain locations in relation to HCFs. Similar approaches may be useful in other settings.

This study compared 2019 values for the National Health Security Preparedness Index (NHSPI) with 2020 rates of coronavirus disease 2019 (COVID-19)-related mortality as reported by the 50 US states and Puerto Rico during the first six months of the US pandemic (March 1 - August 31, 2020).

Data regarding provisional death counts and estimates of excess deaths for COVID-19 according to state and territory were downloaded from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics website. Reporting included the six-month-long period of March 1 - August 31, 2020. Excess mortality rates were calculated as the number of excess deaths per 100,000 persons in each state population using 2019 US Census Bureau data. Mean values for state and territorial NHSPI domain indices were compared to state and territorial rates of COVID-19-related excess mortality using multiple linear regression, including analysis of variance. Correlations between the 51 state and territorial NHSPI values and corresponding COVID-19 excess mortality rates were calculated using Pearson’s correlation coefficient.

These calculations revealed a high degree of variance (adjusted r square = 0.02 and 0.25) and poor correlation (P = .16 and .08) among values for the overall NHSPI as compared to low and high estimates of excess COVID-19 mortality rates for 50 US states and Puerto Rico.

There was also a high degree of variance (adjusted r square = 0.001 and 0.03) and poor correlation (P values ranging from .09 to .94) for values for the six individual domains of the NHSPI as compared to low and high estimates of excess COVID-19 mortality rates for 50 US states and Puerto Rico.

The NHSPI does not appear to be a valid predictor of excess COVID-19 mortality rates for 50 US states and Puerto Rico during the first six months of the pandemic.

In 2009, the Institute of Medicine published guidelines for implementation of Crisis Standards of Care (CSC) at the state level in the United States (US). Based in part on the then concern for H1N1 pandemic, there was a recognized need for additional planning at the state level to maintain health system preparedness and conventional care standards when available resources become scarce. Despite the availability of this framework, in the years since and despite repeated large-scale domestic events, implementation remains mixed.

Coronavirus disease 2019 (COVID-19) rejuvenates concern for how health systems can maintain quality care when faced with unrelenting burden. This study seeks to outline which states in the US have developed CSC and which areas of care have thus far been addressed.

An online search was conducted for all 50 states in 2015 and again in 2020. For states without CSC plans online, state officials were contacted by email and phone. Public protocols were reviewed to assess for operational implementation capabilities, specifically highlighting guidance on ventilator use, burn management, sequential organ failure assessment (SOFA) score, pediatric standards, and reliance on influenza planning.

Thirty-six states in the US were actively developing (17) or had already developed (19) official CSC guidance. Fourteen states had no publicly acknowledged effort. Eleven of the 17 public plans had updated within five years, with a majority addressing ventilator usage (16/17), influenza planning (14/17), and pediatric care (15/17), but substantially fewer addressing care for burn patients (9/17).

Many states lacked publicly available guidance on maintaining standards of care during disasters, and many states with specific care guidelines had not sufficiently addressed the full spectrum of hazard to which their health care systems remain vulnerable.

The aim of this study was to (1) understand types and amounts of Ebola-related information that health organization employees wanted and obtained through formal, informal, internal, and external organizational communication channels; (2) determine potential discrepancies between information wanted and obtained; and (3) investigate how organizational structure might affect information wanted and obtained through these communication channels.

Primary data were collected from 526 health workers in 9 hospitals and 13 public health departments in Texas from June to November 2015. Survey data were collected for 7 types of Ebola-related information health organization employees wanted and obtained through various types of organizational communication channels. Descriptive statistical analyses, mixed design analysis of variance, regression analyses, and multilevel analyses were used to analyze the data.

Hospital employees (mostly nurses in our sample) received more self-care information than they wanted from every communication channel. However, they received less about all other types of information than they wanted from every communication channel separately and combined. Public health department employees wanted more information than they received from every communication channel separately and combined for all 7 types of information.

Discrepancies existed between the types of Ebola-related information wanted and obtained by employees of hospitals and public health departments.

Disaster research can inform effective, efficient, and evidence-based public health practices and decision making; identify and address knowledge gaps in current disaster preparedness and response efforts; and evaluate disaster response strategies. This study aimed to identify challenges and opportunities experienced by Washington State local health departments (LHDs) regarding engagement in disaster research activities.

An online survey was disseminated to the emergency preparedness representative for the 35 LHDs in Washington State. Survey questions sought to assess familiarity and experience with disaster research, as well as identify facilitators and barriers to their involvement. The survey was first piloted with 7 local and state public health emergency preparedness practitioners.

A total of 82.9% of Washington’s 35 LHDs responded to our survey. Only 17.2% of respondents had previous experience with disaster research. Frequently reported barriers to engaging in disaster research included funding availability, competing everyday priorities, staff capacity, and competing priorities during disaster response.

These findings can inform efforts to support disaster research partnerships with Washington State LHDs and facilitate future collaboration. Researchers and public health practitioners should develop relationships and work to incorporate disaster research into LHD planning, training, and exercises to foster practice-based disaster research capacity.

Between May 2010 and September 2011, the University of Minnesota School of Public Health partnered with the Minnesota Department of Health (MDH) to assess the effect of exercises on team performance during public health emergency response.

Participants were divided into 3 research teams exposed to various levels of intervention. Groups consisted of a control group that was given standard MDH training exercises, a didactic group exposed to team dynamics and communication training, and a treatment group that received the didactic training in addition to a post-exercise facilitated debriefing. To assess differences in team performance, teams engaged in 15 functional exercises.

Differences in team performance across the 3 groups were identified, although there was no trend in team performance over time for any of the groups. Groups demonstrated fluctuation in team performance during the study period. Attitudinal surveys demonstrated an increase in workplace satisfaction and confidence in training among all groups throughout the study period.

Findings from this research support that a critical link exists between training type and team performance during public health emergency response. This research supports that intentional teamwork training for emergency response workers is essential for effective public health emergency response. (Disaster Med Public Health Preparedness. 2017;11:7–10)

We examined the representativeness of the nonfederal hospital emergency department (ED) visit data in the National Syndromic Surveillance Program (NSSP).

We used the 2012 American Hospital Association Annual Survey Database, other databases, and information from state and local health departments participating in the NSSP about which hospitals submitted data to the NSSP in October 2014. We compared ED visits for hospitals submitting data with all ED visits in all 50 states and Washington, DC.

Approximately 60.4 million of 134.6 million ED visits nationwide (~45%) were reported to have been submitted to the NSSP. ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. The NSSP ED visits were similar to national ED visits in terms of many of the characteristics of hospitals and their service areas. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented.

NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. (Disaster Med Public Health Preparedness. 2016;10:562–569)

Public health investigations require rapid assessment, response, and initiation of control measures. In 2012, the New Hampshire Department of Health and Human Services used digital pens to rapidly acquire epidemiologic data during a gastrointestinal illness outbreak.

Menus were obtained and a standard questionnaire was administered to exposed persons using digital pens. Questionnaire data were downloaded into an electronic file for analysis.

Sixty-nine (74%) of 93 exposed persons completed a questionnaire. Of 6389 data entries made on digital paper, 218 (3%) required correction; of these, 201 (92%) involved a free-form variable and 17 (8%) involved a check-box variable. Digital pens saved an estimated 5 to 6 hours of data-entry time.

This outbreak provided an opportunity to assess the value of digital pens for decreasing data-entry burden and allowing more timely data analysis in an emergent setting. Depending on the size of the outbreak and complexity of the survey, there is likely a threshold when use of digital pens would provide a clear benefit to outbreak response. As new technology becomes available for use in emergency preparedness settings, public health agencies must continuously review and update response plans and evaluate investigation tools to ensure timely disease control and response activities. (Disaster Med Public Health Preparedness. 2015;9:349–353)