Infectious Diseases - At-Risk Populations Project
About This Project
A unique partnership has been created to help protect the most vulnerable people in America during one of the worst public health catastrophes imaginable – an influenza pandemic.
The Association of State and Territorial Health Officials (ASTHO) received a grant from the Centers for Disease Control and Prevention (CDC) to develop recommendations for state, territorial, tribal, and local health officials on how to protect at-risk populations during an influenza pandemic.
ASTHO is being assisted by the Center for Infectious Disease Research & Policy (CIDRAP) at the University of Minnesota, the National Association of County and City Health Officials (NACCHO), and The Keystone Center.
The At-Risk Populations Project depends heavily on both professional and personal expertise.
An advisory panel of national experts is guiding ASTHO's efforts. The recommendations will stem from three important groups:
Five working groups that consist of more than 70 subject matter experts from across the United States
More than 100 members of at-risk populations, who participated in one of two public engagement meetings - Boston, MA (March 8, 2008) and Kansas City, MO (March 15, 2008)
Stakeholders representing a wide variety of national community- and faith-based organizations, as well as other organizations that work with at-risk populations, will be convened in Washington, DC on March 20.
The suggestions put forward by these groups will be the basis for a set of detailed national recommendations that describe how to:
Collaborate with and engage at-risk populations
Locate and quantify at-risk populations
Communicate with and educate at-risk populations
Provide services, both clinical and non-clinical, to at-risk populations
Test, exercise, measure, and improve preparedness levels of at-risk populations.
ASTHO and CIDRAP staff members are incorporating the vital feedback into the guidance document, along with examples of promising practices and tools that planners can use to advance their own efforts. These national recommendations will be made public on this Web site on April 9, to make it possible for the public-at-large to comment and provide suggestions. In addition, the CDC is providing detailed information on protecting eleven specific at-risk population groups, which will be included as appendices later this summer.
"ASTHO’s goal is to develop sound, evidence-based guidance on the protection of at-risk populations during an influenza pandemic," said ASTHO Executive Director Paul E. Jarris, MD, MBA. "This is a ground-breaking project for the nation.
CDC has chosen to bring the policy process to the at-risk populations who will be affected, as well as to the public health planners and other experts who will have responsibility for implementing the policies. This could mark a turning point in how federal policymaking is conducted."
As the recommendations are finalized, they will be shared with public health planners in a series of regional meetings and will be available on the Internet to help guide and strengthen the work being done.
It is of particular importance to plan for protecting at-risk populations during an influenza pandemic because "Disasters discriminate," said John Auerbach, Advisory Panel Chair and Commissioner of the Massachusetts Department of Public Health. "We hope this guidance will help safeguard the most vulnerable people in America by incorporating the perspectives of at-risk population members, the people who care for them, and the people who plan for their care."
Pandemic influenza is a worldwide outbreak of a new flu virus, one for which people have little or no built up immunity. A severe flu pandemic has the potential to last longer, make people sicker, and cause more deaths than any other health crisis of our time.
Currently, there is no human influenza pandemic. Planners are preparing now to limit illness and death, and to ensure the functioning of government, business, and civil society.
At-Risk Populations Project
Public Comment Period on Draft Guidance
April 15, 2008 – May 15, 2008
Summary
The Association of State and Territorial Health Officials (ASTHO) has released the draft version of At-Risk Populations and Pandemic Influenza: Planning Guidance for State, Territorial, Tribal, and Local Health Departments for public comment. Under a cooperative agreement with the Centers for Disease Control and Prevention (CDC), ASTHO was asked to develop model guidance on the protection of at-risk populations in an influenza pandemic.
Over the past several months, ASTHO performed an extensive review of relevant publications and plans, assembled subject matter expert-led work groups, and convened public and stakeholder engagement meetings to provide key input during the drafting process.
This important project will result in the publication of a critical guidance document to assist public health officials in their pandemic influenza planning efforts.
Topics include:
Collaboration with and Engagement of At-Risk Populations
Identifying At-Risk Populations
Communications with and Education of At-Risk Populations
Provision of Services (Clinical and Non-Clinical)
How to Test, Exercise, Measure, and Improve Preparedness of At-Risk Populations
Reason for Public Comment
Input from multiple stakeholders is integral to providing useful guidance. We hope to hear from as many people who wish to provide comments as possible during this period in order to fully understand what will enhance planning activities for at-risk populations. Please note that any information you submit may be made public.
Points to Consider
Please keep the following in mind as you read the guidance:
Think about which materials will be most useful to you, including the narrative sections, the recommendations, the charts and tools, and the attachment.
Consider the feasibility of implementing this guidance in your jurisdiction, and note what might make it easier to implement.
Chapter 1 - Consider your networks and collaborations and the tools you need to collaborate. Are there additional aspects of collaboration or tools that should be included in this chapter?
Chapter 2 - Reflect on the at-risk populations in your jurisdiction (based on the guidance definition) and whether the methods and tools outlined in this chapter would help you identify those populations.
Chapter 3 - Determine whether the evaluation strategies outlined in this chapter will be useful and feasible for your jurisdiction.
Chapter 4 - Consider whether the clinical and nonclinical services described in this chapter help to illustrate the needs of at-risk populations during a pandemic.
Chapter 5 - Think about your existing quality assurance activities and whether this chapter would enhance your approach to at-risk populations preparedness planning and evaluation.
Instructions for Submitting Comments
Email:arpp@astho.org (preferred)
Project Overview...................................3
Project Objective...........................4
Definition of At-Risk Populations................................4
Planning Assumptions....................................... .......6
Ethical Considerations.................................... ........6
Legal Considerations...........................8
Guidance Structure......................................... ....11
Chapter 1: Collaboration with and Engagement of At-Risk Populations.............................12
Introduction..................................12
Background and Findings.......................................... ..................12
Recommended Planning Activities........................................ .................19
Sample Practices, Tools, and Tips............................................21
Chapter 2: Identifying At-Risk Populations..................................26
Introduction and Background........................................ ..............................26
Sources of Public Data.............................................. ................28
Managing and Mapping Public Data.............................................. .29
Limits to Public Data.............................................. .......................31
Recommended Planning Activities........................................ ................33
Sample Data Collection Sources and Projects.......................................... .......35
Chapter 3: Communications with and Education of At-Risk Populations...........................48
Introduction and Background........................................ ..........................48
Findings.......................................... ..........49
Recommended Planning Activities........................................ ............57
Tools............................................. .....................................61
Chapter 4: Provision of Services (Clinical and Non-Clinical).............................65
Introduction and Background........................................ ...........................65
Essential Clinical Services.......................................... .....................66
Non-Clinical Essential Services.......................................... ...70
Essential Service Providers......................................... ............71
Recommended Planning Activities........................................ .................75
Tools and Practices......................................... ...................................77
Chapter 5: How to Test, Exercise, Measure, and Improve Preparedness of At-Risk
Populations....................................... ................................81
Introduction and Background........................................ ..........................81
Barriers to the Evaluation Process and Options to Overcome Those Barriers......................81
Methods for the Evaluation Process........................................... .........82
Recommended Planning Activities........................................ ...........................86
Matrix with Sample Practices and Tools............................................. ...........88
Discussion-based Exercises......................................... .........................................91
Operation-based Exercises......................................... .......................................94
Afterword......................................... ...........................95
Appendices......................................96
Appendix A: Acknowledgments................................... .......................96
Appendix B: Glossary.....................99
Attachment 1: Proposed Timeline for Enacting Recommendations......105
At the end of each chapter, there are many helpful ideas. This has some of the best links I've seen in any document.
Here's something I found most interesting on page 14. According to an annual survey that tracks trends in public attitudes toward personal preparedness, “Americans with annual household incomes below $25,000 are more likely than those with incomes above $50,000 to believe that…it’s not really possible for the average person to prepare for a major disaster (42 percent vs. 31 percent).”
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