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Gargano L.M.,World Trade Center Health Registry | Caramanica K.,World Trade Center Health Registry | Sisco S.,Office of Emergency Preparedness and Response | Brackbill R.M.,World Trade Center Health Registry | And 2 more authors.
Disaster Medicine and Public Health Preparedness | Year: 2015

Objective In a population with prior exposure to the World Trade Center disaster, this study sought to determine the subsequent level of preparedness for a new disaster and how preparedness varied with population characteristics that are both disaster-related and non-disaster-related. Methods The sample included 4496 World Trade Center Health Registry enrollees who completed the Wave 3 (2011-2012) and Hurricane Sandy (2013) surveys. Participants were considered prepared if they reported possessing at least 7 of 8 standard preparedness items. Logistic regression was used to determine associations between preparedness and demographic and medical factors, 9/11-related post-traumatic stress disorder (PTSD) assessed at Wave 3, 9/11 exposure, and social support. Results Over one-third (37.5%) of participants were prepared with 18.8% possessing all 8 items. The item most often missing was an evacuation plan (69.8%). Higher levels of social support were associated with being prepared. High levels of 9/11 exposure were associated with being prepared in both the PTSD and non-PTSD subgroups. Conclusions Our findings indicate that prior 9/11 exposure favorably impacted Hurricane Sandy preparedness. Future preparedness messaging should target people with low social support networks. Communications should include information on evacuation zones and where to find information about how to evacuate. © Society for Disaster Medicine and Public Health, Inc. 2015.


Gunderson J.,Office of Emergency Preparedness and Response | Crepeau-Hobson F.,University of Colorado at Denver | Drennen C.,Office of Emergency Preparedness and Response
Disaster Prevention and Management | Year: 2012

Purpose: Research and experience following a variety of recent disasters has fostered the development of a range of disaster behavioral health interventions that can be used post-disaster. Consensus documents recommend that five guiding principles be used to inform intervention efforts. These five essential elements, a sense of safety, calming, efficacy, connectedness, and hope, appear critical to the fostering of adaptation and resilience in affected communities. This paper aims to examine the use of these principles in practice. Design/methodology/approach: Translating these five evidence-informed principles into practice requires dissemination, delivery and prioritizing and validation of the elements. Scholars identify actions for dissemination, delivery, and prioritization and validation, and this paper expands on the literature to identify processes that actualize the research into a framework for practice. Findings: This article describes how disaster behavioral health professionals in Colorado have advanced these five principles into practice. Originality/value: While literature clearly dictates the importance of addressing the impacts of extreme stress on individuals and communities, there remains a gap to explain how to bridge the research and practice. These strategies included in this paper begin to bridge this gap and can be used by others charged with disaster planning and response to inform their practices. © Emerald Group Publishing Limited.


Leahy N.E.,New York Presbyterian Hospital | Yurt R.W.,Cornell University | Lazar E.J.,Quality and Patient Safety | Villacara A.A.,System Administration | And 16 more authors.
Journal of Burn Care and Research | Year: 2012

Since its inception in 2006, the New York City (NYC) Task Force for Patients with Burns has continued to develop a city-wide and regional response plan that addressed the triage, treatment, transportation of 50/million (400) adult and pediatric victims for 3 to 5 days after a large-scale burn disaster within NYC until such time that a burn center bed and transportation could be secured. The following presents updated recommendations on these planning efforts. Previously published literature, project deliverables, and meeting documents for the period of 2009-2010 were reviewed. A numerical simulation was designed to evaluate the triage algorithm developed for this plan. A new, secondary triage scoring algorithm, based on co-morbidities and predicted outcomes, was created to prioritize multiple patients within a given acuity and predicted survivability cohort. Recommendations for a centralized patient and resource tracking database, plan operations, activation thresholds, mass triage, communications, data flow, staffing, resource utilization, provider indemnification, and stakeholder roles and responsibilities were specified. Educational modules for prehospital providers and nonburn center nurses and physicians who would provide interim care to burn injured disaster victims were created and pilot tested. These updated best practice recommendations provide a strong foundation for further planning efforts, and as of February 2011, serve as the frame work for the NYC Burn Surge Response Plan that has been incorporated into the New York State Burn Plan. © 2012 by the American Burn Association.


Rinchiuso-Hasselmann A.,Office of Emergency Preparedness and Response | McKay R.L.,Office of Emergency Preparedness and Response | Williams C.A.,Office of Emergency Preparedness and Response | Starr D.T.,Office of Emergency Preparedness and Response | And 4 more authors.
Biosecurity and Bioterrorism | Year: 2011

In fall 2009, the New York City Department of Health and Mental Hygiene (DOHMH) operated 58 points of dispensing (PODs) over 5 weekends to provide influenza A (H1N1) 2009 monovalent vaccination to New Yorkers. Up to 7 sites were opened each day across the 5 boroughs, with almost 50,000 New Yorkers being vaccinated. The policies and protocols used were based on those developed for New York City's POD Plan, the cornerstone of the city's mass prophylaxis planning. Before the H1N1 experience, NYC had not opened more than 5 PODs simultaneously and had only experienced the higher patient volume seen with the H1N1 PODs on 1 prior occasion. Therefore, DOHMH identified factors that contributed to the success of POD operations, as well as areas for improvement to inform future mass prophylaxis planning and response. Though this was a relatively small-scale, preplanned operation, during which a maximum of 7 PODs were operated on a given day, the findings have implications for larger-scale mass prophylaxis planning for emergencies. Copyright 2011, Mary Ann Liebert, Inc.


Rinchiuso-Hasselmann A.,Countermeasures Response Unit | Starr D.T.,Countermeasures Response Unit | McKay R.L.,Office of Emergency Preparedness and Response | Medina E.,Office of Emergency Preparedness and Response | Raphael M.,Office of Emergency Preparedness and Response
Biosecurity and Bioterrorism | Year: 2010

In 2008, the New York City Department of Health and Mental Hygiene (NYC DOHMH) conducted a series of 8 focus groups to determine what improvements could be made to existing plans to ensure that the public would adhere to instructions issued during an emergency that required mass antibiotic distribution following an aerosolized anthrax attack. Discussion focused on perceptions surrounding public health emergencies, overall point-of dispensing (POD) strategy, willingness to pick up medications for others, and additional information that participants would need before and during an emergency. Participation in each group ranged from 7 to 10 members. Most participants indicated a willingness to actively participate in emergency response and to follow directions issued by authorities. Some said they would wait to see how others reacted to medication being provided before taking theirs. Participants expressed a universal desire for education on both dispensing plans and diseases before an incident occurs. They expressed concerns about anxiety levels among the public and maintaining adequate security at dispensing sites, though they felt that NYC's plans were generally realistic. The most trusted sources identified to disseminate information were the mayor, the city health commissioner, and a local cable news channel. While many participants indicated they would use the internet to find information during an emergency, multiple delivery methods must be used to ensure the broadest reach within the community, as not everyone has internet access. Health authorities must partner with the public before, during, and after an emergency to achieve the best possible outcomes from a response effort that relies greatly on public cooperation. © Mary Ann Liebert, Inc.

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