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Qualitative Assessment of a Novel Efficacy-Focused Training Intervention for Public Health Workers in Disaster Recovery

  • Craig Tower (a1), Brian A. Altman (a2), Kandra Strauss-Riggs (a2), Annelise Iversen (a3), Stephanie Garrity (a4), Carol B. Thompson (a5), Lauren Walsh (a2), Lainie Rutkow (a6), Kenneth Schor (a7) and Daniel J. Barnett (a1)...



We trained local public health workers on disaster recovery roles and responsibilities by using a novel curriculum based on a threat and efficacy framework and a training-of-trainers approach. This study used qualitative data to assess changes in perceptions of efficacy toward Hurricane Sandy recovery and willingness to participate in future disaster recoveries.


Purposive and snowball sampling were used to select trainers and trainees from participating local public health departments in jurisdictions impacted by Hurricane Sandy in October 2012. Two focus groups totaling 29 local public health workers were held in April and May of 2015. Focus group participants discussed the content and quality of the curriculum, training logistics, and their willingness to engage in future disaster recovery efforts.


The training curriculum improved participants’ understanding of and confidence in their disaster recovery work and related roles within their agencies (self-efficacy); increased their individual- and agency-level sense of role-importance in disaster recovery (response-efficacy); and enhanced their sense of their agencies’ effective functioning in disaster recovery. Participants suggested further training customization and inclusion of other recovery agencies.


Threat- and efficacy-based disaster recovery trainings show potential to increase public health workers’ sense of efficacy and willingness to participate in recovery efforts. (Disaster Med Public Health Preparedness. 2016;10:615–622)


Corresponding author

Address correspondence and reprint requests to Daniel J. Barnett, Johns Hopkins Bloomberg School of Public Health, Department of Environmental Health Sciences, 615 North Wolfe Street Room E7036, Baltimore, MD 21205 (e-mail:


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1. Altevogt, BM, Pope, AM, Hill, MN, et al. eds. Committee on Research Priorities in Emergency Preparedness and Response for Public Health Systems. Research Priorities in Emergency Preparedness and Response for Public Health Systems: A Letter Report. Washington, DC: The National Academies Press; 2008.
2. Smith, RA, Ferrara, M, Witte, K. Social sides of health risks: stigma and collective efficacy. Health Commun. 2007;21(1):55-64.
3. Witte, K. Putting the fear back into fear appeals: the Extended Parallel Process Model. Commun Monogr. 1992;59(4):329-349.
4. Witte, K, Allen, M. A meta-analysis of fear appeals: implications for effective public health campaigns. Health Educ Behav. 2000;27(5):591-615.
5. McMahan, S, Witte, K, Meyer, J. The perception of risk messages regarding electromagnetic fields: extending the Extended Parallel Process Model to an unknown risk. Health Commun. 1998;10(3):247-259.
6. Balicer, RD, Catlett, CL, Barnett, DJ, et al. Characterizing hospital workers’ willingness to respond to a radiological event [published online October 27, 011]. PLoS One. doi:
7. Barnett, DJ, Balicer, RD, Thompson, CB, et al. Assessment of local public health workers’ willingness to respond to pandemic influenza through application of the extended parallel process model [published online July 24, 2009]. PLoS One. doi:
8. Barnett, DJ, Levine, R, Thompson, CB, et al. Gauging U.S. emergency medical services workers’ willingness to respond to pandemic influenza using a threat- and efficacy-based assessment framework [published online March 24, 2010]. PLoS One. doi:
9. Barnett, DJ, Thompson, CB, Errett, NA, et al. Determinants of emergency response willingness in the local public health workforce by jurisdictional and scenario patterns: a cross-sectional survey [published online March 7, 2012]. BMC Public Health. doi: 10.1186/1471-2458-12-164.
10. Barnett, DJ, Thompson, CB, Semon, NL, et al. EPPM and willingness to respond: the role of risk and efficacy communication in strengthening public health emergency response systems. Health Commun. 2014;29(6):598-609.
11. Federal Emergency Management Agency, US Department of Homeland Security. National Disaster Recovery Framework: Strengthening Disaster Recovery for the Nation. September 2011. Updated February 24, 2015. Accessed August 10, 2015.
12. Merriam, S, Caffarella, R, Baumgartner, L. Learning in Adulthood: A Comprehensive Guide, 3rd ed. San Francisco: John Wiley & Sons; 2007.
13. Knowles, M, Holton, E, Swanson, R. The Adult Learner: The Definitive Classic in Adult Education and Human Resource Development, 7th ed. Amsterdam: Butterworth-Heinemann; 2011.
14. Errett, NA, Egan, S, Garrity, S, et al. Attitudinal determinants of local public health workers’ participation in Hurricane Sandy recovery activities. Health Secur. 2015;13(4):267-273.
15. Denzin, NK, Lincoln, YS. eds. The Sage Handbook of Qualitative Research, 4th ed. Thousand Oaks, CA: Sage Publications; 2011.
16. Bandura, A. Self-efficacy. In:. Corsini Encyclopedia of Psychology. Hoboken, NJ: John Wiley and Sons; 2010.
17. NVivo [computer program]. Version 10. Burlington, MA: QSR International (Americas) Inc; 2012.
18. Walsh, L, Garrity, S, Rutkow, L, et al. Applying a behavioral model framework for disaster recovery research in local public health agencies: a conceptual approach. Disaster Med Public Health Prep. 2015;9(4):403-408.
19. Harrison, KL, Errett, NA, Rutkow, L, et al. An Intervention for enhancing public health crisis response willingness among local health department workers: a qualitative programmatic analysis. Am J Disaster Med. 2014;9(2):87-96.
20. Bandura, A. Exercise of human agency through collective efficacy. Curr Dir Psychol Sci. 2000;9(3):75-78.
21. Van Dyke, ME, McCormick, LC, Bolus, NE, et al. Radiological emergency preparedness: a survey of nuclear medicine technologists in the United States. J Nucl Med Technol. 2013;41(3):223-230.
22. Pillow, MT, Stader, D, Nguyen, M, et al. Perceptions of basic, advanced, and pediatric life support training in a United States medical school. J Emerg Med. 2014;46(5):695-700.



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