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2 The Landscape and Evolution of Public Health Emergency Preparedness and Response Research in the United States
Pages 49-70

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From page 49...
... 1The committee defined PHEPR practices broadly as a type of process, structure, or intervention whose implementation is intended to mitigate the adverse effects of a public health emergency on the population as a whole or a particular sub-group within the population.
From page 50...
... While all of these scoping reviews have added value in identifying common themes across the evidence base and noting particular knowledge gaps, none of them has focused purposefully on the 15 PHEPR Capabilities, which are fundamental in guiding state, local, tribal, and territorial public health agencies in assessing, building, and sustaining PHEPR capacity. To address this gap, the committee sought to understand the extent, range, and nature of PHEPR research across the 15 PHEPR Capabilities, with a specific focus on studies that evaluate the impact of PHEPR practices, and commissioned an expert group to visualize these findings using high-level evidence maps (see Appendix D)
From page 51...
... Capabilities with individual health outcomes as their most common outcome type include Community ­ R ­ ecovery, Fatality Management, Mass Care, Non-Pharmaceutical Interventions, Public ­ Health Surveillance and Epidemiological Investigation, and Responder Safety and Health. These Capabilities are fundamentally different from those with process outcomes, namely Emergency Public Information and Warning, Information Sharing, Medical Countermeasure Dispensing and Administration, Medical Surge, and Public Health Laboratory Testing.
From page 52...
... Given that Emergency Operations Coordination comprises largely organizational, behavioral, and management practices, which are likely to be highly contextspecific, this Capability, in contrast to Medical Countermeasure Dispensing and Administration and Non-Pharmaceutical Interventions, may be better suited to quality improvement 4 Three types of evidence are defined in evidence-based public health: Type 1 is research that describes risk– disease relations and identifies the magnitude, severity, and preventability of public health problems; Type 2 is research that identifies the relative effectiveness of specific interventions aimed at addressing a problem; and Type 3 is research on the design and implementation of an intervention, the contextual circumstances in which the inter­ ention was implemented, and how the intervention was received. Quantitative nonimpact studies encompass v Type 1 evidence, and quantitative impact studies encompass Types 2 and 3 (Rychetnik et al., 2004)
From page 53...
... THE LANDSCAPE AND EVOLUTION OF PHEPR RESEARCH IN THE UNITED STATES 53 FIGURE 2-3  Evidence map: Characteristics of U.S. quantitative impact studies across the PHEPR Capabilities (N = 72)
From page 54...
... Studies Within Specific Practice Areas of the 15 PHEPR Capabilities The committee was interested in examining the distribution of studies not only across the 15 PHEPR Capabilities but also across specific PHEPR practice areas within individual Capabilities.5 Evidence maps for each of the 15 PHEPR Capabilities can be found in Appendix D; one is discussed here as an illustrative example. As a whole, however, the maps in Appendix D show that the distribution of quantitative impact studies is uneven, with few (and in some cases no)
From page 55...
... identifying gaps that can inform priorities for future research. Those practice areas in which quantitative impact studies tend to cluster may be good starting points for considering topics for future evidence reviews, particularly if they can be linked to important knowledge gaps identified by practitioners or policy makers.
From page 56...
... The map shows no quantitative impact studies for the at-risk population practice area, which may indicate that a review on this topic would yield little in the way of findings on effective practices and suggests that the topic is an important research gap. However, it is important to reiterate that Emergency Public Information and Warning is a broad field, and it is likely that some impact research has occurred outside of PHEPR.
From page 57...
... As in all areas of public health, ongoing research and evaluation are essential to improving practice in the PHEPR field. Centers for Disease Control and Prevention–Funded Academic PHEPR Workforce Development and Research Centers Centers for Public Health Preparedness In the PHEPR field, the Centers for Disease Control and Prevention (CDC)
From page 58...
... . Preparedness and Emergency Response Learning Centers  The PERLC program, which was funded from 2009 to 2015, also within schools of public health, was built on a decade of activities carried out by its predecessor program, the CPHPs, and carried on the mission of strengthening linkages between academic public health programs and public health practice to improve curriculum development for both workforce development and graduate education for public health students (Richmond et al., 2014)
From page 59...
... funding. Currently, CDC's Center for Preparedness and Response issues Broad Agency Announcements for Public Health Emergency Preparedness and Response Applied Research to solicit proposals for research funding in several topic areas of interest (CDC, 2018)
From page 60...
... . Specific efforts to strengthen the conduct of research during public health emergencies have TABLE 2-1 Key Federal Stakeholders in Conducting or Supporting Disaster Research Federal Stakeholder Role in Conducting or Supporting Disaster Research Federal Emergency Management Agency (FEMA)
From page 61...
... •  evelop the concepts, doctrine, infrastructure, and personnel needed to begin scientific D investigation and data collection rapidly in various types of incidents. • Integrate the Public Health Emergency Research Review Board into standard operating procedures for review of research before, during, and after a disaster response.
From page 62...
... . Misaligned and Unclear Research Priorities The PERRC and the PERLC funding awards were announced before the 2011 publication of the CDC PHEPR Capabilities, which created a misalignment between research and practice.
From page 63...
... . Furthermore, the response community remains hesitant to accept researchers within public health emergency settings because of cultural differences between the practice and research fields, and research is not standard practice within the given operational response structure.
From page 64...
... determined that annual funding for research and development for the CDC PHEPR Capabilities from 2008 to 2017 averaged $2.8 million. Another aspect of PHEPR funding is related to rapid and sustained funding mechanisms for research during public health emergencies (IOM, 2015)
From page 65...
... As new threats emerge and response contexts evolve and become increasingly complex, it is imperative that the PHEPR system be flexible, responsive, and based on evidence to improve practice and save lives in future public health emergencies. Recommendations for ways to improve and expand the evidence base for PHEPR are presented and discussed in Chapter 8.
From page 66...
... 2011. Public health emergency preparedness archive.
From page 67...
... 2014. The preparedness and emergency response learning centers: Advancing standardized evaluation of public health preparedness and response trainings.
From page 68...
... 2019. Public health emergency pre paredness system evaluation criteria and performance metrics: A review of contributions of the CDC-funded Preparedness and Emergency Response Research Centers.
From page 69...
... : Addressing public health preparedness knowledge gaps using a public health systems perspective. American Journal of Public Health 108(S5)


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