Preparedness Mentoring Project in Lane County, Oregon

State: OR Type: Model Practice Year: 2011

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"National and global events have demonstrated the urgent need to effectively prepare vulnerable populations and the communities in which they live to ensure the safety of all in emergency situations. The Lane County Public Health Emergency Preparedness program addressed this need through a Preparedness Mentoring Project designed to increase the ability of local community agencies that serve vulnerable populations to continue to carry out their mission and offer potentially life-sustaining services like food boxes to their clients and many others who would need this support in a disaster. On any given night in Lane County, Oregon, over 3,959 people are homeless on the streets or living in temporary shelters. Thousands more of our low-income residents consistently rely on local agencies to supplement basic needs including food, shelter, and health support services. Even those who do not typically receive these services may need to resort to them in the aftermath of a disaster. Community Based Organizations (CBOs) are an appropriate and trusted avenue for communication, service provision, and problem solving for many vulnerable populations, especially in chaotic emergency environments when they may be the only resource available to those they serve.

The main objective of the Preparedness Mentoring Project was to develop and test a preparedness curriculum and tools targeting community based organizations serving the homeless population of Lane County to help build a network of community agencies where preparedness is seamlessly integrated into their everyday work practices, where preparedness is neither an afterthought, nor a separate task, but is an essential part of doing business and of assuring that they stay in business even under trying circumstances. This objective was successfully accomplished through a planned program of three workshops and one-on-one mentoring. 36 local community agencies participated in a series of 3 workshops over the course of 6 months, and 26 of them received additional one-on-one on-site preparedness mentoring. The project adopted culturally appropriate training and mentoring materials that incorporated health promotion and behavioral change strategies including the Trans-theoretical Model, Organizational Change theory and Brief Motivational Interviewing as the framework for the intervention.

The demonstration project was funded by a grant of $263,480 from the Centers for Disease Control and Prevention and covered all project costs including 2.3 full-time employee equivalents, contractor and consultant costs, project evaluation and data analysis, workshop costs including facilities, food and incentives, travel and mentoring expenses, and all project supplies and printed materials. This budget was for the entire duration of the project, from October 2008 through September 2009 (one year). The project’s participant-centered techniques drew upon and encouraged each organization’s own capacity to successfully write, adopt, and test emergency preparedness plans, policies and work practices.

By the end of the project, participants drafted an Emergency Plan that was easy to use, relevant, and sustainable. While these proven strategies are widely used in many public health settings, they are not broadly incorporated to the realm of emergency preparedness. In addition, this project collected substantial data throughout its course to evaluate both outcomes and process in order to validate this strategy as a best approach to emergency preparedness promotion. Feedback from key partners and stakeholders was incorporated throughout the project’s lifecycle starting with the initial intervention design and culminating with the program for the final workshop, helping to sustain a true partnership between the local public health department and the community organizations served by the project. By the conclusion, the main objectives were overwhelmingly met: all participating organizations developed coordinated and c"

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Lane County Public Health Department
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Preparedness Mentoring Project in Lane County, Oregon
"National and global events have demonstrated the urgent need to effectively prepare vulnerable populations and the communities in which they live to ensure the safety of all in emergency situations. The Lane County Public Health Emergency Preparedness program addressed this need through a Preparedness Mentoring Project designed to increase the ability of local community agencies that serve vulnerable populations to continue to carry out their mission and offer potentially life-sustaining services like food boxes to their clients and many others who would need this support in a disaster. On any given night in Lane County, Oregon, over 3,959 people are homeless on the streets or living in temporary shelters. Thousands more of our low-income residents consistently rely on local agencies to supplement basic needs including food, shelter, and health support services. Even those who do not typically receive these services may need to resort to them in the aftermath of a disaster. Community Based Organizations (CBOs) are an appropriate and trusted avenue for communication, service provision, and problem solving for many vulnerable populations, especially in chaotic emergency environments when they may be the only resource available to those they serve. The main objective of the Preparedness Mentoring Project was to develop and test a preparedness curriculum and tools targeting community based organizations serving the homeless population of Lane County to help build a network of community agencies where preparedness is seamlessly integrated into their everyday work practices, where preparedness is neither an afterthought, nor a separate task, but is an essential part of doing business and of assuring that they stay in business even under trying circumstances. This objective was successfully accomplished through a planned program of three workshops and one-on-one mentoring. 36 local community agencies participated in a series of 3 workshops over the course of 6 months, and 26 of them received additional one-on-one on-site preparedness mentoring. The project adopted culturally appropriate training and mentoring materials that incorporated health promotion and behavioral change strategies including the Trans-theoretical Model, Organizational Change theory and Brief Motivational Interviewing as the framework for the intervention. The demonstration project was funded by a grant of $263,480 from the Centers for Disease Control and Prevention and covered all project costs including 2.3 full-time employee equivalents, contractor and consultant costs, project evaluation and data analysis, workshop costs including facilities, food and incentives, travel and mentoring expenses, and all project supplies and printed materials. This budget was for the entire duration of the project, from October 2008 through September 2009 (one year). The project’s participant-centered techniques drew upon and encouraged each organization’s own capacity to successfully write, adopt, and test emergency preparedness plans, policies and work practices. By the end of the project, participants drafted an Emergency Plan that was easy to use, relevant, and sustainable. While these proven strategies are widely used in many public health settings, they are not broadly incorporated to the realm of emergency preparedness. In addition, this project collected substantial data throughout its course to evaluate both outcomes and process in order to validate this strategy as a best approach to emergency preparedness promotion. Feedback from key partners and stakeholders was incorporated throughout the project’s lifecycle starting with the initial intervention design and culminating with the program for the final workshop, helping to sustain a true partnership between the local public health department and the community organizations served by the project. By the conclusion, the main objectives were overwhelmingly met: all participating organizations developed coordinated and c"
The Lane County Human Services Commission 2010 One Night Homeless Count reveals that 3,959 people in Lane County are homeless on the streets or living in temporary shelters. The report states that homelessness increased 47% from the previous count in 2009. Homeless persons include marginally housed, or shelter-dependent, individuals in shelters, homeless families, veterans, runaway youth, and women in shelter programs for domestic violence. In public health emergencies (e.g., pandemic illnesses, earthquakes), special consideration is necessary to assure the health and safety of this vulnerable population, and those who are low or no-income and that may have multiple co-morbidities (e.g., substance abuse, mental illness) who may be on the verge of homelessness. Many of these individuals are disconnected from or unable to receive messages through mainstream media, may be unable to act on crucial messages and potentially life saving information, and/or may require specialized assistance relevant to their circumstances, capabilities, and available resources. Homeless persons, in particular, may experience a greater burden of stress, social disruption, or even death during a disaster, and especially so during a prolonged event like a pandemic illness if/when services and communication channels they rely on are interrupted or completely disappear (see Influenza Pandemic Planning Guide for Homeless and Housing Service Providers, Seattle-King County, 2006). Disaster events have repeatedly established that, without appropriate planning, traditional response systems are quickly overwhelmed by the resulting human needs. The great diversity of special health and medical concerns, language and cultural barriers, and other life circumstances present many challenges for emergency managers. Emergency management systems can benefit by partnering with Community Based Organizations (CBOs) that already provide day-to-day services to people who are most vulnerable during disasters (see Meeting the Needs of Vulnerable People in Times of Disaster, California Governor’s Office of Emergency Services, 2000). However, in communities like Lane County, Oregon, where disasters are infrequent, CBOs lack regular cues to action to motivate and encourage their preparations. Many factors, including lack of clear policy, limited funding resources, expertise, or administrative commitment can prevent CBOs from successfully implementing preparedness activities or normalizing preparedness in their work practices.
Agency Community RolesWhile Lane County Public Health served as the lead agency in the development and implementation of the Preparedness Mentoring Project, the project counted on the substantial input and cooperation of local stakeholders. Key roles of LCPH in the development and implementation of the project included applying for funding; project management (e.g. hiring, supervising and training staff members, developing timelines, monitoring budgets), project design (e.g. developing project objectives, intervention strategies, curriculum development), project implementation (e.g. organizing workshops, mentoring agencies), and project evaluation (e.g. data collection and analysis, and reporting). The project was staffed by paid employees of Lane County Public Health. Costs and ExpendituresNational and global events have demonstrated the urgent need to effectively prepare vulnerable populations and the communities in which they live to ensure the safety of all in emergency situations. The Lane County Public Health Emergency Preparedness program addressed this need through a Preparedness Mentoring Project designed to increase the ability of local community agencies that serve vulnerable populations to continue to carry out their mission and offer potentially life-sustaining services like food boxes to their clients and many others who would need this support in a disaster. On any given night in Lane County, Oregon, over 3,959 people are homeless on the streets or living in temporary shelters. Thousands more of our low-income residents consistently rely on local agencies to supplement basic needs including food, shelter, and health support services. Even those who do not typically receive these services may need to resort to them in the aftermath of a disaster. Community Based Organizations (CBOs) are an appropriate and trusted avenue for communication, service provision, and problem solving for many vulnerable populations, especially in chaotic emergency environments when they may be the only resource available to those they serve. The main objective of the Preparedness Mentoring Project was to develop and test a preparedness curriculum and tools targeting community based organizations serving the homeless population of Lane County to help build a network of community agencies where preparedness is seamlessly integrated into their everyday work practices, where preparedness is neither an afterthought, nor a separate task, but is an essential part of doing business and of assuring that they stay in business even under trying circumstances. This objective was successfully accomplished through a planned program of three workshops and one-on-one mentoring. 36 local community agencies participated in a series of 3 workshops over the course of 6 months, and 26 of them received additional one-on-one on-site preparedness mentoring. The project adopted culturally appropriate training and mentoring materials that incorporated health promotion and behavioral change strategies including the Trans-theoretical Model, Organizational Change theory and Brief Motivational Interviewing as the framework for the intervention. The project’s participant-centered techniques drew upon and encouraged each organization’s own capacity to successfully write, adopt, and test emergency preparedness plans, policies and work practices. By the end of the project, participants drafted an Emergency Plan that was easy to use, relevant, and sustainable. While these proven strategies are widely used in many public health settings, they are not broadly incorporated to the realm of emergency preparedness. In addition, this project collected substantial data throughout its course to evaluate both outcomes and process in order to validate this strategy as a best approach to emergency preparedness promotion. Feedback from key partners and stakeholders was incorporated throughout the project’s lifecycle starting with the initial intervention design and culminating with the program for the final workshop, helping to sustain a true partnership between the local public health department and the community organizations served by the project. By the conclusion, the main objectives were overwhelmingly met: all participating organizations developed coordinated and consistent emergency plans, and reported a significant change in their feelings of self-efficacy and therefore their confidence to respond in an emergency. ImplementationThe project tasks: hire and train staff, develop and test curriculum materials, recruit participants, plan and conduct workshops, conduct mentoring, collect data (before, during and after), analyze and evaluate data, and write report. In October of 2008, Lane County Public Health obtained funding from the CDC, and hired two staff to lead the project and provide mentoring to community organizations. Staff training began by learning about Motivational Interviewing methods used by the WIC program in the State of Oregon, and the Transtheoretical Model of Behavior Change. Anna-Marie Jones and CARD were contracted and provided training on their Prepare to Prosper approach of empowerment and positive messaging. The curriculum was developed to include these methodologies and input from a focus group made up of members of the Vulnerable Populations Emergency Preparedness Coalition (VPEP), who reviewed the initial materials. This research, training and development phase took place over the first 4 months of the project. Workshop planning included selecting sites and dates and recruiting organizations to participate. VPEP members provided linkages to other community organizations and assisted with the recruitment process, most notably by signing up to participate and validating the project with their peers. 77 Community agencies that offered services to the homeless, including shelters, transitional housing, developmentally disabled and mental health services agencies, and the local food bank and its network of food box and meal providers, were indentified. 36 were enrolled as participants by January 2009. The first workshop was conducted in March, the second one in June and the final one in September of 2009. 26 of the enrolled organizations also received on-site mentoring, which began in March right after the first workshop. Mentoring continued until early September 2009, right before the program closed with the final workshop. Baseline data was collected via a survey before the start of the program, and a final survey of participants was administered at the final workshop. In addition, the mentors collected data and tracked plan development progress from their first mentoring meeting until the final one. Plans developed by the participants were also collected at the end of the project. The Preparedness Mentoring Project was carried out from October 2008 to September 2009, and the final program evaluation and report were done from February to May, 2010 for final evaluation and report The first quarter of the project primarily entailed activities related to engagement of community partners and stakeholders and the development of the training curriculum and other materials with feedback from the participating partners. Event planning and promotional activities related to the three scheduled workshops and mentoring were also carried out in the first quarter. During the second quarter the curriculum and training materials were finalized and mentors were trained in the application and use of the developed materials. The first of three workshops will occurred by the sixth month of the project. Agencies were paired with a mentor and mentoring activities begun by the midpoint of the project. Through the third quarter and the first part of the fourth quarter mentoring continued and two additional workshops were conducted. Program evaluation and quality control activities occurred throughout the life of the project. All measures of performance were shared in a mid-project report, as well as in a final report concluded approximately 18 months after the start of the project.
Objective 1: Develop and test a preparedness curriculum and mentoring program that is appropriate for and relevant to Community Based Organizations (CBOs). CBOs are engaged in preparedness for different reasons than preparedness professionals and those reasons are valid and important to understand if we want to actively engage them in this work. To ensure that these motivations were taken into account a number of steps were taken to evaluate the acceptability, appropriateness and relevance of the mentoring program to the CBO setting. Key performance measures included verbal feedback from advisory panel members, participant ratings and comments regarding workshop presentations, tools, materials and mentoring experiences, and staff written observations and notes from workshops and mentoring sessions. Data was collected via the following: (1) Notes from facilitated discussions with advisory panel members: five local community-based organizations that serve persons who are homeless provided verbal comments on the perceptions of the applicability and usefulness of teaching tools and curriculum (2) Workshop Evaluations: at the conclusion of each of the three workshops, participants completed a workshop evaluation form. The domains included a rating of each of the key elements of the workshop and handouts/materials; and an assessment of what worked well and areas for improvement; (3) Workshop Transcriptions, Presentations, and Notes: detailed notes were taken at each workshop that captured the topics that were covered as well as discussion points. The Workshop facilitators and planners recorded debriefing notes about Workshop 1 and Workshop 3; (4) Mentoring Contact Logs: Mentors logged all contacts they made with each agency, including the date, time, purpose and outcome of the contact; (5) Post-Mentoring Notes: Within 24 hours of visiting an agency to do a mentoring session, mentors noted key data about that visit including topics discussed, challenges, solutions, accomplishments; and (6) Pre/Post Intervention Surveys: surveys completed before the first workshop and after the last workshop, where agencies indicated their perceptions of the most important lessons learned, aspect most appreciated, and suggestions for improvement. All data collected was evaluated and analyzed by an independent evaluation consultant. The results of the evaluation indicate that the curriculum and mentoring program were very well received by the agencies. The preparedness curriculum and mentoring program were well received, relevant and applicable to the CBO setting, and were delivered in appropriate and meaningful language. Participant satisfaction with the topics covered in each workshop was consistently rated as “very helpful” or “helpful” by at least 90% of participants for all items. Staff and attendees commented that the mood remained very high and engaging at each workshop and that people laughed a lot. Attendee comments were very enthusiastic about the speakers, the variety of organizations that were present, and the positive approach to emergency preparedness. Likewise, most respondents rated their one-on-one mentoring experience as excellent (76.5%) or very good (17.6%). While the program was being implemented, challenges were identified and used to adjust the program. For example, one of the main challenges identified in the first workshop was the vast amount of new information provided to attendees that left some feeling overwhelmed about where to begin. This information was used and specifically discussed at the first mentoring session following the workshop to provide guidance to those agencies who received mentoring. Additional adjustments were recommended for future workshops including 1) help people break the information down into manageable tasks and next steps – perhaps in an audience brainstorming session that incorporates their next step into their homework prior to the second workshop, and 2) have all workshop attendees comp
The intervention activities (workshops and mentoring) of the preparedness mentoring project were designed to build a culture of preparedness among community based organizations of Lane County and have succeeded in creating sustained commitment and action among participating organizations. Informal conversations with participating organizations have revealed many activities which have continued more than two years since the conclusion of the project. Examples include: formal adoption of plans by boards of directors and organization leadership; regularly scheduled preparedness planning committee workgroup meetings; creation of formal written agreements with partner agencies; staff training on the incident command system and organization emergency plans; and adoption of protocols that include preparedness planning as part of a client case management plan. All participating CBOs continue to maintain an Oregon Health Alert Network (HAN) account and Lane County Public Health continues to use the HAN to share news releases and public health alerts with agencies during actual events and regularly scheduled drills. Lane County Public Health and the Lane County Vulnerable Populations Emergency Preparedness Coalition also continue to express commitment to preparedness planning for CBOs and the clients they serve as evidenced in work plans and the VPEP coalition charter. Although staffing and financial resources are not currently allocated for ongoing training and mentoring, other activities in support of the project achievements may be pursued as resources allow. Several activities have been identified which may support the continued success of the project. Recommendations include building a peer-to-peer support network where agencies can continue to support or mentor one another (e.g., create an online peer support network), and improving access to materials and trainings (e.g. online). It may also be relevant to generate support through funding and policy. For example, common local grantors for non-profits may be an important ally. They may be encouraged to provide financial support for preparedness activities or can require evidence of planning to demonstrate that an agency is a good investment for funding. Others who wish to replicate the preparedness mentoring project may also wish to consider the above recommendations to improve project sustainability.
 
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