An intervention for enhancing public health crisis response willingness among local health department workers: a qualitative programmatic analysis.

OBJECTIVES:This study evaluated the impact of a novel multimethod curricular intervention using a train-the-trainer model: the Public Health Infrastructure Training (PHIT). PHIT was designed to 1) modify perceptions of self-efficacy, response efficacy, and threat related to specific hazards and 2) improve the willingness of local health department (LHD) workers to report to duty when called upon. METHODS:Between June 2009 and October 2010, eight clusters of US LHDs (n = 49) received PHIT. Two rounds of focus groups at each intervention site were used to evaluate PHIT. The first round of focus groups included separate sessions for trainers and trainees, 3 weeks after PHIT. The second round of focus groups combined trainers and trainees in a single group at each site 6 months following PHIT. During the second focus group round, participants were asked to self-assess their preparedness before and after PHIT implementation. SETTING:Focus groups were conducted at eight geographically representative clusters of LHDs. PARTICIPANTS:Focus group participants included PHIT trainers and PHIT trainees within each LHD cluster. MAIN OUTCOME MEASURE(S):Focus groups were used to assess attitudes toward the curricular intervention and modifications of willingness to respond (WTR) to an emergency; self-efficacy; and response efficacy. RESULTS:Participants reported that despite challenges in administering the training, PHIT was well designed and appropriate for multiple management levels and disciplines. Positive mean changes were observed for all nine self-rated preparedness factors (p < 0.001). The findings show PHIT's benefit in improving self-efficacy and WTR among participants. CONCLUSIONS:The PHIT has the potential to enhance emergency response willingness and related self-efficacy among LHD workers.