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1
The University of Texas School of Public Health
at Houston Center for Biosecurity Public
Health Preparedness March 4, 2004
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Presenters

Scott Lillibridge, MD Professor of Epidemiology Director and PI
Jackie Dingley, RN, MPH, MBA Distance Learning Coordinator For State of Texas
Stephen Waring, DVM, PhD Assistant Professor Associate Director of Research
John Herbold, DVM, MPH, PhD Associate Professor Associate Director of Training and Education
Kristy Lillibridge, DVM Project Director (SEIS) Assistant Professor
Frederick Burkle, MD, MPH Project Manager, University of HawaiI Geographic Expansion Component
Mark Keim, MD CDC Medical Officer Director, Pacific Emergency Health Initiative
Hardy Loe, Jr., MD, MPH Associate Director Planning and Evaluation
Scott Harrison, MBA Director Management and Operations
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• 4th - Student Enrollment
• 5th - number of Faculty
• 7th - NIH Funding
• 1st - Hispanic Students (except
  Puerto Rico SPH)

4
UT School of Public Health at Houston Regional
Campuses
Dallas
El Paso
HOUSTON
San Antonio
Brownsville
C E N T E R F O R B I O S E C U R I T Y
A N D P U B L I C H E A L T H P R E P A R E
D N E S S improving our nations
health security
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The Texas Medical Center - Houston
C E N T E R F O R B I O S E C U R I T Y
A N D P U B L I C H E A L T H P R E P A R E
D N E S S improving our nations
health security
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A-CPHP Collaborations with Other UT System
Institutions
UT Dallas UT Southwestern
UT Tyler
UT Austin
UT MB
UT San Antonio
UT Health Science Center at Houston Center for
Biosecurity and Public Health Preparedness
C E N T E R F O R B I O S E C U R I T Y
A N D P U B L I C H E A L T H P R E P A R E D
N E S S improving our nations
health security
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Texas Population Data Projected for 2004
TOTAL WHITE BLACK HISPANIC OTHER
Texas 22,158,126 11,267,243 2,548,851 7,553,619 788,413
Metropolitan 18,907,386 9,247,716 2,281,785 6,619,760 758,125
Non-Metropolitan 3,250,740 2,019,527 267,066 933,859 30,288
C E N T E R F O R B I O S E C U R I T Y
A N D P U B L I C H E A L T H P R E P A R E
D N E S S improving our nations
health security
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Texas Public Health Organization
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Texas Public Health Workforce Training Facts -
2002 Survey

• Source of Training 94.0 from TDH
• Access to Tools of Workforce
• Internet Access 45.7
• T1 Line Access 53.2
• Basic ITV Access 38.0

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UT A-CPHPGeographic Training Priorities

• Metropolitan Centers (88 pop)
• Regional TDH Public Health Offices
• Border HDs (Critical Transit Sites)
• Rural

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Training Strategies to Address the Public
Health Workforce Needs in Texas

• High impact events (annual meetings)
• Large health departments
• Regional health departments
• Initial programs face to face
• Move to distance learning on existing Texas
  educational backbone
• Partnering will be critical to success!

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State Agency Perspectives

• Jacquelyn (Jackie) Dingley, RN, MPH, MBA
• Distance Learning Coordinator
• Texas Department of Health
• Office of Public Health Practice

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Public Health Workforce Development in Texas

• Challenges
• Large diverse state
• New Role Working with Preparedness Partners
• Collaboration is key
• Texas Department of Health
• Texas Association of Local Health Officials
• UT Academic Center for Public Health Preparedness
• Texas Public Health Training Center (a
  collaborative of the 3 Schools of Public Health
  in Texas)
• Other Public Health Partners

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Collaborative Workforce Development Efforts of
TDH

• Conducting state-wide training needs assessments
• Determining training priorities
• Partnering in training grants contracts
• Partnering in the development delivery of
  training programs

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Public Health Preparedness Courses Provided by
TDH (Funded by CDC Bioterrorism Cooperative
Grant)

• Surveillance/Disease Reporting
• Principles of Infectious Disease Epidemiology
• Smallpox Mass Vaccination
• Strategic National Stockpile Management
• Public Health Risk Communication
• Health Alert Network/Crisis Communications

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Public Health Preparedness Courses of TDH
Provided by Public Health Partners(Multiple
Funding Sources)

• Principles of Public Health Practice
• Public Health Leadership 2 courses
• Public Health Agency/System Preparedness
• Building an Effective Community-wide Response
• Disease Outbreak Investigation
• Forensic Epidemiology
• Disaster Life Support 2 courses
• Core/Basic
• Public Health Emergency Management Planning
• 
  Training by UT A-CPHP

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UT A-CPHP Contributions to the Texas Department
of Health

• Expertise/Consultative Role
• Liaison/Convener Role
• Leadership Role

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Training the Public Health Workforce for
Terrorism with a Focus on Bioterrorism

• Stephen Waring, DVM, PhD
• Associate Director
• Research
• John Herbold, DVM, MPH, PhD
• Associate Director
• Training and Education

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Texas A-CPHP Training Goals

• Develop education and training capacities in
  bioterrorism, infectious disease, and other
  public health emergencies
• Move into a robust extramural training program
  supported by distance learning
• Commitment to life-long learning

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Interdisciplinary ApproachIdentifying and
Connecting the Silos
Public Health Practice
Medical Science
Industry
Basic Science
PH Science
Agriculture
Regulatory
Continuum for Learning, Training, Application
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Intramural EducationExamples of Courses Developed

• Modular courses designed to offer blocks of
  instruction concentrating on relevant topics with
  focus on Bioterrorism
• Disaster Preparedness and Response
• Fall 2003
• Disaster Epidemiology
• Incident Command System
• Risk Communications
• Spring 2004
• Outbreak Detection and Control
• Leadership in Disasters

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IntramuralExamples of SPH Courses Developed

• Agents of Bioterrorism
• Offers depth and up-to-date instruction on
• Epidemiology, Microbiological, Clinical
• Acquisition, propagation, storage, dissemination
  issues
• Detection (surveillance/field/laboratory)
• Current Prevention/Control Guidelines
• Attack Scenarios

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IntramuralExamples of SPH Courses Expanded

• Emerging Zoonoses
• New lectures focusing on
• emergence factors to include BT/agroterrorism
• Early detection/syndromic surveillance
• Molecular/genetic epidemiology
• Vaccine development
• SARS as a model for BT

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IntramuralExamples of Courses Expanded

• Student Practicum
• Biosafety and biosecurity (Select Agent
  compliance and Lab Safety)
• Hazards of medical waste disposal
• Environmental risk factors for special pathogens
• Airborne pathogens in occupational setting
  (protecting workers in response)

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IntramuralPlatforms for Delivery

• Online Courses on BlackBoard
• Web Based instruction
• Affords reaching outside firewall
• ITV to reach Regional Campuses and other partners
• Web Cam (Polycom)
• For conferences and seminars

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IntramuralMPH with Focus on BT/PreparednessA-CPH
P Certificate Level

• CORE
• Epidemiology
• Biostatistics
• Environmental
• Behavioral
• Management/Policy

• SPECIAL TOPICS
• Surveillance/REA
• GIS/ Spatial Analysis
• Risk Communication
• Disaster Preparedness
• Emerging Diseases
• Occupational Safety
• Food/Agroterrorism

(12 Credits)
(18 Credits)
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SPH Intramural Training Summary

• SPH Courses (n92 students)
• Via ITV to 5 geographic areas of Texas
• Practicum/Internships (n10 students)
• Certificate MPH emphasis beginning Fall 2004
• Courses adapted or developed to meet needs
• epidemiology, zoonoses, occupational safety, risk
  communication, incident command

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Web Development
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Extramural Training StrategyTarget Audience
PH Workforce
Intramural Extramural
Forums Workshops
Drills/table top Consultation

• Leadership

PH Agencies
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Extramural Education/TrainingEnhancing Program
Impact

• Train the Trainer Focus
• Professional Partnerships
• Community PH Workforce Outreach
• Continuing Education

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Extramural Education/TrainingTrain the Trainer
Focus

• August 2003
• BT agent outbreak investigation table top
  exercise for TDH regional health authorities and
  community health nurses
• Ongoing
• TDH disease outbreak investigation training
  module development for statewide regional
  epidemiology response teams

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Extramural Professional Partnerships

• Forum Objectives
• Understand public health priorities of the
  legislative policy makers
• Examine vision/expectations of elected officials
  for Public Health
• Build effective working relationships between
  public health leaders and local elected officials
• Provide opportunities for needed discussion of
  public health priorities among forum participants

Partners TALHO TPHA UT-SPH TDH TIHPR
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Extramural Professional Partnerships

• Texas Public Health Association
• Annual Meeting
• Bioterrorism and Public Health Program Focus
• April 2004

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Extramural Community Workforce

• November 2003
• Houston Health Department Preparedness Conference

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Extramural Community Workforce

• March 2004
• TDH Region 8
• Leon Valley, Texas

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Extramural- Continuing Education

• Nationwide Teleconference
• What Clinicians Need to Know About Animal
  Diseases Transmissible to Man and Terrorism
• TNT Audio Conference Series
• Contemporary Topics on Infectious Diseases
• September 16, 2003
• Statewide Seminar
• Evolving Strategies in Bioterrorism
  Professional and Environmental Readiness, A
  Case-Based Approach to Bio Terrorism
• October 28, 2003
• San Antonio, TX

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Extramural- Continuing Education

• Local/Regional Symposium
• Veterinarians and Their Responsibilities for
  Agents of Bioterrorism Awareness and Support of
  Public Health Surveillance
• Bexar County Veterinary Medical Association
• November 2003
• Statewide Videoconference
• Texas Agroterrorism Conference
• (CDC Grant to UT Tyler)
• January 2004

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Training to Date August 2003 February 2004
Numbers Trained
Level 1 Training (awareness/opportunistic) 1,758
Level 2 Training (Course 1-8 Hours) 974
Technical Assistance (Federal, State, Local) 119 (hours)
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Selected UT A-CPHP Recurrent Training
Commitments for the Remainder of FY 2004
Course Audience Number Faculty Length
Outbreak Response TDH Regions 8 4 1 day
PH Leadership TDH Regions and local PH 9 4 3 day
BDLS TDH Regions and LHD staff 8 6 1 day
CDLS TDH Regions and LHD Staff 8 4 0.5 day
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Extramural TrainingFuture Directions

• Additional module development
• Adaptation of SPH academic specialty center
  products
• Disaster response training collaboration with
  Texas Veterinary Medical Association
• Syndromics and rapid identification training
  collaboration with Texas Medical Association
• Respond to geographic regional specific needs
  through our satellite campuses and distance
  learning

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Framework Document Training Priorities by Texas
A-CPHP Target Audience
Leadership Leadership Workforce Workforce Agencies Agencies
Now Developing Now Developing Now Developing
Enhance training education capacities ? ? ? ? ? ?
Assessment of training needs ? ? ? ? ? ?
Monitor training and needs ? ? ?
Develop competency-based training ? ? ? ?
Evaluation ? ? ? ?
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Student Epidemic Intelligence Society (SEIS)

• Kristy Lillibridge, DVM
• Project Coordinator

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Mission of Student EIS

• To provide response training for SPH Students for
  bioterrorism and other public health emergencies
• To provide hands on experience with public
  health professionals from local and state health
  departments
• To enrich the academic experience for student and
  faculty members

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SEISOrganizational Activities

• Fall 2003
• First membership meeting for students and faculty
• 47 members
• Creation of SEIS Bylaws
• Election of student officers and local Health
  Department liaisons

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SEISOrganizational Activities

• Recruitment ongoing
• SEIS Office and Computers set up
• Creation of response team database
• Information distributed about current outbreak
  situations (e.g., HAN, PROMED)
• Initiation of SEIS Special Lecture Series
• Outbreak investigations with special guests from
  the local health department
• Bioterrorism preparedness and response and the
  role of public health

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SEIS and West Nile VirusLearning Bioterrorism
Response
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SEIS MobilizationsRelating to Disease
Detection/Containment

• Emergency Response Activity in Support of the
  City and County Health Departments
• West Nile virus outbreak
• Local health department BT response exercise
• Tuberculosis outbreak in an elementary school
• Tularemia positive bioterrorism sensors alert
  (BioWatch mobilization)

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SEIS A Day in the OfficeCase Interviews and
Outbreak Response
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SEISWest Nile Cohort Study, July 2003
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SEISRecent Activities

• Spring 2004
• Officers meeting
• General Meeting recruit new members, update
  database, provide overview of activities
• Special lecture Dr. Joe McCormick on tales of a
  virus hunter and his experiences conducting
  outbreak investigations with special emphasis on
  bioterrorism
• List-serve activities Updates on health
  security, SARS, Avian Influenza

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SEISUpcoming Events

• Special lectures
• Dr. CJ Peters (UTMBBiodefense Director)
• Field investigations
• Cindy Kilborn, MPH (Chief of Epidemiology, Harris
  County Public Health)
• duties of a local public health officer
• CDC special guest speaker (TBA)
• Exercise
• Accessing Special Populations in Detection and
  Containment Response
• assist TDH on seroprevalence studies of HIV, Hep
  B, Hep C, WNV, SLE in the homeless population
• assess risk factors for infection and potential
  interventions in this hard to reach population

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SEIS PegsCertificate of Completion

• Requirements
• Participate in at least one field emergency
  mobilization
• Participate in Data Entry and Database Management
  on one outbreak
• Documented Attend at least 2 SEIS special
  lectures
• Complete Basic Disaster Life Support Training
  (BDLS)

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Zoonoses

• Stephen Waring, DVM, PhD
• Assistant Professor

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Public Health Zoonosis ExpertiseRelated to
Bioterrorism and EID Response

• Teaching
• Training
• Research
• Consulting

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Zoonosis ExpertiseExamples of Teaching

• Academic courses
• Emerging Zoonoses
• Emerging Infectious Diseases
• Infectious Disease Epidemiology
• Outbreak Investigation
• Agents of Bioterrorism
• Guest lectures in ongoing courses
• SPH
• Other Institutions
• UTMB, Texas AM University, UT Health Science
  Centers, HBU, UH, etc.

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Zoonosis ExpertiseExamples of Training

• Exercises
• Tabletop exercises
• Disease outbreaks
• Bioterrorism agents
• Collaborations /Training Risk Communications
• Auburn, ISU, KSU, UTMB, UT-Tyler

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Zoonosis ExpertiseExamples of Consulting

• Local/Regional
• Houston DHHS - planning and implementation of
  programs relevant to zoonotic disease BioWatch
• State
• TDH, TAHC, TVMA investigation, policy,
  research, assessment
• National
• Armed Forces Epi Board, National Academy of
  Science, WMI
• International
• Foreign Government - SARS Epidemic

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Zoonosis ExpertiseExamples of Research(Funded
through other sources)

• WNV
• Prion proteins
• Vector-borne zoonoses
• Chagas
• Tick-borne (Lyme, Ehrlichiosis)
• Rabies
• Food-/Water-borne
• Viral Hemorrhagic Fevers

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Training Activities with our NIOSH Supported
Center for Worker Safety

• Presentations at professional safety
  organizations
• Example WMD orientation lectures for local,
  national industrial hygiene health physics risk
  managers
• Modification of existing safety training courses
  to include terrorism
• Example 40 hour Radiation Safety Officer course
  now includes section on possible terrorist acts
  involving radioactive materials dirty bombs

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Safety Training for PH Workers

• Development of new educational curricula for
  safety professionals in PH workforce
• Addressing hazards not inherent to the workplace
• Bridging the gap between safety and security
• vulnerability assessment

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Training at the Vulnerable US-Mexico Border
(August 2004)
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Progress Along the US-Mexico Border

• This program was a unique collaboration with key
  organizations regarding capacity building in
  bio-terrorism and EID emergency preparedness
• TDH Public Health Region 9/10
• El Paso City-County Health District
• US-Mexico Border Health Association/PAHO
• Local health jurisdiction (Mexico side)
• Mexicos Health Secretariat Division of
  Epidemiology

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Future Training at the Border Detection and
Disease Containment

• Field Epidemiology Session in El Paso and Ciudad
  Juarez (April 2004)
• Case investigation
• Case-Finding /Surveillance/Reporting
• Environmental Investigation
• Prophylaxis and Control Measures
• bilingual

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• University Of Hawaii
• Expanded Geographic Coverage
• Frederick Burkle, MD, MPH, FAAP, FACEP
• Project Manager
• Department of Public Health Sciences
• and Epidemiology
• University of Hawaii School of Medicine

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Expanded Geographic Coverage

• Collaboration between
• UT School of Public Health Academic Center for PH
  Preparedness
• University of Hawaii Department of PH Sciences
  Epidemiology
• The Hawaii Department of Public Health
• The University of Hawaii Research Center

66
Expanded Geographic Coverage Hawaii and US
Affiliated Pacific Islands

• Funded locally in January 2004
• Principal Investigators
• Bruce S. Anderson, MPH, Ph.D
• Professor Director of the University of Hawaii
  Center for Environmental Health
• (Former Director of Health, State of Hawaii)
• Scott Lillibridge, MD
• Professor Director, UT A-CPHP
• CDC Technical Liaison
• Mark E. Keim, MD
• Director and Founder, CDC Pacific
• Emergency Health Initiative (PEHI)

PEHI
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Expanded Geographic CoverageGoals

• Enhance the local public health preparedness
  effort of the Hawaii Department of Health and
  links with existing CDC Bioterrorism Focus area G
  initiatives
• Further develop the University of Hawaii as a
  regional public health preparedness resource for
  the US Affiliated Pacific Islands (USAPI)
• Enhance existing capacities within the University
  of Hawaii Department of Public Health Sciences
  Epidemiology (DPHSE) to address these needs

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Expanded Geographic CoverageProgrammatic
Significance

• Hawaii six island communities of USAPI are
  active partners in the CDC Cooperative Agreement
  on Public Health Response of Bioterrorism (Active
  Program with CDC)
• University of Texas School of Public A-CPHP
  currently provides one of the few external
  academic on the ground public health
  preparedness training services within Hawaii

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Expanded Geographic CoverageTraining Needs

• Survey of State of Hawaii Department of Health
  on preparedness needs of public health workforce
  local agencies
• BT 101 course for DOH professionals and first
  responders
• Requests for specific University of Texas
  transportable and distance learning offerings and
  exercises (e.g., smallpox)
• Island-based disease detection and
  control/containment
• Strategic Stockpile Implementation Emergency
  dispensing mass immunization operations
• Selected Public health bioterrorism competencies
• Biosecurity early warning systems
• Public Health aspects of Civilian-military
  cooperation, information sharing, and exercises

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Expanded Geographic CoverageStrategy to Optimize
Target Audience Contact/Interest

• Utilize training and exercise sites at the
  Hawaii Department of Health and those used for
  first responder education (e.g., Kapiolani
  Community College)
• Provide workforce with continuing education
  credits as well as University credits expand
  categories
• Flexible course hours
• Distance learning for State of Hawaii
  neighboring islands and affiliated Pacific Islands

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Proposed UT-UH Training Matrix
Training Need Course Audience
Use of PPE, critical thinking in BT situation, agent awareness Principles of Emergency Response to  BT Hawaii and  USAPI Public health workers, nurses
Risk Communication Public health risk communication Hawaii and  USAPI Public health leaders, planners, managers, information officers
Pacific Interconnection Federal assistance and BT/PH available resources Pacific Health Summit for Sustainable Disaster Risk Management Hawaii and  USAPI Public health leaders, planners, managers
Smallpox Readiness Smallpox Table Top for Health Departments and City Officials Health Department, City Officials, Hospital Community
MPH - Capacity Building For Global PH Emergencies International Emergency Health MPH Elective Students
MPH - PH Preparedness UT Public Health (ITV) Preparedness Course MPH Elective Students
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Pacific Health SummitSustainable Disaster Risk
ManagementJune, 2004

• Objectives
• Identify opportunities for an integrated
  region-wide all-hazards (including BT) approach
  to risk management in the Pacific islands
• Encourage knowledge sharing and the use of
  indigenous methods to promote sustainable
  community based emergency health

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Grant Progress

• University of Hawaii John A. Burns School of
  Medicine, Department of Epidemiology and Public
  Health Sciences
• Training Developed 2004
• Biosecurity, bioterrorism bioagents Annual BT
  101 course offerings (credit and CME) to wide PH
  audience
• Surveillance outbreak investigation Seminar
  format
• Future Training Directions 2005
• Health preparedness public health systems for
  biosecurity in Hawaii the Pacific Seminar
  format
• Dilemmas controversies in biosecurity
  preparedness Seminar format
• Offered at Department of Health off campus Sites

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Selected ActivitiesUH PH Preparedness Program

• Collaborating with a Area Health Education
  Centers (AHEC)-HRSA Grant to develop problem
  based multidisciplinary and interdisciplinary
  cases and exercises for Hawaii and Pacific
  Island community through distance learning
• Providing lectures to University of Hawaii
  Social Sciences multidisciplinary program on
  bioterrorism
• NDMS annual conference (April 2004) invited
  lecture Grasping Public Health Emergencies
  What have we learned from the SARS epidemic
  (related to preparedness for Bioterrorism)?

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Special Geographic PH IssuesHawaii and the US
Affiliated Pacific Islands

• Civilian-Military Public Health Preparedness
  Co-exist
• UH-UT are working with DOD (US Pacific Command)
  on training and curriculum development to better
  address the interface between civilian and
  military public health requirements

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History Of Grant ProgressEvaluation

• Phase 1
• Will utilize the University of Hawaii Course and
  Faculty Evaluation (CAFÉ) system
  www.cafe.Hawai'i.edu (copy distributed)
• Phase 2
• Outcome Evaluations and measures of effectiveness
  (MOEs) currently being studied within the
  Department of Public Health Sciences
  Epidemiology Coordination with UT

77
UH-UT Future Interests

• Geographic Expansion Grant Centers (GEGCs)
  workshop to discuss unique public health needs
  and requirements of Native Populations, generate
  solutions to unique problems, and enhance
  collaboration between GEGCs
• Graduate University of Hawaii partner into a
  stand alone preparedness center

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Conclusion

• Working in collaboration with state and local
  departments of health
• To provide a community outreach resource
• To create and enhance a strong public health
  preparedness system for assessment, training,
  education and evaluation
• To achieve ultimate goal of
• supporting lifelong learning

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Evaluation

• Hardy Loe, MD
• Associate Director
• Planning and Evaluation

80
EvaluationExperiences to date

• Training Event
• 3rd Annual City of Houston Health Department
  Training Conference
• Two-day training session co-sponsored with the
  Houston Health and Human Services Department and
  local health departments
• Total Attendees 396

81
EvaluationExperience to date

• Training Topics Covered
• Bioterrorism
• Emerging Infectious Disease I-IV
• Bioterrorism Investigation
• Epidemiology
• Law Enforcement
• Risk Communications
• Quarantine Training

82
EvaluationAttendance by Discipline
83
EvaluationAttendance by Employer
84
EvaluationEvaluation Instrument

• Item Overall Conference
• Instrument queried
• Usefulness, currency of information
• Were workshop objectives met?
• Was knowledge of plans/systems better?
• Suggestions for improvement?
• Quality, effectiveness of speakers?
• Usefulness, value of content

85
EvaluationEvaluation Instrument

• Item Individual Session
• Instrument queried
• Knowledge of presenter
• Clarity of presentation
• Improved understanding of subject
• Helpfulness, utility of presentation
• Desire to share with colleagues or implement at
  place of work

86
EvaluationLessons Learned on Overall Program
Were sessions informative? Yes 91
Was new information gained? Yes 89
Were objectives at least partially met? Yes 80
Was understanding of subject improved? Yes 73
Was the training helpful and useful? Yes 56
Number of new topics suggested 13
Number of suggestions for improvement 16
87
EvaluationSummary of Program

• The training was successful in reaching a large
  number of individuals representing diverse
  essential occupations from organizations with
  significant community preparedness
  responsibilities
• The perception of participants was that the
  workshops were successful in disseminating useful
  information and in increasing understanding
• Without pre-test/post-test of knowledge or
  competency, evaluation results are more subjective

88
EvaluationAnalysis of Agroterrorism Workshop

• UT-Health Center at Tyler
• Engaging Community Preparedness Interactive
  Televideo Conference (CDC funded)
• Audience
• Veterinarians
• Public Health workers
• EMS
• Cooperative Extension staff
• Environmental specialists
• Texas Department of Public Safety
• Agricultural Associations
• U.S.D.A.
• Insurance representatives
• Students
• 131/148 attendees completed program evaluations

89
EvaluationAnalysis of Agroterrorism Workshop
Training Sites Training Sites Training Sites Training Sites Training Sites Training Sites
Overton Amarillo El Paso Lubbock Weslaco Total
Increased my overall awareness of potential event 1 1 3 0 0 0 4
2 3 2 1 0 - 6
3 20 7 8 3 4 42
4 24 2 16 15 21 79
Increased my knowledge of surveillance reporting requirements 1 0 2 0 0 0 2
2 3 1 1 1 0 6
3 18 8 7 8 7 48
4 25 4 17 9 18 73
Example of questions 1 poor 4 excellent
90
EvaluationSummary Of Current Strategy

• Focus for each training session
• Quantitative assessments
• Number trained
• Occupational title
• Place of employment
• Qualitative assessments
• Achievement of training objectives
• Effectiveness of presentation
• Quality of presenters
• Perception that knowledge improved
• Value and relevance to responsibilities

91
EvaluationRevisions Under Consideration for
Future

• Assessment of learning acquisition
• Pre-test, Post-test Instrument
• To measure learning
• To establish baseline to measure knowledge
  retention
• Utilize competencies in planning and evaluation
• Develop follow-up to training at appropriate
  intervals
• To test retention
• To attempt to relate performance to training
• Develop web-based training capabilities
• To facilitate training and follow-up at all levels

92
Business Focus

• Scott Harrison, MBA
• Director
• Management and Operations

93
Center Management

• The Management and Operations Director assures
  that programmatic, operational, and fiscal
  policies and procedures are followed
• A committed management core with a decentralized
  program management structure

94
Management Program Units
Hired Program Manager
Funded Center PI, Co-PIs Staff (7 Faculty 3
Staff)
Funded Center Support Units Co-Is Staff (8
Faculty 7 Staff)
Hire Center Training Coordinator
- Established accounting structure - Processed
personnel actions - Administrative set-up of
partners - Finalized management structure -
Launched staffing plan initiative
Hire Center Deputy Director
Hire Center Sr. Support Specialist
Preliminary Curriculum Development
Curriculum Refinement and Continued Training
95
Financial Resource AllocationsExpenses Through
February 29, 2004
Budget Expenditures Encumbrances Total Balance
A. Personnel 622,318 220,040 269,326 489,366 132,952
B. Consultants 37,000 3,960 1,500 5,460 31,540
C. Equipment 28,500 18,806 0 18,806 9,694
D. Supplies 16,695 753 611 1,364 15,331
E. Travel 121,312 11,178 17,195 28,373 92,939
F. Other Expenses 111,727 5,320 4,275 9,595 102,132
G. Contractual 233,165 8,359 28,314 36,673 196,492
Total Direct Costs 1,170,717 268,416 321,221 589,637 581,080
96
Center Support Organizations

• UTHSC-H School of Health Information Sciences
• The charge of this unit is to direct the
  Information Technology for Emergency Public
  Health Practice efforts of this project. It is
  developing distance-based learning modules and
  web-site.
• Texas Public Health Training Center (TPHTC)
• The TPHTC is responsible for supporting the
  logistical, assessment, evaluation and marketing
  needs of this project. TPHTC is also responsible
  for liaison between critical public health
  partners.

97
Implementing Partners

• University of New Mexico Health Science Center,
  School of Medicine, EMS Academy
• The charge of this unit is to develop a
  curriculum that integrates the public health and
  EMS to response to incidents of bioterrorism and
  other public health emergencies Contract
  Completed March 2004
• University of Hawaii
• This is an ASPH Geographic Expansion Grant.
  The primary goal of this collaboration is to
  enhance local public health preparedness.
• Contract Completed January 2004
• Staff Hired Feb 2004.

98
Partnering

• Scott Lillibridge, MD
• Director

99
Strategic Partnering

• The Center for Biosecurity and Public Health
  Preparedness has received written endorsement
  from 82 organizations and institutions
• Commitments vary from formal, structured
  collaboration to less intensive interactions,
  written communications and service on advisory
  boards

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State Texas Department of Health

• Technical assistance to TDH on Hospital
  Preparedness Committee
• Training collaboration with TDH Bioterrorism
  Preparedness Staff
• Liaison with TDH Office of Public Health Practice
  related to Workforce Development for Emergency
  Preparedness
• Texas Department of Health Central and Regional
  Offices

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State Texas Association Of Local Health
Officials (TALHO)

• A professional association of local Public Health
  professionals in Texas representing
• 65 Local Full Service (Designated as
  Participating) Health Departments Who Contract
  with the Texas Department of Health
• 85 Local Limited Service (Designated as
  non-participating) Health Departments
  (Independent)
• Operators of the Health Alert Network, An
  Electronic Connection with All Local Health
  Departments for Communications and Distance
  Learning Transmission
• Represents the Preparedness Centers largest
  constituency of the Public Health Workforce

102
State Texas Association Of Municipal Health
Officials (TAMHO)

• A unit of the Texas Municipal League, a
  professional organization that promotes interests
  of city governments and departments in Texas
• Represents the Academic Preparedness Centers
  target audience of the Public Health workforce in
  Texas municipalities (some also members of TALHO)

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State Texas Public Health Training Center
(TPHTC)

• Provides support services to the Academic
  Preparedness Center and provides training the
  Public Health Workforce (HRSA Funded)
• Extends partnership and coordination to
• Other Schools of Public Health in Texas
• Represented on the Texas State Strategic Health
  Partnership
• 18 Member Advisory Committee representing the
  constituencies of the Public Health Workforce in
  Texas

104
Federal Partnerships

• Membership on the Senior Advisory Committee to
  Secretary Tom Ridge, Department of Homeland
  Security
• National Academy Science Study on Animal Diseases
  (Related to BT)
• Department of Defense Epidemiology Board

105
Local Public Health Department Partners

• Houston Health and Human Services Department
• Harris County Health and Environmental Services
  Department
• Dallas County Health Department

106
Public Agency Partners for Emergency
Preparedness(Expanded Audience for Training)

• Dallas Office of Emergency Preparedness
• Harris County Mental Health Authority
• North Texas Poison Center
• Houston EMS
• Greater Houston Chapter of the Red Cross
• Governors EMS and Trauma Advisory Council

107
Professional Association Partners(Connectivity
For Training)

• Texas Nurses Association
• CE for Recertification
• Texas Medical Association
• Basic Disaster Life Support
• American Veterinary Medical Association
• Zoonotic Disease Curriculum and Public Health
• Texas Public Health Association
• Annual Conference, Policy Forums

108
Collaborations with Other A-CPHPs

• OU School of Public Health A-CPHP
• First Responder PH Interface
• Harvard School of Public Health A-CPHP
• Serve on Advisory Committee
• St. Louis University A-CPHP
• Training and Cooperation on Drills
• Specialty Center Collaborations with TAMU and
  Medical College of Georgia

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Value of Partnering

• Better Able to Define Training Needs and
  Priorities Among Diverse Constituency in a Very
  Large State
• Partners Provide Evaluative Feedback on
  Performance
• Opportunities for Collaboration in Training
• Promotion of Preparedness Center Facilitated
• Assistance in Mobilizing Public Health Workforce
  Constituency to Participate in Training

110
Core Activities Based on A-CPHP Framework
Current Developing
Relationships - state/local health agencies ?
Build/expand training/education capacities ? ?
Assessment of training needs ? ?
Monitor training and needs ? ?
Develop competency-based training ?
Evaluation ? ?
Sharing best practices ? ?
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The University of Texas School of Public Health
at Houston Center for Biosecurity Public
Health Preparedness