Use of H1N1 funding to contract with advocacy groups and CBOs

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Health department emergency response planners in Maricopa County, Arizona, were successful in expanding their existing outreach activities to get key messages about pandemic influenza to hard-to-reach communities.

During the 2008-2009 budget period, the local health department was administering a pilot program aimed at integrating difficult-to-reach populations into the county's emergency preparedness response infrastructure. When the pandemic occurred, local health officials incorporated H1N1 into their outreach efforts.

The pilot program initially targeted Maricopa County's Asian Pacific Islander (API) community, but as the H1N1 pandemic unfolded and PHER funds became available, the county expanded the program to reach other communities as well. The pilot program, which was initiated with Public Health Emergency Preparedness (PHEP) funding, sought to build relationships with leaders in the API community by way of a contract with the primary community based organization (CBO) serving that population.

As part of the program, the county worked with the CBO to complete surveys and a gap analysis to assess the community's knowledge and attitudes about emergency response and existing networks that might be of use. Public health staff and the contracted CBO also worked to identify and train trusted community leaders who could be credible spokespeople during emergencies. The last stage of the pilot was the development of an emergency response plan that includes the strategy for effectively communicating with the population at large through text, e-mail, or social networking; a database of contact information for community members; procedures for emergency notification and activation of API community leadership for roles in command centers; volunteer recruitment; translation; media communication and more.

During the 2009 H1N1 pandemic, the health department, using lessons learned during the pilot, expanded collaboration with CBOs serving faith-based groups, the elderly, disabled, and the African American and Hispanic communities. CBO key contacts were provided with flu prevention materials for the public, guidance documents, technical assistance and information about H1N1 vaccination sites. Community organizations in turn communicated, and when necessary, translated, those messages for their respective constituencies. The CBOs were critical in scheduling immunization clinics in conjunction with previously scheduled community activities and organizing expert speakers to address specific groups. Maricopa County is currently developing formal contracts with the additional agencies.

Maricopa County is still assessing the impact of the expanded pilot program, but hopes to replicate the outreach model for additional communities such as refugees, the hearing and sight impaired and others. Maricopa County has found that community based organizations are ready, willing and capable partners in emergency response which was well demonstrated during the H1N1 pandemic.

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