Transcript Community Assessment for Public Health Emergency Response

Community Assessment for Public Health
Emergency Response (CASPER):
Role of the Epidemiologist
LCDR Sara J. Vagi, PhD
U.S. Public Health Service
Health Studies Branch, National Center for Environmental Health
Division of Environmental Hazards and Health Effects
CASPER Definition
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Epidemiologic technique designed to provide
quickly and at low cost, household-based
information about an affected community’s needs
after a disaster in a simple format to decisionmakers.
Critical Post-Disaster Needs
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Water
Food
Shelter
Sanitation
Medicine
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Solid Waste
Electric Power
Heat
Transportation
Communication
Goals of CASPER
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Determine the general and
health needs of the
community
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Produce population- based
estimates for decisionmakers
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Inform response efforts and
planning for future disasters
CASPER Methodology
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Multi-stage probability sample
 30 clusters (census blocks)
 7 households
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Questionnaire development
Household-interview
Data weighted to obtain population estimates
Report generated within a day or two of data
collection
Report shared with partners in response and
recovery efforts
Use of CASPER
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Man-Made
 Deepwater Horizon Gulf Coast Oil Spill, 2010
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Hurricanes
 Hurricane Ike, Galveston, TX, 2008
 Hurricane Katrina, New Orleans, 2005
 Hurricanes Charley & Ivan, Florida, 2004
 Hurricane Isabel, North Carolina, 2003
 Hurricane Andrew, Florida and Louisiana, 1992
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Earthquakes/Tsunamis
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American Samoa, 2009
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Izmit, Turkey, 1998
Ice storms
 Kentucky, 2009
 Maine, 1998
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Volcanic activity
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Mexico, 1998
CASPER phases
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Prepare for the CASPER
 Determine objectives
 Determine assessment area
 Develop questions and create questionnaires
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Conduct the CASPER
 Select sample
 Organize and train assessment teams
 Conduct household interviews
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Analyze the data
 Determine sampling weight
 Calculate weighted frequencies and percentages
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Write the report and share results
The role of the epidemiologist is to bring
sound epidemiologic principles and practices
into all phases of the CASPER!
The Preparation Phase
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Prepare for the CASPER
 Determine objectives
• Not always the role of the epi
• But epi must see that the appropriate tool is being used to meet the
objectives
 Determine assessment area
• How do we define the “affected” or “exposed”?
• Assumption: All households in sampling frame are similarly affected
 Develop questions and create questionnaires
• Household-based
• Action-oriented data
Map of sampled area
The Preparation Phase
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Prepare for the CASPER
 Determine objectives
• Not always the role of the epi
• But epi must see that the appropriate tool is being used to meet the
objectives
 Determine assessment area
• How do we define the “affected” or “exposed”?
• Assumption: All households in sampling frame are similarly affected
 Develop questions and create questionnaires
• Household-based
• Action-oriented data
• Pilot
Conducting the survey
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Conduct the CASPER
 Select sample
• Obtaining an adequate sample size (n=210)
• Avoiding the convenience sample
 Organize and train assessment teams
 Conduct household interviews
• Reducing interviewer bias
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Balancing the ideal with the real world situation
Response Rates, Kentucky ice storm
Area I
Area II
Area III
Area IV
176
187
190
189
Completion Rate
83.8%
89.1%
90.5%
90.0%
Cooperation Rate
95.1%
97.9%
96.9%
95.4%
Contact Rate
52.8%
54.4%
62.9%
48.9%
Completed interviews (n)
Final phases
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Analyze the data
 Determine sampling weight
 Calculate weighted frequencies and percentages
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Write the report
 This begins in the preparation phase
 Know your data and its limitations
Conclusions
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Planning early for later steps
 “Start with your table shells!”
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Maintaining sound epidemiology
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Balancing the ideal with the real-world situation
Thank you
For more information please contact Centers for Disease Control and
Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: [email protected] Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official
position of the Centers for Disease Control and Prevention.
National Center for Environmental Health
Division of Environmental Hazards and Health Effects