Minigrants to Local Health Departments: An Opportunity to Promote Climate Change Preparedness.

CONTEXT: Human health is threatened by climate change. While the public health workforce is concerned about climate change, local health department (LHD) administrators have reported insufficient knowledge and resources to address climate change. Minigrants from state to LHDs have been used to promote a variety of local public health initiatives. OBJECTIVE: To describe the minigrant approach used by state health departments implementing the Centers for Disease Control and Prevention's (CDC's) Building Resilience Against Climate Effects (BRACE) framework, to highlight successes of this approach in promoting climate change preparedness at LHDs, and to describe challenges encountered. DESIGN: Cross-sectional survey and discussion. INTERVENTION: State-level recipients of CDC funding issued minigrants to local public health entities to promote climate change preparedness, adaptation, and resilience. MAIN OUTCOME MEASURES: The amount of funding, number of LHDs funded per state, goals, selection process, evaluation process, outcomes, successes, and challenges of the minigrant programs. RESULTS: Six state-level recipients of CDC funding for BRACE framework implementation awarded minigrants ranging from $7700 to $28 500 per year to 44 unique local jurisdictions. Common goals of the minigrants included capacity building, forging partnerships with entities outside of health departments, incorporating climate change information into existing programs, and developing adaptation plans. Recipients of minigrants reported increases in knowledge, engagement with diverse stakeholders, and the incorporation of climate change content into existing programs. Challenges included addressing climate change in regions where the topic is politically sensitive, as well as the uncertainty about the long-term sustainability of local projects beyond the term of minigrant support. CONCLUSIONS: Minigrants can increase local public health capacity to address climate change. Jurisdictions that wish to utilize minigrant mechanisms to promote climate change adaptation and preparedness at the local level may benefit from the experience of the 6 states and 44 local health programs described.

Enhancing Reporting of After Action Reviews of Public Health Emergencies to Strengthen Preparedness: A Literature Review and Methodology Appraisal.

OBJECTIVE: This literature review aimed to identify the range of methods used in after action reviews (AARs) of public health emergencies and to develop appraisal tools to compare methodological reporting and validity standards. METHODS: A review of biomedical and gray literature identified key approaches from AAR methodological research, real-world AARs, and AAR reporting templates. We developed a 50-item tool to systematically document AAR methodological reporting and a linked 11-item summary tool to document validity. Both tools were used sequentially to appraise the literature included in this study. RESULTS: This review included 24 highly diverse papers, reflecting the lack of a standardized approach. We observed significant divergence between the standards described in AAR and qualitative research literature, and real-world AAR practice. The lack of reporting of basic methods to ensure validity increases doubt about the methodological basis of an individual AAR and the validity of its conclusions. CONCLUSIONS: The main limitations in current AAR methodology and reporting standards may be addressed through our 11 validity-enhancing recommendations. A minimum reporting standard for AARs could help ensure that findings are valid and clear for others to learn from. A registry of AARs, based on a common reporting structure, may further facilitate shared learning. (Disaster Med Public Health Preparedness. 2019;13:618-625).

Potential of DNA microarrays for developing parallel detection tools (PDTs) for microorganisms relevant to biodefense and related research needs.

Development of parallel detection tools using microarrays is critically reviewed in view of the need for screening multiple microorganisms in a single test. Potential research needs with respect to probe design and specificity, validation, sample concentration, selective target enrichment and amplification, and data analysis are discussed. Data illustrating selected probe design issues for detecting multiple targets in mixed microbial systems is presented. Challenges with respect to cost, time, and ease of use compared to other methods are also summarized.