Participation in One Health Networks and Involvement in the COVID-19 Pandemic Response: A Global Study.

The COVID-19 pandemic exemplifies a One Health issue at the intersection of human, animal, and environmental health that requires collaboration across sectors to manage it successfully. The global One Health community includes professionals working in many different fields including human medicine, veterinary medicine, public health, ecosystem health, and, increasingly, social sciences. The aims of this cross-sectional study were to describe the involvement of the global One Health community in COVID-19 pandemic response activities. One Health networks (OHNs) have formed globally to serve professionals with common interests in collaborative approaches. We assessed the potential association between being part of an OHN and involvement in COVID-19 response activities. Data were collected in July-August 2020 using an online questionnaire that addressed work characteristics, perceived connection to OHNs, involvement in COVID-19 pandemic response activities, and barriers and facilitators to the involvement. The sample included 1,050 respondents from 94 countries across a range of organizations and work sectors including, but not restricted to, those typically associated with a One Health approach. Sixty-four percent of survey respondents indicated involvement in pandemic response activities. Being part of an OHN was positively associated with being involved in the COVID-19 response (odds ratio: 1.8, 95% confidence interval: 1.3-2.4). Lack of opportunities was a commonly reported barrier to involvement globally, with lack of funding the largest barrier in the WHO African region. This insight into diverse workforce involvement in the pandemic helps fill a gap in the global health workforce and public health education literature. An expanded understanding of the perceived roles and value of OHNs can inform targeted interventions to improve public health education and workforce capacity to prepare for and respond to public health emergencies.

A Practitioner-Driven Research Agenda for Syndromic Surveillance.

Syndromic surveillance has expanded since 2001 in both scope and geographic reach and has benefited from research studies adapted from numerous disciplines. The practice of syndromic surveillance continues to evolve rapidly. The International Society for Disease Surveillance solicited input from its global surveillance network on key research questions, with the goal of improving syndromic surveillance practice. A workgroup of syndromic surveillance subject matter experts was convened from February to June 2016 to review and categorize the proposed topics. The workgroup identified 12 topic areas in 4 syndromic surveillance categories: informatics, analytics, systems research, and communications. This article details the context of each topic and its implications for public health. This research agenda can help catalyze the research that public health practitioners identified as most important.

Workforce Competencies in Syndromic Surveillance Practice at Local Health Departments.

CONTEXT: As the science and practice of syndromic surveillance (SyS) evolve, it has increasing utility for public health surveillance at the local level. Local health departments (LHDs) require specific organizational and workforce capabilities to use SyS data. In 2013, more than half of the LHDs reported using SyS, although little has been reported about LHD workforce capabilities in SyS. OBJECTIVE: To conduct an assessment of self-reported knowledge and skills in SyS tasks to effectively target technical assistance to different levels of LHD need. DESIGN, SETTING, AND PARTICIPANTS: A stratified sampling design based on LHD jurisdiction population and SyS status was employed. Data were drawn from the 2015 Biosurveillance Needs Assessment Survey, which captured variables related to LHD use of SyS, management of systems, and self-reported proficiencies in a typology of SyS functionalities developed by a workgroup of subject matter experts in SyS. Respondents were US-based LHD public health practitioners. Estimation weights were applied during analysis to determine the national representation of the responses. MAIN OUTCOME MEASURES: Respondents self-reported proficiency in 26 SyS tasks within 5 categories, analyzed by LHD jurisdiction size and respondents' years of SyS experience. RESULTS: SyS expertise varied widely across LHDs. Less than 50% of workers who have access to SyS demonstrated overall proficiency within any of the task areas: communication, data use, data analysis, quality monitoring and assurance, and system design and development. SyS users were strongest in data use tasks. Proficiency in SyS practice corresponded directly with respondents' years of SyS experience and the LHD jurisdiction size. CONCLUSION: SyS practitioners display a wide range of proficiencies both within and across SyS tasks. Considerable gaps in proficiencies of all areas of SyS practice indicate a need for technical assistance and knowledge dissemination to improve SyS practice as an important component of an LHD surveillance strategy.

Cross-Disciplinary Consultancy to Enhance Predictions of Asthma Exacerbation Risk in Boston.

This paper continues an initiative conducted by the International Society for Disease Surveillance with funding from the Defense Threat Reduction Agency to connect near-term analytical needs of public health practice with technical expertise from the global research community. The goal is to enhance investigation capabilities of day-to-day population health monitors. A prior paper described the formation of consultancies for requirements analysis and dialogue regarding costs and benefits of sustainable analytic tools. Each funded consultancy targets a use case of near-term concern to practitioners. The consultancy featured here focused on improving predictions of asthma exacerbation risk in demographic and geographic subdivisions of the city of Boston, Massachusetts, USA based on the combination of known risk factors for which evidence is routinely available. A cross-disciplinary group of 28 stakeholders attended the consultancy on March 30-31, 2016 at the Boston Public Health Commission. Known asthma exacerbation risk factors are upper respiratory virus transmission, particularly in school-age children, harsh or extreme weather conditions, and poor air quality. Meteorological subject matter experts described availability and usage of data sources representing these risk factors. Modelers presented multiple analytic approaches including mechanistic models, machine learning approaches, simulation techniques, and hybrids. Health department staff and local partners discussed surveillance operations, constraints, and operational system requirements. Attendees valued the direct exchange of information among public health practitioners, system designers, and modelers. Discussion finalized design of an 8-year de-identified dataset of Boston ED patient records for modeling partners who sign a standard data use agreement.

Using Social Media for Actionable Disease Surveillance and Outbreak Management: A Systematic Literature Review.

OBJECTIVE: Research studies show that social media may be valuable tools in the disease surveillance toolkit used for improving public health professionals' ability to detect disease outbreaks faster than traditional methods and to enhance outbreak response. A social media work group, consisting of surveillance practitioners, academic researchers, and other subject matter experts convened by the International Society for Disease Surveillance, conducted a systematic primary literature review using the PRISMA framework to identify research, published through February 2013, answering either of the following questions: Can social media be integrated into disease surveillance practice and outbreak management to support and improve public health?Can social media be used to effectively target populations, specifically vulnerable populations, to test an intervention and interact with a community to improve health outcomes?Examples of social media included are Facebook, MySpace, microblogs (e.g., Twitter), blogs, and discussion forums. For Question 1, 33 manuscripts were identified, starting in 2009 with topics on Influenza-like Illnesses (n = 15), Infectious Diseases (n = 6), Non-infectious Diseases (n = 4), Medication and Vaccines (n = 3), and Other (n = 5). For Question 2, 32 manuscripts were identified, the first in 2000 with topics on Health Risk Behaviors (n = 10), Infectious Diseases (n = 3), Non-infectious Diseases (n = 9), and Other (n = 10). CONCLUSIONS: The literature on the use of social media to support public health practice has identified many gaps and biases in current knowledge. Despite the potential for success identified in exploratory studies, there are limited studies on interventions and little use of social media in practice. However, information gleaned from the articles demonstrates the effectiveness of social media in supporting and improving public health and in identifying target populations for intervention. A primary recommendation resulting from the review is to identify opportunities that enable public health professionals to integrate social media analytics into disease surveillance and outbreak management practice.

Arterial roads and area socioeconomic status are predictors of fast food restaurant density in King County, WA.

BACKGROUND: Fast food restaurants reportedly target specific populations by locating in lower-income and in minority neighborhoods. Physical proximity to fast food restaurants has been associated with higher obesity rates. OBJECTIVE: To examine possible associations, at the census tract level, between area demographics, arterial road density, and fast food restaurant density in King County, WA, USA. METHODS: Data on median household incomes, property values, and race/ethnicity were obtained from King County and from US Census data. Fast food restaurant addresses were obtained from Public Health-Seattle & King County and were geocoded. Fast food density was expressed per tract unit area and per capita. Arterial road density was a measure of vehicular and pedestrian access. Multivariate logistic regression models containing both socioeconomic status and road density were used in data analyses. RESULTS: Over one half (53.1%) of King County census tracts had at least one fast food restaurant. Mean network distance from dwelling units to a fast food restaurant countywide was 1.40 km, and 1.07 km for census tracts containing at least one fast food restaurant. Fast food restaurant density was significantly associated in regression models with low median household income (p < 0.001) and high arterial road density (p < 0.001) but not with percent of residents who were nonwhite. CONCLUSION: No significant association was observed between census tract minority status and fast food density in King County. Although restaurant density was linked to low household incomes, that effect was attenuated by arterial road density. Fast food restaurants in King County are more likely to be located in lower income neighborhoods and higher traffic areas.

Using problem-based learning as a strategy for cross-discipline emergency preparedness training.

The rapid and effective response to a bioterrorist event requires the coordinated efforts of trained personnel from different agencies. This article describes the design and implementation of a 1-week cross-disciplinary course employing problem-based learning (PBL) for professionals with backgrounds in public health, fire/emergency medical services (EMS), law enforcement, emergency management, and hospital administration. The curriculum provided opportunities for professionals from different disciplines to meet and learn the priorities and resources of partner agencies. In course evaluations, participants rated the training highly and found it applicable to their work and a good use of time and training resources. PBL techniques were successful in fostering cross-agency communication, thereby showing promise as an effective training method for meeting local and national emergency preparedness objectives.