Insights on Public Health Professionals Non-technical Skills in an Emergency Response (Multi-Team System) Environment.

This paper provides practitioner and academic insights into the importance of examining non-technical skills in a multiteam system emergency response. The case of public health professionals is highlighted, illustrated with unique qualitative field data which focused upon the use of non-technical skills at a meso level of analysis. Results reflected the importance of context upon the multiteam system and highlighted seven non-technical skills used by public health professionals to support an effective response. Recommendations for future research and implications for practice are noted for this hard to access professional group, located within emerging advances in the scientific inquiry of complex and increasingly evident, multi-team systems.

Digital Transformation of Face-To-Face Focus Group Methodology: Engaging a Globally Dispersed Audience to Manage Institutional Change at the World Health Organization.

Focus group discussions (FGDs) are widely used to obtain qualitative data from purposely selected groups of people. This paper describes how the Learning and Capacity Development (LCD) unit of the World Health Organization (WHO) Health Emergencies Programme (WHE) digitalized FGDs to engage with WHO staff from around the world, to listen, share, and collect their feedback in the development of a WHO learning framework. The impact of the COVID-19 pandemic and the introduction of local lockdowns and travel restrictions resulted in the wide use of digital platforms, such as Zoom, for employee communications and collaboration capable of reaching employees wherever they are working. The LCD/WHE team drew upon the experience of WHO colleagues from human resources, country, and regional offices to set up and hold FGDs in 6 languages with participants from all WHO regions. Building on the findings of a 2019 WHO staff survey, which was part of a comprehensive, organization-wide career development initiative, the digitalized FGDs allowed for the exchange of substantive feedback, novel ideas, and alignment, connecting across different geographies, disciplines, and levels of seniority. As a result, FGDs can be successfully conducted online, but it is essential to remove barriers to participation by adopting a multilingual and flexible approach in multinational and international organizations such as the WHO.

Multilingual Approach to COVID-19 Online Learning Response on OpenWHO.org.

In pursuit of equitable access to emergency-related knowledge, the World Health Organization (WHO) translates COVID-19 and other infectious disease courses into multiple languages on its open-access online learning platform OpenWHO.org. Languages spoken by vulnerable or underserved populations in low- and middle-income countries and in outbreak-prone and affected areas are prioritized. Accessing learning in preferred languages enhances uptake and comprehension. In this study, we assess and compare the initial enrollment levels and global reach of these multilingual courses. On average, OpenWHO's 38 COVID-19 courses have each been translated into 4.8 languages. The platform hosts courses in 55 different languages with 10.4 million words translated. The findings identify which available languages were most utilized for COVID-19 learning to inform course production and outreach strategies. Languages were used differently across geographic regions, calling for localized learning offerings. A streamlined multilingual publishing scheme, ensuring quick and effective delivery of diverse languages, is critical to achieving greater equity of access to knowledge.

Could Linguistic Complexity Be Automatically Evaluated? A Multilingual Study on WHO's Emergency Learning Platform.

The ability of assessing any type of linguistic complexity of any given contents could potentially improve knowledge reproduction, especially tacit knowledge which can be expensive during a pandemic. In this paper, we develop a simple and crosslinguistic model of complexity which considers formal accounts on the study of linguistic systems, but can be easily implemented by non-linguists' groups, e.g., communication experts and policymakers. To test our model, we conduct a study on a corpus extracted from the World Health Organization (WHO)'s emergency learning platform in 6 languages. Data extracted from open-access encyclopaedic entries act as control groups. The results show that the measurements adopted signal a trend for a minimization of complexity and can be exploited as features for (automatic) text classification.

Trust and Public Health Emergency Events: A Mixed-Methods Systematic Review.

The systematic review examined the phenomenon of trust during public health emergency events. The literature reviewed was field studies done with people directly affected or likely to be affected by such events and included quantitative, qualitative, mixed-method, and case study primary studies in English (N = 38) as well as Arabic, Chinese, French, Russian, and Spanish (all non-English N = 30). Studies were mostly from high- and middle-income countries, and the event most covered was infectious disease. Findings from individual studies were first synthesized within methods and evaluated for certainty/confidence, and then synthesized across methods. The final set of 11 findings synthesized across methods identified a set of activities for enhancing trust and showed that it is a multi-faceted and dynamic concept.

Developing the first-ever global learning strategy to frame the future of learning for achieving public health goals.

Health is at the forefront of everyone's mind. Every country on the planet is currently experiencing the COVID19 pandemic, which is not just causing death and disease, but damaging societies and economies on a significant scale across the world.1 The current pandemic has brought into sharp focus the socio-economic factors and inequities in how people experience health and ill health and shone a spotlight on the need for lifelong learning so that health professionals, volunteers, and the public alike can adapt and respond to health threats. But even before the pandemic, the world was changing profoundly in the past few decades, and these changes impacted people's health. Unfortunately, the role of education and learning in the health domain has not kept pace with these changes. Many factors converge to create a major evolution, and some say, revolution, in how education, training and learning for health can and should be leveraged to protect and promote people's health. This paper summarizes some of the critical ideas of an 18-month process to create the first-ever global learning strategy for health by the World Health Organization.

Changes in Users Trends Before and During the COVID-19 Pandemic on WHO's Online Learning Platform.

OpenWHO provides open access, online, free and real time learning responses to health emergencies. Before the pandemic, courses on 18 diseases were provided. The increase to 38 courses in response to COVID-19 have led to a massive increase in the number of new learners. As a result, the COVID-19 pandemic affected learners' trends. This paper presents initial findings of changes perceived in the use and user groups' attendance to the World Health Organization's (WHO) health emergency learning platform OpenWHO. Enrolment statistics were based on data collected in December 2019 and March 2021. A descriptive analysis was conducted to explore changes in the usage pattern of the platform. Several user characteristics shifted between before and during the pandemic. More women, younger and older learners joined the learning during the pandemic. Public health education leaned toward a more equitable reach including previously underrepresented groups.

Evaluating Complexity of Digital Learning in a Multilingual Context: A Cross-Linguistic Study on WHO's Emergency Learning Platform.

Reproduction of knowledge, especially tacit knowledge can be expensive during a pandemic. One of the most common causes is the reduced information accessibility during the translation process. Having the ability to assess the linguistic complexity of any given contents could potentially improve knowledge reproduction. Authors conduct two cross-linguistic studies on the World Health Organization (WHO)'s emergency learning platform to assess the linguistic complexity of two online courses in 10 languages. Morpho-syntactically annotated treebanks, unannotated materials from Wikipedia and language-specific corpora are set as control groups. Preliminary findings reveal a clear reduced complexity of learning contents in the most candidate languages while retaining the maximum amount of information. Creating a baseline study on low-resourced languages on the learning genre could be potentially useful for measuring impact of normative products at country and local level.

Delivering WHO's Life-Saving Information in Real-Time During a Pandemic Through an Online Learning Platform: Evidence from Global Use.

Accessibility, multilingualism and real-time knowledge transfer are the tenets of the OpenWHO learning platform. A descriptive analysis was conducted using anonymised statistical datasets retrieved from the OpenWHO reporting system to understand global use trends. When examining OpenWHO use in the areas with the highest burden of COVID-19 cases, a strong correlation was identified between the burden of COVID-19 and OpenWHO user activity. Further, health professionals are the top users of COVID-19 materials. The massive demand for OpenWHO courses confirms the need for real-time learning materials in accessible, multilingual formats during a pandemic. Learning is a global public good and is an essential component of the response to health emergencies.

One Year of Pandemic Learning Response: Benefits of Massive Online Delivery of the World Health Organization's Technical Guidance.

The World Health Organization (WHO) launched the first web-based learning course on COVID-19 on January 26, 2020, four days before the director general of the WHO declared a public health emergency of international concern. The WHO is expanding access to web-based learning for COVID-19 through its open-learning platform for health emergencies, OpenWHO. Throughout the pandemic, OpenWHO has continued to publish learning offerings based on the WHO's emerging evidence-based knowledge for managing the COVID-19 pandemic. This study presents the various findings derived from the analysis of the performance of the OpenWHO platform during the pandemic, along with the core benefits of massive web-based learning formats.

An Analysis of the Growth in Uptake of OpenWHO's Online Learning Resources for COVID-19.

From 26 January - 21 April 2020, 9 online courses for COVID-19 were published on OpenWHO.org. The courses are available in 18 different languages, totalling 53 learning resources and more than 1.5 million course enrolments. This paper analyses key trends in the growth of enrolments in these resources. The number of enrolments increased significantly between 26 January and 21 April, with distinct spikes in growth preceded by important global milestones in the timeline of the outbreak. The surge in users demonstrates that the platform is serving as a source of digitized learning for COVID-19, helping meet the broad demand for outbreak-related information.

Global Access to OpenWHO's Online Learning Resources for COVID-19.

This poster presents the COVID-19 online learning response by the World Health Organization's (WHO) OpenWHO learning platform for health emergencies. Platform use shifted during the pandemic from being the highest in the WHO African and Eastern Mediterranean regions to the American and European regions. The largest traffic channels were search engines, social media and WHO websites.

Identifying and Assessing Competencies for Staff Working in Public Health Emergencies.

Competency-based learning involves identifying the knowledge, skills and attributes required for carrying out workplace roles. In 2018, the World Health Organization's (WHO) Health Emergencies Programme (WHE) introduced a competency framework with competency-based assessment (CBA) methodology. The CBA focuses on behavioural indicators that participants demonstrate and training faculty observe during training events. This article introduces the CBA of WHE. It is essential to use the framework to design learning programmes and provide the basis to appraise and manage WHE personnel and team performance.

Serving Health Emergency Responders Through Online Learning - Findings from OpenWHO's Global User Metrics.

This poster presents some preliminary findings of the OpenWHO.org platform's global use trends, in terms of the geographical distribution and occupational characteristics of its users. Assessment of user profiles is essential to measure the platform's impact, most notably related to the attainment of its core mission: the provision of life-saving knowledge worldwide. A quantitative study was conducted on the global metrics of OpenWHO's user statistics. Common user categories encompassed a wide range of professional bodies and occupations, both within public health and beyond, ranging from students and volunteers, to WHO staff, to members of international organizations and NGOs. Global tendencies in platform use confirm that that the mission of OpenWHO, to provide timely, up-to-date and easy-to-understand lifesaving knowledge to healthcare workers based in-country and responding to outbreaks at the front line, is being met.

Global Reach of an Online COVID-19 Course in Multiple Languages on OpenWHO in the First Quarter of 2020: Analysis of Platform Use Data.

BACKGROUND: At the onset of the coronavirus outbreak, the World Health Organization's (WHO) Health Emergencies Learning and Capacity Development Unit, together with the WHO's health technical lead on coronaviruses, developed a massive open online course within 3 weeks as part of the global response to the emergency. The introductory coronavirus disease (COVID­19) course was launched on January 26, 2020, on the health emergencies learning platform OpenWHO.org. OBJECTIVE: The aim of this paper is to investigate the geographic reach of different language courses accessed by a worldwide audience seeking information on COVID-19. Users' professional identities and backgrounds were explored to inform course owners on the use case. The course was developed and delivered via the open-access learning platform OpenWHO.org. The self-paced resources are available in a total of 13 languages and were produced between January 26 and March 25, 2020. METHODS: Data were collected from the online courses' statistical data and metrics reporting system on the OpenWHO platform. User patterns and locations were analyzed based on Google Analytics and the platform's own statistics capabilities, and data sets were overlaid. This analysis was conducted based on user location, with the data disaggregated according to the six WHO regions, the top 10 countries, and the proportion of use for each language version. Data included affiliation, gender, age, and other parameters for 32.43% (52,214/161,007) of the users who indicated their background. RESULTS: As of March 25, 2020, the introductory COVID-19 course totaled 232,890 enrollments across all languages. The Spanish language course was comprised of more than half (n=118,754, 50.99%) of all course enrollments, and the English language course was comprised of 38.21% (n=88,988) of enrollments. The WHO's Region of the Americas accounted for most of the course enrollments, with more than 72.47% (138,503/191,130) enrollment across all languages. Other regions were more evenly distributed with less than 10% enrollment for each. A total of 32.43% (52,214/161,007) of users specified a professional affiliation by choosing from the 12 most common backgrounds in the OpenWHO user profiles. Before the COVID-19 pandemic, users were spread over the 11 distinct affiliations, with a small fraction of users identifying themselves as "Other." With the COVID-19 introductory course, the largest number of users selected "Other" (16,527/52,214, 31.65%), suggesting a large number of users who were not health professionals or academics. The top 10 countries with the most users across all languages were Argentina, Chile, Colombia, Ecuador, India, Mexico, Peru, Spain, the United Kingdom, and the United States. CONCLUSIONS: The online course has addressed a worldwide learning need by providing WHO's technical guidance packaged in simple formats for access and use. The learning material development was expedited to meet the onset of the epidemic. Initial data suggest that the various language versions of the course, in particular Spanish, have reached new user groups, fulfilling the platform's aim of providing learning everywhere to anyone that is interested. User surveys will be carried out to measure the real impact.

Emergency Risk Communication: Lessons Learned from a Rapid Review of Recent Gray Literature on Ebola, Zika, and Yellow Fever.

A rapid review of gray literature from 2015 to 2016 was conducted to identify the lessons learned for emergency risk communication from recent outbreaks of Ebola, Zika, and yellow fever. Gray literature databases and key websites were searched and requests for documents were posted to expert networks. A total of 83 documents met inclusion criteria, 68 of which are cited in this report. This article focuses on the 3 questions, out of 12 posed by World Health Organization as part of a Guideline development process, dealing most directly with communicating risk during health emergencies: community engagement, trust building, and social media. Documents were evaluated for credibility using an Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) checklist? and if the document contained a study, a method-specific tool was applied. A rapid content analysis of included sources was undertaken with relevant text either extracted verbatim or summarized and mapped against the questions. A database subset was created for each question and citations were assigned to the subset(s) for which they contained relevant information. Multiple designations per document were common. Database subsets were used to synthesize the results into a coherent narrative. The gray literature strongly underlines the central importance of local communities. A one-size-fits-all approach does not work. For maximum effectiveness, local communities need to be involved with and own emergency risk communication processes, preferably well before an emergency occurs. Social media can open new avenues for communication, but is not a general panacea and should not be viewed as a replacement for traditional modes of communication. In general, the gray literature indicates movement toward greater recognition of emergency risk communication as a vitally important element of public health.

Integrating emergency risk communication (ERC) into the public health system response: Systematic review of literature to aid formulation of the 2017 WHO Guideline for ERC policy and practice.

The World Health Organization (WHO) commissioned a systematic review of literature to facilitate evidence syntheses for the development of emergency risk communication (ERC) guidelines for its member states. The goal of this review was to integrate ERC best practices into governmental and non-governmental health systems for all emergencies of public health concern, by addressing three questions: (1) to identify best practices for the integration of ERC into national and international public health preparedness; (2) to identify mechanisms to establish effective intra-agency, inter-agency, and/or cross-jurisdictional information sharing; and (3) to identify methods to coordinate risk communication activities between responding agencies across organizations and levels of response. The review covered scientific and grey literature publications between January 2003 and February 2016, and searches were conducted in 17 English language electronic libraries besides Chinese, Portuguese and Spanish language databases. A mixed deductive-inductive process was used to synthesize findings across studies through identifying thematic areas. While 8,215 articles were initially retrieved, after a sequential screening process, the final evidence syntheses comprised of 21 articles for question (1) and 24 for questions (2) and (3) combined (due to overlap of themes). The confidence in findings was assessed by the Qualitative Evidence Syntheses (GRADE-CERQual) tool. PRISMA guidelines were followed to the extent possible given the limitations inherent to a review largely based on qualitative studies. The identified literature was very context-specific and referred to mechanisms, practices from the field, and recommendations that were derived from planning or response efforts implemented at the national or local levels in specific countries. Integration of ERC functions into public health emergency preparedness, planning and response activities was influenced by reforming components of the leadership structure when needed, modifying organizational factors, and nullifying restrictions (including amending laws/ regulations) that might have been an obstacle to the timely release of information. Exercises and trainings were recognized as effective strategies to identify the barriers and successes in this process of integration. Key elements to enhance information sharing and coordination across organizations included the creation of networks, task-forces and committees across disciplines, organizations and geographic areas. Engagement of local stakeholders was also important to guarantee the flow of information up and down the incident command system. On the whole, few empirical studies, especially from low- and middle-income countries, related to the WHO research questions, demonstrating the need for research in these areas. To facilitate an accurate identification of the gaps, the authors suggest integrating current findings with case studies across the WHO regions to better understand the specific evidence that is needed in practice across the multitude of ERC functions.

Health-Related Disaster Communication and Social Media: Mixed-Method Systematic Review.

This mixed-method evidence synthesis drew on Cochrane methods and principles to systematically review literature published between 2003 and 2016 on the best social media practices to promote health protection and dispel misinformation during disasters. Seventy-nine studies employing quantitative, qualitative, and mixed methods on risk communication during disasters in all UN-languages were reviewed, finding that agencies need to contextualize the use of social media for particular populations and crises. Social media are tools that still have not become routine practices in many governmental agencies regarding public health in the countries studied. Social media, especially Twitter and Facebook (and equivalents in countries such as China), need to be incorporated into daily operations of governmental agencies and implementing partners to build familiarity with them before health-related crises happen. This was especially observed in U.S. agencies, local government, and first responders but also for city governments and school administrations in Europe. For those that do use social media during health-related risk communication, studies find that public relations officers, governmental agencies, and the general public have used social media successfully to spread truthful information and to verify information to dispel rumors during disasters. Few studies focused on the recovery and preparation phases and on countries in the Southern hemisphere, except for Australia. The vast majority of studies did not analyze the demographics of social media users beyond their geographic location, their status of being inside/outside the disaster zone; and their frequency and content of posting. Socioeconomic demographics were not collected and/or analyzed to drill deeper into the implications of using social media to reach vulnerable populations. Who exactly is reached via social media campaigns and who needs to be reached with other means has remained an understudied area.

A Conceptual Framework for the Evaluation of Emergency Risk Communications.

OBJECTIVES: To articulate a conceptual framework in support of evaluation activities in emergency risk communications (ERC). METHODS: The framework proposed is based on a systematic review of the scientific literature (2001-2016) combined with data derived from a series of semistructured interviews with experts and practitioners in ERC, and it is designed to support local, national, and international public health organizations in implementing evaluation studies in ERC. RESULTS: We identified a list of ERC outcomes from the full-text review of 152 articles and categorized these into 3 groups, depending upon the level at which the outcome was measured: (1) information environment, (2) population, and (3) public health system. We analyzed interviewees' data from 18 interviews to identify practices and processes related to the effectiveness of ERC and included these as key structural components and processes in the developed evaluation framework. CONCLUSIONS: Researchers and public health practitioners interested in the evaluation of ERC can use the conceptual framework described in this article to guide the development of evaluation studies and methods for assessing communication outcomes related to public health emergencies.

A Systematic Review of Literature on Effectiveness of Training in Emergency Risk Communication.

Although disaster preparedness training is regularly conducted for a range of health-related professions, little evidence-based guidance is available about how best to actually develop capacity in staff for conducting emergency risk communication. This article presents results of a systematic review undertaken to inform the development of World Health Organization guidelines for risk communication during public health and humanitarian emergencies. A total of 6,720 articles were screened, with 24 articles identified for final analysis. The majority of research studies identified were conducted in the United States, were either disaster general or focused on infectious disease outbreak, involved in-service training, and used uncontrolled quantitative or mixed method research designs. Synthesized findings suggest that risk communication training should include a focus on collaboration across agencies, training in working with media, and emphasis on designing messages for specific audience needs. However, certainty of findings was at best moderate due to lack of methodological rigor in most studies.