A community-based participatory approach and engagement process creates culturally appropriate and community informed pandemic plans after the 2009 H1N1 influenza pandemic: remote and isolated First Nations communities of sub-arctic Ontario, Canada
A community-based participatory approach and engagement process creates culturally appropriate and community informed pandemic plans after the 2009 H1N1 influenza pandemic: remote and isolated First Nations communities of sub-arctic Ontario, Canada
复制标题
DOI：
10.1186/1471-2458-12-268
复制
发表时间：
2012-04-03
影响因子：
4.5
通讯作者：
Tsuji, Leonard J. S.
中科院分区：
文献类型：
--
作者：
Charania, Nadia A.;Tsuji, Leonard J. S.
背景资料：由于预先确定的社会和经济不平等，突发公共卫生事件有可能对弱势群体造成不成比例的影响。在国际上，在2009年H1N1流感大流行之前，现有的大流行计划是在有限的公众咨询下制定的;因此，一些第一民族社区的独特需求和特点可能没有得到道德和充分的解决。让公众参与流行病规划可以提供有关当地价值观和信仰的重要信息，这些信息最终可能导致流行病规划的可接受性、可行性和实施。因此，本研究的目的是引出和解决第一民族社区成员的建议修改后，2009年H1N1流感大流行的社区一级pandemic plans.Methods：研究领域包括三个偏远和孤立的第一民族社区位于亚北极安大略，加拿大。以社区为基础的参与性办法和社区参与进程（即，采用半定向访谈（n = 13）、非结构化访谈（n = 4）和会议（n = 27））。参与者被有目的地抽样，并代表各种社区利益相关者（e。例如，在一个实施例中，地方政府、卫生保健、神职人员、教育等）参与社区的流行病应对。收集的数据进行人工转录和编码使用演绎和归纳的主题分析。这些数据随后通知修改的社区级pandemic plannes.Results：纳入社区级pandemic plannes. Results的主要修改涉及增加社区的具体细节。例如，“供应品”作为流行病准备和应对的一个额外类别出现，因为由于研究社区的地理位置偏远，包括供应品和资源的详细信息非常重要。此外，还必须详细说明如何、何时、何地以及由谁负责执行大流行病计划中概述的建议。此外，所涉及的组织的角色和责任进一步澄清。结论：我们的研究结果说明了参与公众，特别是第一民族，在大流行规划，以解决当地的观点的重要性。所采用的社区参与过程成功地纳入了基于社区的投入，以制定最新和文化上适当的社区一级流行病计划。由于这些流行病计划是动态的，我们建议不断更新这些计划，以满足社区不断变化的需求。希望这些修改后的计划将导致在下一次公共卫生紧急情况期间，这些偏远和孤立的第一民族社区的大流行病应对能力和卫生成果得到改善。此外，本文提出的修改建议可能有助于更新其他类似社区的社区级流行病计划。
Background: Public health emergencies have the potential to disproportionately impact disadvantaged populations due to pre-established social and economic inequalities. Internationally, prior to the 2009 H1N1 influenza pandemic, existing pandemic plans were created with limited public consultation; therefore, the unique needs and characteristics of some First Nations communities may not be ethically and adequately addressed. Engaging the public in pandemic planning can provide vital information regarding local values and beliefs that may ultimately lead to increased acceptability, feasibility, and implementation of pandemic plans. Thus, the objective of the present study was to elicit and address First Nations community members' suggested modifications to their community-level pandemic plans after the 2009 H1N1 influenza pandemic.Methods: The study area included three remote and isolated First Nations communities located in sub-arctic Ontario, Canada. A community-based participatory approach and community engagement process (i.e., semi-directed interviews (n = 13), unstructured interviews (n = 4), and meetings (n = 27)) were employed. Participants were purposively sampled and represented various community stakeholders (e. g., local government, health care, clergy, education, etc.) involved in the community's pandemic response. Collected data were manually transcribed and coded using deductive and inductive thematic analysis. The data subsequently informed the modification of the community-level pandemic plans.Results: The primary modifications incorporated in the community-level pandemic plans involved adding community-specific detail. For example, 'supplies' emerged as an additional category of pandemic preparedness and response, since including details about supplies and resources was important due to the geographical remoteness of the study communities. Furthermore, it was important to add details of how, when, where, and who was responsible for implementing recommendations outlined in the pandemic plans. Additionally, the roles and responsibilities of the involved organizations were further clarified.Conclusions: Our results illustrate the importance of engaging the public, especially First Nations, in pandemic planning to address local perspectives. The community engagement process used was successful in incorporating community-based input to create up-to-date and culturally-appropriate community-level pandemic plans. Since these pandemic plans are dynamic in nature, we recommend that the plans are continuously updated to address the communities' evolving needs. It is hoped that these modified plans will lead to an improved pandemic response capacity and health outcomes, during the next public health emergency, for these remote and isolated First Nations communities. Furthermore, the suggested modifications presented in this paper may help inform updates to the community-level pandemic plans of other similar communities.