FORUM ON MEDICAL AND PUBLIC HEALTH PREPAREDNESS FOR DISASTERS AND EMERGENCIES AND ACTION COLLABORATIVE ON DISASTERS/PUBLIC HEALTH EMERGENCY RESEARCH

灾害和紧急情况医疗和公共卫生防备论坛以及灾害/公共卫生紧急情况研究行动合作

• 批准号: 10937101
• 负责人: ROBERT DAY
• 金额: $ 4万
• 依托单位: NATIONAL ACADEMY OF SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-26 至 2024-09-25
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10937101
• 关键词: Academia; Academy; Acute; Address; Adolescent; Affect; Applied Research; Area; Artificial Intelligence; Big Data to Knowledge; Biological Products; COVID-19 pandemic; Caring; Categories; Charge; Chemical Exposure; Child; Childhood; Clinical; Clinical assessments; Collaborations; Collection; Color; Communication; Communities; Complex; Data; Data Collection; Data Science; Data Set; Department of Defense; Development; Disabled Persons; Disasters; Education; Educational workshop; Elderly; Emergency Situation; Emergency research; Emergency response; Engineering; Ensure; Environmental Health; Equity; Ethical Issues; Ethics; Evaluation; Event; Evidence based practice; Evolution; Exercise; Federal Government; Food; Fostering; Foundations; Funding; Government; Guidelines; Health; Health Services Accessibility; Health system; Heat Waves; Hurricane; Hybrids; Individual; Industry; Information Resources; Infrastructure; Institution; Institutional Policy; Institutional Review Boards; International; Knowledge acquisition; Lactation; Learning; Link; Maintenance; Medial; Medical; Medical emergency; Medicine; Mental Health; Natural Disasters; Nuclear; Outcome; Paper; Performance; Personal Satisfaction; Persons; Phase; Play; Policies; Population; Populations at Risk; Prevention; Primary Care; Private Sector; Privatization; Procedures; Process; Professional Organizations; Public Health; Radiation; Readiness; Recovery; Reporting; Research; Research Personnel; Role; Safety; Science; Security; Services; Shelter facility; Strategic Planning; Structure; System; Technology; Terrorism; Training; Training and Education; Transportation; Trauma; United States Department of Veterans Affairs; United States Dept. of Health and Human Services; United States National Academy of Sciences; United States National Institutes of Health; Volunteer Organization; Water; Wildfire; Woman; Work; behavioral and social science; climate change; community engagement; computerized tools; design; digital health; digital technology; experience; hazard; improved; improved outcome; interest; man; medical countermeasure; meetings; member; novel therapeutics; open data; pregnant; prevent; process improvement; psychologic; public health emergency; public health research; research and development; resilience; response; social; symposium; synergism; tribal community; virtual; volunteer; vulnerable community

Policy Context There are many governmental agencies and private organizations charged with ensuring the Nation’s capacity to prevent and respond to the health effects that arise from disasters, both man-made and natural as exemplified by the recent SARS COV-2 global pandemic and increasingly frequent and severe natural disasters including heatwaves, hurricanes, and wildfires across the nation. While each of these stakeholders is critical in guaranteeing adequate prevention, response and recovery, efforts must be coordinated to foster functional strategies, communications, and collaborations to ensure optimal outcomes improving the health and well-being of our communities. Challenges arise, however, from the diverse set of responsibilities of the primary stakeholders, the Department of Health and Human Service (HHS) and the Department of Homeland Security (DHS) and coordinating the efforts among the many other governmental agencies (federal, state, and local), industry, professional societies, foundations, academia, and other interested parties. Aligning the responsibilities and focus of each stakeholder greatly assists in ensuring adequate protection and response. Each stakeholder offers unique assets that must be linked to an overall strategy. It is here where the appropriate federal agencies, including the HHS, DHS, Department of Defense, Department of Transportation, and Veterans Affairs, play a vital role in developing a national strategy and logistical support and coordinating with the private sector. The Forum for Medical and Public Health Preparedness for Disasters and Emergencies (the “Forum”) began to address these issues and coordination of stakeholders in 2008. The Forum provides a venue where the major stakeholders may sit down together and discuss the primary issues, afford organizations the opportunity to make assessments, discuss policies, and review outcomes. These areas focus not only on the immediate responses to disasters and public health emergencies, but also the intermediate and long-term needs that arise (e.g. providing adequate shelter, food and water safety, primary care, mental health) during the recovery phase and efforts to enhance preparedness, cooperation and information sharing. The activities of the federal government, volunteer organizations, the private sector, and others in the areas of medical and public health preparedness, resilience, and recovery are of increasing complexity, both in terms of technology and policy. Currently, it is difficult for the nation's medical emergency response, public health and mental health systems, and health research enterprise to meet the rapidly increasing and diverse medical and health challenges that result from all types of disasters including terrorism and natural disasters. Unfortunately, gaps continue to exist. Addressing the physical, psychological, and social needs, especially among at-risk population (e.g., pregnant and lactating women, children and adolescents, elderly, individuals with disabilities and pre-existing conditions, communities of color, and worker subpopulations) that result from various disasters will therefore require universal preparedness by all systems responsible for the public's health and well-being. Preparedness, response, and recovery are required for all hazards and should include all segments of the population during each phase of the event. The research and development needs of these initiatives are immense and thus require the federal government to seek to promote and coordinate needed scientific assessments and capacity building across the nation and with international partners. Such coordination will require the best advice available as federal agencies seek guidance in developing its strategic plans for advancing medical and public health preparedness, response, and recovery to disasters. These initiatives include scientific, technical, and workforce issues in the medical and public health arenas (infrastructure, clinical, environmental, and public health, research needs, including the development of new drugs and biologics and the collection and funding of critical data collection in a timely manner); effective training, education, and communication exercises; and evaluations of preparedness and post-disaster performance. The multiple and complex ethical issues surrounding these developing fields must also be considered. Technical Context The Forum will promote open discussion of existing systems and lessons learned from previous disasters and public health emergencies and identify areas for improvement. The upcoming FY2024 will consider opportunities to address four broad categories: (1) Digital Technology and Health Security, (2) Advancing Preparedness, (3) Expanding Access, and (4) Climate Change and Cascading Events. Within these areas, topics that might be on the meeting agendas of the forum include: Digital Technology and Health Security Topics within this theme focus on advancing digital technology and artificial intelligence as it relates to health security. Exploration of health preparedness for radiation, nuclear and chemical exposures and crisis standards of care will also be leveraged. Advancing Preparedness Topics within this theme focus on the Behavioral and Social Science aspects of preparedness. Discussions will concentrate on ways in which these scientific fields can advance the nation’s preparedness across all hazards and populations. Expanding Access Topics within this theme focus on expanding access to care/services to tribal communities, and other at-risk populations. Discussions will focus on leveraging preparedness experiences and opportunities for equitable reach to these vulnerable communities across the disaster cycle. Climate Change and Cascading Events Topics within this theme focus on cascading events related to climate change. Dissemination of declarations and the evolution of the Stafford Act will be discussed. Action Collaborative on Disaster/Public Health Emergency Research The Forum will continue to convene an Action Collaborative on Disaster/Public Health Emergency Research (the “Action Collaborative”) based upon the receipt of additional supporting funds from NIH and other sponsors. Recent efforts to respond to the COVID-19 crisis and the multiple increasing national disasters highlights the critical need to develop improved U.S. capacity for pre-, during- and post-event research and science. For this year the Action Collaborative will strive to further our collective capacity for timely disaster and public health research, especially with respect to at-risk populations and improvements in disaster data science. Focused interests and activities of the Action Collaborative may include 1) outlining and defining processes for designing and conducting research, particularly transdisciplinary research involving vulnerable and at-risk populations, 2) ensuring community engagement and IRB/ethical considerations in disaster research. 3) defining processes for expanding and enhancing a coordinated network of disaster researchers across the U.S. and globally; 4) facilitating platforms, exchanges, and processes for data collection, harmonization, integration, and warehousing research, 5) exploring appropriate venues to support the development and maintenance of a rapid response mechanisms for the National Academies and other platforms or forums to continue to meet sponsor needs for convening, generating ideas, and sharing information during the initial, as well as later stages of a public health emergency, and 6) promoting improved processes for developing, coordinating, and implementing the federal and academic research enterprise in response to disaster and public health emergencies, especially improving timeliness to avoid missing critical data. The Action Collaborative convenes in-person and/or virtual meetings and workshops which significantly influence the field of disaster science. For example, the hybrid 2022 landmark Pediatric Disaster Science Symposium convened academic, clinical and community stakeholders, along with subject matter experts, to scope perspectives, information and scientific needs related to disasters affecting child populations. Discussions focused around prioritization of pediatric disaster science foci, opportunities for alignment and synergy of scientific efforts, capacity building around evidence-based practices and scientific discovery to improve outcomes of children. Development and implementation of relevant virtual or in-person workshops or hybrid meetings may be pursued during this period of performance.

政策上下文 有许多政府机构和私人组织负责确保该国预防和应对灾难所带来的健康影响的能力，包括人造和自然的灾难，这是最近的SARS COV-2全球大流行以及日益频繁的频繁和严重的自然灾害，包括热带，飓风，飓风和全国的野生灾害。尽管这些利益相关者中的每一个对于保证充分的预防，响应和恢复至关重要，但必须协调努力以培养功能策略，沟通和协作，以确保最佳成果改善我们社区的健康和福祉。然而，挑战来自主要利益相关者，卫生与公共服务部（HHS）和国土安全部（DHS）的潜水员责任，并协调许多其他政府机构（联邦，州和地方），工业，行业，专业社会，基金会，学术界，学术界和其他有趣的政党之间的努力。 一致责任利益相关者大大协助确保充分的保护和回应。每个利益相关者都提供必须与整体策略相关的独特资产。在这里，适当的联邦机构，包括HHS，国土安全部，国防部，交通运输部和退伍军人事务，在制定国家战略和后勤支持以及与私营部门的协调方面发挥了至关重要的作用。 灾难和紧急情况的医疗和公共卫生准备论坛（“论坛”）于2008年开始解决这些问题和利益相关者的协调。论坛提供了一个场地，主要利益相关者可以一起坐下来讨论主要问题并讨论主要问题，使组织有机会进行评估，讨论政策和审查概况。这些领域不仅着重于对灾害和公共卫生紧急情况的直接反应，还着重于在恢复阶段的中间和长期需求（例如提供足够的庇护所，食品和水安全，初级保健，心理健康），并努力增强准备，合作，合作和信息共享。 在技​​术和政策方面，联邦政府，志愿组织，私营部门以及其他领域中的活动都具有更高的复杂性。目前，美国的医疗应急响应，公共卫生和精神卫生系统以及健康研究企业很难应对各种类型的灾难以及包括恐怖主义和自然灾害在内的各种灾难所带来的迅速增加和多样化的医疗和健康挑战。不幸的是，差距继续存在。 解决身体，心理和社会需求，尤其是在高危人群中（例如，怀孕和哺乳的妇女，儿童和青少年，年龄较大，残疾人和先前存在的状况，有色人种和工人的子群），因此需要各种灾难造成的各种灾难造成的所有系统都需要所有负责公众的健康和健康和福祉的系统。所有危害都需要准备，响应和恢复，并应在活动的每个阶段包括所有人口的部分。这些举措的研发需求是巨大的，因此要求联邦政府寻求在全国范围内以及与国际合作伙伴一起促进和协调所需的科学评估和能力建设。这种协调将需要提供最佳建议，因为联邦机构寻求指导，以制定其战略计划，以推动医疗和公共卫生准备，应对措施以及对灾难的康复。这些举措包括医学和公共卫生领域（基础设施，临床，环境和公共卫生，研究需求，包括新药和生物制剂的开发以及及时收集和资金收集的研究需求）中的科学，技术和劳动力问题；有效的培训，教育和沟通练习；并评估准备工作和污点后表现。还必须考虑围绕这些发展领域的多重且复杂的道德问题。 技术环境 该论坛将促进对现有系统的公开讨论以及从以前的灾难和公共卫生紧急情况中汲取的经验教训，并确定改进的领域。即将到来的2024财年将考虑解决四个广泛类别的机会：（1）数字技术和健康安全，（2）提高准备准备，（3）扩大访问权限，以及（4）气候变化和级联事件。在这些领域中，论坛会议议程中可能存在的主题包括： 数字技术和健康安全 该主题中的主题侧重于推进与健康安全有关的数字技术和人工智能。还将利用探索辐射，核和化学暴露以及危机标准护理标准的健康准备。 推进准备 该主题中的主题着重于准备的行为和社会科学方面。 讨论将集中在这些科学领域可以推动所有危害和人口中的国家准备的方式。 扩展访问 该主题中的主题着重于扩大向部落社区和其他高危人群获得护理/服务的访问。讨论将着重于利用准备经验和在整个灾难周期中向这些脆弱社区公平触及的机会。 气候变化和级联事件 该主题中的主题集中于与气候变化有关的级联事件。将讨论宣言的传播和《斯塔福德法》的演变。 关于灾难/公共卫生紧急研究的行动合作 该论坛将继续方便在收到NIH和其他赞助商的额外支持资金的基础上，就灾难/公共卫生紧急研究（“行动协作”）进行动作合作。最近努力应对COVID-19危机和多重增加的民族灾难的努力凸显了发展提高美国前，期间和事后研究和科学能力的关键需求。 今年，该行动合作将努力进一步提高我们进行及时的灾难和公共卫生研究的集体能力，尤其是在处于危险中的人口和灾难数据科学的改善方面。行动协作的集中兴趣和活动可能包括1）概述和定义研究和进行研究的过程，尤其是涉及脆弱和处于危险人群的跨学科研究，2）确保在灾难研究中确保社区参与以及IRB/伦理学考虑因素。 3）定义流程，以扩大和增强美国和全球的灾难研究人员的协调网络； 4）开发数据收集，协调，整合和仓库的平台，交流和流程，5）探索适当的场所，以支持和维护国家学院和其他平台或其他平台或其他平台或论坛的快速响应机制，以继续满足赞助商的需求针对灾难和公共卫生紧急情况，实施联邦和学术研究企业，尤其是提高及时性，以避免丢失关键数据。 动作合作召集了面对面和/或虚拟会议和讲习班，这些会议极大地影响了灾难科学领域。例如，混合动力2022年地标儿科灾难科学研讨会召集了学术，临床和社区利益相关者以及主题专家，以范围观点，信息和科学需求与影响儿童人群的灾害有关。讨论的重点围绕着小儿灾难科学的优先次序，对科学努力的一致性和协同作用，围绕循证实践的能力建立的机会以及改善儿童结果的科学发现。在此期间，可以进行相关的虚拟或面对面研讨会或混合会议的开发和实施。