Pillars of Governmental Environmental Public Health | A Guide to Scalable Environmental Public Health Programs
Characteristics of a Successful Zoonoses and Vector Control Program Phased response plans for disease response and miti- gation are an important part of success and include the ability to analyze historical data to determine thresholds. Public trust and good customer service are valuable driv- ers that ensure programs address non-outbreak-related vectorborne disease issues in a way that instills confidence and trust in public health. This strategy could mean reg- ular assessment of program gaps and response to those gaps to strengthen areas of weakness. Forecasts are an important element for the success and con- tinued success of a vectorborne program as climate change expands the range of vectors that can carry diseases. Human disease tracking and surveillance can detect vec- tor movement and disease emergence in a jurisdiction. For example, mosquito indices can be calculated as the average number of infected vectors collected per trap-night. A vector index for mosquitoes, such as an index of 0.5 for 2 weeks, can help departments know when to consider implementation of more drastic control measures like aerial spraying.
This support is difficult to measure, but departments can use needs assessments to try to capture some indicators. Our research found that training completion serves as an important outcome measure for this program. Specifically, tracking whether staff receive annual integrated pest or vector management training provides a key indicator of program implementation success. EPH departments often develop risk thresholds for each disease relevant to their area and have a plan to act once the thresholds are surpassed. These thresholds might be vector-specific, such as a vector index, and/or human-spe - cific, such as the number of human disease cases. Data analysis of disease trends plays a big part in establishing thresholds and considering environmental and surveil- lance factors into disease response is essential for this program with very mobile vectors. For example, assuming surveillance is consistent, a department’s jurisdiction could be in a vulnerable position if surveillance does not detect disease activity for an extended period. In the case of West Nile virus, this could mean that the birds in the area are increasingly susceptible to the virus, therefore increasing the viral abundance in the environment, which might result in an increase in human cases in the upcoming year.
Meaningful Outcome Measures
Staffing
PURPOSE
METRIC
Program effectiveness
• Number of disease outbreaks responded to within target timeframe per year * • Number of case investigations completed within the required timeframe per year • Number of specimen collections and safe disposals completed per season.
The workload for this program is disease and vector dependent; the more diseases that are monitored and investigated, the more staffing is generally necessary. Mosquitoes seem to be a ubiquitous problem, but some diseases like hantavirus or Lyme disease tend to be regional or in concentrated areas. Tourism might also play a role in the determination of staff numbers. Mosquitoes and pests can hinder the growth of a tourism economy and, therefore, some jurisdictions where tourism is a big economic driver might choose to invest more in their mosquito or pest control programs in target areas. Partnerships and internships with local universities can provide some seasonal staffing support from students needing to fulfill a practicum or applied experience intern -
Workforce development • Percentage of staff completing required integrated pest management training annually * Partner engagement • Number of partner education events/contacts conducted per year * * EPH professionals who participated in focus groups, key informant interviews, and/or the national field survey consistently identified this metric as moderately to extremely useful. Support of the public is important because funding for pro- gram activities often comes from taxes and special districts.
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