Partnerships for community resilience: perspectives from the Los Angeles County Community Disaster Resilience project.

Community partnerships are critical to public health practice in general,1 and in particular to local health department programs to improve emergency preparedness and community resilience.2 Greater integration of organizations can build trust and increase participation in emergency preparedness activities that increase knowledge and contribute to enhanced preparedness and recovery plans.3 By creating well-functioning partnerships across organizations, health departments can also pool together a diverse set of resources to enhance their preparation for, response to, and recovery from a disaster or emergency.3,4 To facilitate building such relationships, the Centers for Disease Control and Prevention (CDC) identified 11 community sectors with which local health departments may consider developing partnerships. These sectors include businesses, community leadership, cultural and faith-based groups and organizations, emergency management, health care, social services, housing and sheltering, media, mental/behavioral health, organizations serving the interests of at-risk populations such as older persons, and education and childcare.2 In 2011, the Los Angeles County Department of Public Health created the Los Angeles County Community Disaster Resilience initiative to develop strategies and enhance partnerships towards building community resilience.5–7 One goal of this project was to support the department in strengthening partnerships with non-governmental organizations, not simply between the Emergency Preparedness and Response Program that administers the initiative, but also with other department divisions to enhance their integration into community resilience development. To capture the baseline for our work, a cross-sectional survey was administered to a sample of Los Angeles County Department of Public Health staff in 2012. The survey included questions about partnerships with other organizations. The goal of this paper is to describe partnership activities conducted by the Los Angeles County Department of Public Health and the types of organizations that have partnerships with the department. In addition, this paper investigates perceived barriers to partnerships. The survey was administered to Los Angeles County Department of Public Health staff from October, 2012 to December, 2012. Potential respondents included a sample of various levels of staff within each program in the department that included representation from program directors or managers, analysts, and administrative staff. The sample was also selected proportional to the size of the program so there was greater representation from the three largest programs: Acute Communicable Disease Control, Community Health Services, and the Emergency Preparedness and Response Program. Potential respondents were invited to participate via email and were asked to fill out the survey online (LimeSurvey8). Three reminder emails were sent to respondents over the survey period. The survey was administered by collaborators at the RAND Corporation. The survey included several categories of questions, including respondents' programs within the department, roles within the programs, challenges in building partnerships, current partnerships, and activities conducted with partners. The survey instrument was pilot tested with five Los Angeles County Department of Public Health respondents to assess readability and flow and to determine if the questions were interpreted as intended. A total of 262 invitations were sent out and 89 responses received for a response rate of 34.0%. The two largest groups of respondents were program directors and public health nurses, each constituting 22.5% of all respondents. Other respondents included program managers (15.7%), executive administrators (12.4%), physicians (12.4%), health educators (6.7%), analysts/planners (6.7%), administrators (3.4%), and epidemiologists (1.1%). The three largest programs (Acute Communicable Disease Control, Community Health Services, and Emergency Preparedness and Response) accounted for approximately 53% of all respondents.