1. Vulnerable Populations Tools
Developed by
Montgomery County APC

2. Presentation Objectives
Define vulnerable populations
Describe two tools that will assist in preparing vulnerable populations
Case Management Tool for Aging and Disabled - Checklist
Latino Health Promoter Curriculum - TTT

3. Definition of Vulnerable Populations
Determined by your own population within your community and what populations will be most at-risk during an emergency event.
Notes: Vulnerability is determined not so much by the event, rather, by the different social, economic, and political processes and conditions that society creates under which people face hazards.[1]
[1] Dr. Randy Rowel, Special Populations Bioterrorism Initiative: Emergency Response Needs for Low-Income Populations, Morgan State University, School of Public Health Policy, October 24, 2005.

4. Examples of Vulnerable Populations
Limited English Proficiency
Economically disadvantaged
Isolated from the community
Physically or mentally challenged
Pregnant Women
Children
Homeless
Persons with chronic conditions
Seniors
Minority groups
These are examples of groups of vulnerable populations. Each community needs to assess what populations will be vulnerable during an emergency event. These populations will be often those same populations that local health departments serve every day.
Bill—you might want to talk about some vulnerable populations in your community.

5. Case Management Tool
Purpose: Part of community engagement model, introduce emergency preparedness into the workforce
Pilot tested through collaborative effort with SME’s in Aging and Disability Program.
Case Management Tool was developed when as we have worked with our Aging and Disability program. They made the form as part of their case management file, where it is reviewed by the case manager. They have also made it a part of their contract with agencies that A& D work with for home care services.
The pilot of this case management form was very successful-collecting the 9 items for the emergency toolkit. Emergency Preparedness Checklist for Case Management and Home Care Services (which includes Plan to Be Safe messages).
Aging and Disability Program (Plan 9 supplies)
Baseline: 50% had a 3-day supply of 5 or more items.
30 day: 62.5% had a 3-day supply of 5 or more items
90 day: 90.6% had a 3-day supply of 5 or more items
100% of case workers documented having a conversation with the family and helping the family make an emergency plan. 5

6. Engage County and Community Programs
County Programs
Aging and Disability
Community Health Nurses-Pregnant women and families with young children
Foster Care
Health Clinics (HIV, STD, TB)
Case Management Services
Community Programs
Faith Community Nurses
Home Health Agencies
Home Visiting Programs
Rehabilitation Centers
Case Management Programs
Montgomery APC developed the Case Management Checklist in order to engage County and Community Services in assisting with preparing their clients and patients for emergency events. It is built upon Montgomery APC’s Plan to Be Safe Campaign and the three steps:
Have a Conversation
Make a Plan
Make a Kit
It also helps to encourage the family and the service provider to develop a plan on how they would communicate during an emergency event. In Montgomery County this was recently used during the February snow storms.

7. Case Management Tool
Modification/Use-original files available upon request
Intended to be copied and placed into case management records
Available for free through Montgomery APC’s webpage.

8. Latino Health Promoter Curriculum
Purpose: To train promotores de salud in Public Health Emergency Preparedness
3-Day training
Developed based upon focus group studies to educate gatekeepers to promote emergency preparedness in daily work with Latino Community
The Latino Health Promoter Curriculum was developed based upon Focus Groups which were conducted in 2006 some of the results are as follows:
Participants had difficulty defining “emergency”
Wide range of perceived personal emergency risks
Few participants reported receiving information on EP
Concern with government’s readiness
Most participants did not have an EP plan
Immigration identified as a current emergency
Carter-Pokras, Olivia, PhD, Zambrana, Ruth E., PhD, Mora, Sonia E., and Aaby, Katherine A., MPH, RN. Emergency preparedness: knowledge and
perceptions of latin american immigrants. Journal of Health Care for the Poor and Underserved. 18 (2007): 465–481.

9. Background
Scarce information on emergency preparedness (EP) knowledge and attitudes in Latinos
Racial/ethnic minorities more vulnerable to disasters
Need to develop culturally and linguistically competent (EP) interventions
Why we did the project and the need.

10. Objectives of the Montgomery APC/LHI Project
Compile information/assess Latino’s knowledge, perceptions of risk, and preferred and actual sources of information on EP.
Develop culturally appropriate EP materials to be replicated and used in other jurisdictions
Develop and test an EP intervention among low-income Latinos-through a mini-pilot project
Step 1: In order to develop this curriculum Montgomery APC performed focus groups in the Latino community in Montgomery County to understand the best way to communicate emergency preparedness messages to the community.
Step 2: Montgomery APC developed a curriculum for Latino Health Promoters (or other lay health promoters) on emergency preparedness.
Step 3: Once the health promoters gained knowledge and awareness of emergency preparedness they performed educational sessions in the community. Montgomery APC was able to gather data from the mini-pilot project that demonstrated that participants were more prepared for emergencies after participating in the intervention, than before.
For the purposes of this presentation we are going to walk through the Latino Health Promoter Curriculum.

11. Factors Contributing to Success of Using Latino Health Promoters
Carefully designed culturally & linguistically competent intervention
Limited number of key messages
Collaboration with trusted agencies
Incentives?
Skills, talents, enthusiasm, experience of promoters
Community trust in promoters
Why did we use Latino Health Promoters to deliver the message to the Latino Community?
The data indicate that the promoter-led community education sessions on emergency preparedness are remarkably effective in increasing the Latino community’s readiness for emergencies. In a recent national survey on emergency preparedness among the United States public, 43 percent in general and 33 percent of Latinos said they felt very prepared or prepared for a disaster with no warning (terror attack or earthquake). When asked about a disaster with a warning (hurricane or wildfire), the numbers increased—60 percent in general and 48 percent of Latinos.
Results from Montgomery County, MD’s mini-pilot project using Latino Health Promoters as messengers resulted in 70 percent of participants saying they felt prepared to deal with an emergency which is substantially higher than both scenarios proposed to respondents in the national survey.
The same national survey also found that 43 percent of the public in general said they had a family emergency preparedness plan, whereas 100 percent of the Montgomery County, MD mini-pilot participants reported they had a plan. Redlener, I. et. al. (2007).The American Preparedness Project: here the US Public Stands in 2007 on
Terrorism, Security, and Disaster Peparedness: Annual Survey of the American Public. New York: National Center for Disaster Preparedness, Columbia University Mailman School of Public Health and The Children’s Health Fund.
Factors that may have contributed to the project’s success are:
A carefully designed, culturally and linguistically appropriate intervention, based on audience research and the lessons learned from years of experience of the Vías program.
Use of a limited number of messages to help the promoters master basic concepts and to help the community understand key actions to undertake.
Collaboration with trusted community agencies that serve Latinos.
The provision of incentives, although no participant mentioned these in the post intervention questionnaires.
The skills, talents, creativity, and enthusiasm of the experienced Vías promoters.
The trust that the Vías promoters enjoy in the communities where the interventions were conducted; they are well known through their ongoing work at these site.

12. Health Promoter Curriculum
Basic information on public health emergencies and actions to take to prepare for an emergency
Outreach, community engagement techniques, and use of educational materials
Outlines specific knowledge and skills learning objectives, training content and methods
Includes simple record keeping tool
What is included in the Latino Health Promoter Curriculum

13. Have a Conversation
The curriculum is built upon Montgomery County’s Plan to Be Safe Campaign’s three messages:
Have a Conversation-talk with your family about emergencies.
Make a Plan-Write down a communication plan and share it with your family. Have contact information for different members in the area you live, as well as outside of the area you live to serve as the point of contact.
Make a Kit-keep a kit of essential items that your family will need to have in case of an emergency where you cannot leave the house or have no electrical power.

14. Make a Plan

15. Prepare a Kit

16. Conclusion
Training curriculum & accompanying materials facilitate replication in other sites.
Careful attention to building relationships with community & nurturing promoters

17. Activity 9: Preparing for Emergencies
RULES:
Form two teams
30 seconds to state how the object is related to emergency preparedness
Must state if this an essential item or not
Incorrect answers allow the other team to answer
Points are awarded to the team that can correctly answer the two questions
Sample Activity from the LHI Curriculum.
Bill- you can walk people through the activity or actually perform the activity with the group depending upon time.

18. Answer-Not Essential

19. Mario in Florida:
Essential-phone numbers and contact information of relatives or friends outside of your state are always good to have in case you can’t reach others in your family. This person could serve as the point of contact to call if you can’t reach anyone else.

20. Essential-if you are in need of a wheelchair or other mobility device for special needs, place that into your kit.

21. Essential-a battery operated flashlight
Essential-a battery operated flashlight. Even better are the crank radio/flashlight combinations.

22. Montgomery County Public Schools Emergency Preparedness Plans
Essential-Emergency plans that you feel are important to the safety of your family members. Having your children’s school plans will make you feel better as a parent to know what is going on.

23. Essential-extra batteries.

24. Essential-if you have a pet, place food, bedding and toys into your kit.

25. For Emergencies call: 911
Essential-emergency contact information for public safety agencies is essential.

26. Essential-have enough not only for drinking, but cooking and hygiene as well.

27. Not essential.

28. Essential-first aid kits are good to have for minor emergencies
Essential-first aid kits are good to have for minor emergencies. These kits do not have to be very extensive. Extra bandages, band aids, over the counter medications, thermometers, etc. are good to have on hand.

29. Not essential.

30. Essential-battery operated radios are a good way to hear communication when there are electrical outages. Crank radios are even better.

31. Essential-manual can opener for food.

32. Essential-diapers and other items are important to include if you have young children. Formula and other dietary needs should be included as well.

33. Essential

34. Essential-have a variety of food that can be eaten with out electrical power. Think of any dietary needs required for your family.

35. Not essential-dairy products will spoil.

36. Not essential-other hygiene items should be included however.

37. Essential-prescription medications that you are taking should be included in your kit.

38. Essential-emergency plans for your family.

39. Latino Health Promoter Curriculum
Modification/Use-Can be implemented with any Health Promoter or outreach program that works with the Latino community.
Available for free through Montgomery APC’s webpage

40. Contact Information
us:
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