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Cambridge Public Health Department
Advanced Practice Center for Emergency Preparedness
Planning Brief: Cambridge Public Participation Project
Overview
In fall 2006 the Cambridge Public Health Department’s Advanced Practice Center for
Emergency Preparedness (APC) held two public engagement opportunities to discuss
emergency preparedness planning in the context of pandemic influenza. The
Massachusetts Department of Public Health cosponsored these events. The discussions
were designed to focus on the needs of vulnerable persons and their service providers
during and following an emergency or disaster. For the purpose of the Cambridge Public
Participation Project populations included the homeless and their service providers
(September 2006) and elderly and disabled and their service providers (October 2006).
The goals for the public participation project were:
 Review the Cambridge pandemic plan and its assumptions for meeting the needs
of vulnerable populations in the event of an outbreak;
 Engage the homeless, elderly, and disabled communities—along with their
service providers—in a discussion of emergency preparedness planning; and
 Identify areas where further preparedness planning (by local government, service
agencies, and individuals) for vulnerable populations is needed.
Discussion with Homeless Community
For the pandemic planning discussion with the homeless community, the Cambridge
APC utilized an existing, monthly meeting of service providers to the homeless. This
monthly meeting includes representation from the client community and a scope of
service organizations which ranges from healthcare to municipal government. The group
discussion was facilitated by staff from the APC and included education on seasonal,
avian, and pandemic influenza, as well as all hazards preparedness planning and home
preparedness recommendations. Discussion questions were focused on local emergency
and disaster response (provision of health services and vaccination; communication with
service providers and general public) and the response roles of providers to their clients
(continuity of operation and services; communication with clients).
Discussion with Elderly & Disabled Communities
Working through service organizations, the Cambridge APC extended an invitation to
register for a discussion on pandemic planning as it pertains to the needs of the elderly
and disabled communities. Approximately 45 clients and service providers participated
in the 3 hour discussion, which was facilitated by APC staff and covered those
preparedness planning topics referenced above.
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Vaccination & Access to Health Services
Through the Cambridge Public Participation Project, participants assisted in identifying
challenges to providing health services in a disaster situation. Such services could
include mass prophylaxis, treatment at an alternate care facility, or public information
campaigns for prevention and containment. Challenges identified by participants
included:
 Challenges for Homeless Community
o Lack of medical history
o Fear of health system & vaccine
o Transportation to service location
o Locating homeless persons during emergency situations
o Perceptions about persons who are homeless
 Challenges for Elderly & Disabled Communities
o Ensuring physical accessibility of facilities
o Lack of policy for service animals
o Personnel require training in behavioral health and disability awareness
o Overcoming language barriers and isolation of homebound elders and
disabled persons
o Fear of health system by undocumented persons
Communication in a Disaster Situation
The best messenger for critical information in a disaster situation is a source who is
viewed as trusted. For some persons this source may be a service agency instead of the
emergency personnel responding to the incident. Participants in the Cambridge Public
Participation Project assisted in identifying challenges to reaching vulnerable populations
with important safety messages. Challenges identified by participants included:
 Challenges for Homeless Community
o Advance identification of trusted sources
o Identification of existing communication networks
o Rapid development of communications that incorporate multiple
languages and pictograms (illustration)
 Challenges for Elderly & Disabled Communities
o Language barriers (including American Sign Language) and literacy levels
o Education in advance of an emergency or disaster (working conversations
in ahead of time)
o Coordinating messages across modes of communication
o Involving other organization networks (places of worship, cultural
organizations, etc.)
Recommendations
The following recommendations for further preparedness planning and programming
were developed as a result of the Cambridge Public Participation Project. Accompanying
these recommendations are notes of specific actions taken toward their implementation.
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Establish an ongoing relationship and communication with service provider
network. [Staff from the Cambridge Public Health Department now regularly
attends the monthly meetings of homeless service providers.]
Ensure accessibility at all emergency response sites. [Ongoing.]
Written materials should be translated in predominant languages and produced at
appropriate literacy levels. [Ongoing. Staff from the Cambridge Public Health
Department developed a public information campaign on emergency preparedness
at home. These materials were developed to address low literacy through use of
pictograms and have been translated into Spanish, Haitian Creole, and Brazilian
Portuguese. It was mailed to every Cambridge household in November 2006.]
Appear on public access programming with emergency preparedness information
for the public. [Staff from the Cambridge Public Health Department appeared on
Be Live, a community television program, to discuss emergency preparedness at
home.]
Assist service organizations in identifying their essential services for the purpose
of developing a continuity of operation plan. [Ongoing. Staff from the Cambridge
Public Health Department is available to consult with service organizations about
emergency preparedness planning and continuity of operations planning (COOP).
A COOP template is available to guide them through the process.]
Conclusion
The public participation project was effective in seeking input on local emergency
planning assumptions while also encouraging preparedness among residents and service
providers. This was particularly true when working with vulnerable populations to best
understand their needs and how an emergency or disaster could impact those needs. The
project allowed local health planners to identify strategies for further work both internally
and with external partners. It was also an opportunity to build important partnerships
with service providers, who are essential to effective communication with vulnerable
members of our communities.