Culturally-Specific Populations Emergency Communications Project
Clackamas, Clatsop, Columbia, Multnomah,
Tillamook and Washington Counties
Final Report
Overview, Synthesis, Recommendations
Prepared for
Northwest Oregon Health Preparedness
Organization (NW-HPO)
December 2006
Prepared by:
Valerie Katagiri, MPH
503-988-4633 (Multnomah County Office of Emergency Management)
valerie.katagiri@co.multnomah.or.us
Project excerpts and paraphrases of final reports from:
African American Health Coalition
El Programa Hispano/Catholic Charities
SMG/Hacienda CDC (HCDC)
Latino Network
Native American Rehabilitation Association
Asian Health Services Center
African Community Center of Oregon/Immigrant and Refugee Community Organization
Immigrant and Refugee Community Organization
Ecumenical Ministries of Oregon/Russian Oregon Social Services
Culturally-Specific Populations
Emergency Communications (CSPEC) Project
Final Project Report – December 31, 2006
Project goal: Methods for communicating with culturally-specific populations in an
emergency will be clearly defined, and enhanced, in order to improve the timely
distribution of information. As a result, culturally-specific populations throughout the
region will receive, understand, trust, and be able to act upon the information they receive.
Background
HPO: The Northwest Oregon Health Preparedness Organization (HPO), formed in 2001,
is a partnership between public and private health organizations. The HPO plans for
large-scale health emergencies so that the community can respond effectively and
efficiently to protect the public’s health. The HPO receives funding from the Health
Resources and Services Administration (HRSA).
HRSA and its relationship to the HPO: The Health Resources and Services
Administration (HRSA) is a part of the U.S. Department of Health and Human Services.
HRSA began administering hospital and healthcare system preparedness grants to states
across the nation in 2002. The grants focus on communities’ capacity to assure a strong
healthcare response to bioterrorism and other public health emergencies.
In the fall of 2004, the Oregon Department of Human Services (DHS) established seven
Healthcare Preparedness Regions within the state. Each region was asked to create a
“healthcare preparedness board” to carry out two related missions: 1) support hospital and
healthcare system preparedness efforts; and 2) administer grant funds provided by HRSA.
The HPO serves as the healthcare preparedness board for Healthcare Preparedness
Region 1. Six counties are part of Healthcare Preparedness Region 1: Clackamas,
Clatsop, Columbia, Multnomah, Tillamook, and Washington counties.
The HPO works regionally to ensure that during a health emergency:
 hospitals and clinics can care for more patients;
 accurate and timely health information is available to healthcare providers and the
public; and
 community, local, and state agencies can provide a coordinated response.
An important part of emergency response is developing strategies and networks to
communicate effectively with culturally-specific populations. The HPO’s leadership
determined that in an emergency, the needs of culturally-specific and other special
DRAFT CSPEC Final Summary Report - 3/8/2016
1
populations is a priority. In early 2006, they allocated $293,000 to support the CulturallySpecific Populations Emergency Communications (CSPEC) Project.
All HPO projects, activities and staff are funded by HRSA. Funds for projects flow from
HRSA to Oregon DHS, then through the Oregon Association of Hospitals and Health
Systems (OAHHS), and finally to hospitals and other community partner organizations.
The community-based organizations (CBOs) participating in the CSPEC project were
funded through this mechanism.
The Culturally-Specific Populations Emergency Communications (CSPEC)
Project Concept
Contracting with CBOs: The underlying project concept was that the work should be
done by CBOs, not a government agency. Community-based organizations (CBOs) were
awarded contracts to develop plans and capabilities that would elicit appropriate
emergency responses from culturally-specific populations so that the surge capacity at
hospitals and clinics would not be jeopardized. In tandem with this effort, the HPO is also
developing emergency communication and behavioral health plans to support these
community efforts.
Project Structure: Liaisons were chosen on the basis of their credibility with their
communities. They, in turn, recommended CBOs known to be capable of accomplishing
goals. Contracts were created by the HPO, in collaboration with the Liaisons and chosen
CBOs. The project manager coordinated contract signing meetings to build relationships
with the CBOs and to ensure that the project deliverables were understood by the CBOs.
If there were populations not served by the selected CBOs, CBOs were encouraged to
identify community partners to reach these additional populations. Supportive materials
were developed for the CBOs (e.g., focus group/survey guides, preparedness resources,
etc.).
Target Populations: Due to time and funding constraints, the CSPEC project focused on
particular cultural populations within the six counties in Region 1 while acknowledging
that the specific needs of other special populations are also just as important.
Populations emphasized in this five-month pilot project included:
 African American
 Latino
 Native American
 Asian
 African and Russian immigrants and refugees
Nine community-based organizations (CBOs) were selected to work with the following
populations between April – October 2006:
DRAFT CSPEC Final Summary Report - 3/8/2016
2









African American Health Coalition (AAHC) - African American community in
Multnomah County
El Programa Hispano/Catholic Charities (EPH-CC) - Latino community in
Clackamas, Clatsop, Columbia, Multnomah, Tillamook, and Washington counties
SMG/Hacienda CDC - Latino community in Clackamas, Clatsop, Columbia,
Multnomah, Tillamook, and Washington counties (special note: at the end of July
2006, SMG merged with Hacienda CDC; their contract was re-written to
incorporate this change)
Latino Network (LN) - Latino community in the Clackamas, Clatsop, Columbia,
Multnomah, Tillamook, and Washington counties
Native American Rehabilitation Association (NARA) - Native American
community
Asian Health Services Center (AHSC) - Korean and Chinese communities in
Multnomah and Washington counties
African Community Center of Oregon/Immigrant and Refugee Community
Organization (AACO/IRCO) - African immigrant and refugee communities
Immigrant and Refugee Community Organization (IRCO) - Cambodian, Hmong,
Lao, Mien, and Vietnamese communities
Ecumenical Ministries of Oregon/Russian Oregon Social Services (EMO/ROSS) Russian speaking communities in Clackamas and Multnomah counties
Project Roles
Liaison: Primary role is to develop and maintain one-on-one relationships with CBOs
and provide support
1. Develop Contracts with CBOs
 Contract negotiations to include:
o Determine level of interest
o Overall project goal
o Deliverables: including activities and levels of activities
o Determine capability and capacity to successfully perform the work
o Amount of funding
o Timelines
o Determine technical/other assistance the CBO will need from project staff
 Contract execution to include:
o Obtain contract signatures from relevant CBO representative
o Ensure understanding of all contract components (deliverables, timelines,
reporting, financial reimbursement)
2. Provide Other CBO Supports
 Ensure understanding of work, response system, etc.
 Provide technical assistance and answer questions
 Address barriers to accomplishing project deliverables
DRAFT CSPEC Final Summary Report - 3/8/2016
3
3. Provide Supportive Materials to CBOs
 Contract language to include:
o Contract with OAHHS
o Deliverables, outcomes, timelines, reporting guidelines
o Report Form
o HRSA Program Cost Directives
o Code of Federal Regulations on purchases over $5,000
 Individual CBO orientation and materials
o History of HPO and culturally specific populations emergency
communications project development; overall project goal; planning
scenario; presentation support
 Community-level materials
o County response plans, etc.
4. Provide Content Expertise to CBOs (include but not limited to):
 Public information (e.g. risk communication, communication techniques, etc.)
 Health-related response (e.g., What is quarantine? What is shelter in place?
Appropriate access to available medical care)
5. Coordinate with Project Manager
 Contract negotiations and execution
 Provide feedback to project manager on CBO progress
 Ensure the project deliverables are being accomplished in conjunction with
project manager
 Address barriers to accomplishing project deliverables
 Participate in monthly meetings with CBO and project manager
Project Manager: Primary role is project oversight and coordination
1. Manage CBO Contracts (based on philosophy of Professional Accountability)
 Assess CBO process and progress
 Solicit and review reports, ensure delivery of reports to OAHHS, identify
implementation problems, and address identified problems
 Contract oversight: meeting deliverables, ensure expenditure of finances
 Enforcement (last resort)
2. Coordinate and Facilitate Project
 Convene and facilitate one-time project orientation for all participating CBOs and
liaisons at start of project
 Convene and facilitate monthly meetings with all participating CBOs to identify
accomplishments and challenges related to progress on contract deliverables
 Convene and facilitate team meetings with Emergency Management, liaisons,
Region 1 Coordinators
3. Provide Supportive Materials
 Community-level materials
o County response plans, etc.
 Standard emergency response information
DRAFT CSPEC Final Summary Report - 3/8/2016
4
4. Provide Content Expertise to Include (but not limited to):
 Public information (e.g. risk communication, communication techniques, etc.)
 Health-related response (e.g. What is quarantine? What is shelter in place?
Appropriate access to available medical care)
5. Coordinate a Consistent Community Emergency Communications Plan
 Coordinate all CBO emergency communications information and submit to
Region 1 Staff by August 30, 2006 for integration into the Region 1 health and
medical communications plan
 Identify other channels for dissemination of culturally specific populations plan by
August 30, 2006
Region 1 Staff: Primary role is to provide support to project manager and liaisons
1. Contracts with CBOs
 Contract language to include:
o Contract with OAHHS
o Deliverables, outcomes, timelines, reporting guidelines
o Report Form
o HRSA Program Cost Directives
o Code of Federal Regulations on purchases over $5,000
 Write contracts (coordinate with State PHP/OAHHS)
2. Provide Supportive Materials
 CBO orientation materials
o History of HPO and culturally specific populations emergency
communications project development; overall project goal; planning
scenario
3. Attend Meetings
 Attend team meetings with Emergency Management, Liaisons
 Participate in planning meetings to provide content/subject matter expertise and
resource information as needed to support overall HPO approaches and
perspective
4. Provide Content Expertise to Liaisons and Project Manager (include but not limited
to):
 HPO/Region 1 background and planning efforts
 Public information (e.g. risk communication, communication techniques, etc.)
 Health-related response (e.g. What is quarantine? What is shelter in place?
Appropriate access to available medical care)
5. Ensure Communications
 Circulate pertinent information to HPO Steering Committee for feedback and
direction
CBO Project Goals:
CBOs conduct community assessments to understand:
DRAFT CSPEC Final Summary Report - 3/8/2016
5

How communication currently works within culturally specific communities
o Community leaders?
o Word-of-mouth?
o Specific media?
o Community centers, places of worship?
o Grocery stores, local businesses? Etc??

Special considerations for successful communication in an emergency
o Financial constraints?
o Lack of sick leave at work?
o Immigration issues?
o Distrust of government?
o Conflicting advice from trusted sources?
o Fear of experimental vaccinations/medications?
o Transportation challenges?
o Interpretation and translation needs?

Likely community response to emergencies
o How will they access care?
o Will they comply with public official instructions (e.g., staying at home,
avoiding public transportation, etc)?
o Will they gather at a particular community place? Other?

Community preparedness needs
o Do they have family emergency plans?
o Do they have emergency kits?
o Do they know if their workplace has an emergency plan, and if so do they
know it is?
o Do they know if their child’s school or childcare site has an emergency
plan, and if so do they know what it is?
o Do they know if their family member’s nursing home has an emergency
plan, and if so do they know what it is?
o Do they have a medical provider; do they know how to contact in an
emergency?
o Do they know how to provide basic first aid?
o What affects their ability to prepare for an emergency (i.e., cultural,
financial, lack of storage space, etc.)?
Deliverables for CBOs:
 Community Assessment (written report detailing development, implementation,
results)
 Written Plan describing how to communicate with special populations/list of
contacts
 Conduct or participate in community event/s or community gathering/s to increase
emergency preparedness knowledge and outreach
DRAFT CSPEC Final Summary Report - 3/8/2016
6
Deliverables for Project Managers:
A project manager was hired in March 2006 to work with the Multnomah County Interim
Director of the Office of Emergency Management in leading and moving this project
forward.
 Project Managers reviewed CBO contracts with each of the nine CBOs. Contracts
were signed as follows:
AHSC:
March 23, 2006
IRCO:
March 23, 2006
EMO/ROSS:
March 23, 2006
AAHC:
March 28, 2006
NARA:
April 12, 2006
ACCO/IRCO:
April 25, 2006
SMG:
May 4, 2006
EPH:
May 18, 2006
LN:
May 18, 2006

Overall CSPEC project budget tracking and Liaison reimbursements were
coordinated with HPO staff, Liaisons, and Multnomah County’s Grants
Management and Accounting Office.

Individual CBO project Narrative and Budget reports (mid-project and end-ofproject) were requested, acknowledged, reviewed, and reconciled; final copies
were forwarded to the HPO, OAHHS, and Liaisons. Project reporting deadlines
were as follows:
Mid-Project: June 15 for 6 CBOs (August 15 for 3 CBOs*)
End-Project: September 15 for 6 CBOs (November 15 for 3 CBOs*)
* Note: Because three CBOs signed late in the process, their project completion
deadlines were moved from end of August to end of October (reporting deadlines
are two weeks after the project completion deadlines). The project’s Advisory
Team decided to extend the deadline to give all CBOs a minimum of five months
to complete their work.

Two-hour Advisory Team meetings with Emergency Management-related staff,
Liaisons, and Region 1 Coordinators were convened on:
March 13, 2006
March 27, 2006
April 10, 2006
April 24, 2006
May 22, 2006
June 20, 2006
July 18, 2006
August 15, 2006
September 19, 2006
October 17, 2006
DRAFT CSPEC Final Summary Report - 3/8/2016
7
Initially, the Advisory Team met twice a month to plan for the smooth ramp-up of
the CSPEC project. After the CBO Orientation and the signing of most CBO
contracts, the Advisory Team met once a month to debrief the past monthly CBO
meeting and plan for the next one (agendas and meeting notes are available upon
request).
(Note: During the project continuation period, November 2006 – August 2007,
Advisory Team meetings will only be scheduled if there is an issue that warrants a
meeting. The Liaison role was transferred to the Project Leaders during the project
continuation period.)

A Project Orientation for all participating CBOs and liaisons was convened and
facilitated on April 4, 2006 (see agenda and meeting notes).

Follow-up monthly meetings, primarily targeted for front-line staff involved in the
project development, implementation, and evaluation, were coordinated to discuss
accomplishments and challenges related to contract deliverables. The 3-hour
monthly CBO meetings were held:
May 2, 2006
June 6, 2006
July 11, 2006
August 1, 2006
September 12, 2006
October 3, 2006
November 7, 2006
(Note: During the project continuation period, CBO meetings will be held
quarterly, most likely in February, May, and August 2007.)

A variety of EP materials were shared at the Orientation and monthly meetings.
Examples included:
o Dept of State Police Office of EM’s “Individual and Family Disaster
Preparedness”
o FEMA’s and ARC’s “Emergency Preparedness Checklist”, “Your Family
Disaster Plan”, “Food and Water in an Emergency”, “Your Family
Disaster Supplies Kit”, etc.
o MC OEM’s 2006 Emergency Preparedness Calendar
o DVD’s of the “All About Avian Influenza or Bird Flu” by ECHO.
o A list of Pandemic Flu Resources
o Emergency Kits (72-hour) from American Red Cross

Content experts invited to speak at the Orientation or to participate in monthly
meetings included:
o Kathryn Richer (NW Oregon HPO/HRSA)
o Dr. Gary Oxman (Avian/Pan Flu Overview)
o Sean Derrickson, MHASD A&D Community Services (behavioral health)
DRAFT CSPEC Final Summary Report - 3/8/2016
8
o
o
o
o
o
o
Adrienne Donner and Scott France, Citizen Readiness Initiative
David Gassaway and Rodney Rogers, American Red Cross
Kate Griffith, Coalition of Health Clinics
Jessica Guernsey, Avian Flu Outreach for MCHD
Cathy Harrington, City of Gresham
Virginia Lundquist, HPO Steering Committee, and Shaunna Stone (RN
student)
o Catherine Potter, Parish Health, Providence
o Anna Turner, Tri-Met
o Scott Winegar, Portland Police
Conference and Training Opportunities for CBOs
 Governor’s Briefings on Pan Flu (Summit in March 2006 and follow-up “Next
Steps in Pan/Flu Planning” in August 2006)
 Avian/Pan Flu training (June 27, 2006 training for CBOs)
Dissemination Issues
Issues of dissemination need to be discussed by the CBOs and the HPO’s Steering
Committee. Who will hold, maintain/update, and disseminate the Plans?
A short article briefly describing the project was submitted to the Oregon DHS Public
Health and appeared in their November 2006 electronic newsletter.
Project Manager’s Involvement in Related Meetings/Conversations/Community
Events:
 Metropolitan Alliance for the Common Good meeting with Pia de Leon
 Scott Bradway, City of Portland Water Bureau, re:“Boil Your Water”
 Public Health Emergency Special Populations Public Information Planning Task
Force, State of Oregon DHS
 Latino Coalition event in May 2006
 Avian/Pan Flu Communications committee
 Discussions re: integrating information from this project with Business Continuity
efforts (including DHS presentation on 10/25/06 at DHS)
 MC OEM website development to include CSPEC project overview
 Meeting with Scott France, Citizens Readiness Initiative
 Participation in HPO Coordinating System table top exercises
 Project Overview presentation at HPO Steering Committee meeting on Sept 18
 Participation in Community Surge Planning meeting on September 25
 Participation in PanDorA TTX on Nov 2
 Participation in Voluntary Emergency Registry project development (Aging and
Disabilities)
 Participation in meetings to discuss project and Oregon’s 2-1-1 system
 Ongoing meetings/communications with Jessica Guernsey to discuss project and
MCHD’s Avian/Pan Flu planning efforts
DRAFT CSPEC Final Summary Report - 3/8/2016
9

Discussions with Keith Berkery and Kerry Dugan to discuss project and City of
Portland’s Citizen Corps efforts, best use of UASI dollars, etc.
Other Connections/Contacts:
Maria Elena Wah-Fitta, Public Information Officer
Rhode Island Department of Health
Maria.WahFitta@health.ri.gov
(401) 222-3998
Maria asked if they could model part of Rhode Island’s community plan on ours, saying
of the project concept that, “your CBO Plan is fabulous” and it “seems so well thought
out!”
Monica Ochoa-Delgado, MPH
Chicago Department of Public Health
333 S. State St., 2nd Floor, Chicago, IL 60605
312-747-9691 office; 312-505-9910 cell
Ochoa_Monica@cdph.org
Monica, Community Relations/ Multicultural Affairs point person at the Chicago
Department of Public Health's Emergency Preparedness and Response Program, said they
are very interested in seeing our final report, because they are trying to do the same at
CDPH.
Pam Heilman, RN, MPH
Program Supervisor, CD, Immunizations and Emergency Preparedness
503-588-5612; 503-991-6917 - cell
Pheilman@co.marion.or.us
Pam has an intern working on a similar project in Marion County, Oregon and may have
her contact us for more information.
Scott Bradway, 503-823-1951, City of Portland Water Bureau.
sbradway@water.ci.portland.or.us Would like to link into the emergency system that
reaches culturally-specific populations when they have to send out “Boil Your Water”
alerts.
Public Health Emergency Special Populations Public Information Planning Task Force,
State of Oregon DHS, contact Christie Holmgren, 971-673-1310,
Christie.j.holmgren@state.or.us
Kerry Dugan, City of Portland, Chair of Portland Citizen Corps Council, 503-823-2360,
cell 503-793-5624; kdugan@ci.portland.or.us
Patty Rueter, POEM, 503-823-3809, prueter@ci.portland.or.us
DRAFT CSPEC Final Summary Report - 3/8/2016
10
Summary of CSPEC Project Findings (Report excerpts, paraphrases):
Ecumenical Ministries of Oregon/Russian Oregon Social Services (EMO/ROSS)
Assessment of Russian-speaking population (RSP) in the Portland Metro area
(Multnomah and Clackamas counties)
1. Basic Demographic Information
Assessments and focus groups were conducted at many different locations such as ROSS
Domestic Violence program and ESL classes, SOAR, IRCO, program for seniors, Jewish
Child and Family Services, Capitol Neighborhood House, program for seniors, Bernie
Road Child Care Center, Gunderson Safety Event, Euro-Bakery, and church “Salamita”.
Due to the short timeframe given for the project, the project participants did not reflect
the size and distribution of the main characteristics in the entire Russian-speaking
population (RSP) in Portland. For example, the average age of the surveyed group was
51.4, while actual average age of RSP is significantly lower. The majority of the group
members were younger women or seniors, and many participants were unemployed. This
discrepancy is because the assessment included ROSS’s social service clients who are
Russian-speaking newcomers with limited English skills, seniors, and women. However,
these participants were nevertheless considered ideal for the assessment, because they
represent the most isolated and the most difficult to reach (and therefore the most
vulnerable) in case of a Public Health Emergency (PHE).
While interpreting the data presented below, though, it is important to remember that the
surveyed group was lacking in employed middle-aged (40-65 years old) men. Due to the
culture of the RSP, men often make the important decisions in difficult and extreme
situations and thus play a leading role in the response to a PHE.
Gender:
206 people in the surveyed group. 100 participants were men and 106 were
women.
Marital Status
62% married
16% Divorced
6% Widow
16% Single
(82 participants reported having children under 18-years-old living with them.)
Age. Age of participants varied from 19 to 84, with an average age of 51. The age
distribution was:
19-40 years old = 41%
40-65 years old = 24%
65-84 years old = 35%
DRAFT CSPEC Final Summary Report - 3/8/2016
11
Immigration Status:
Refugee = 37%
Permanent Resident = 15%
Parole = 14%
Citizen = 31%
Unknown = 3%
As one could expect, the majority of the participants are newcomers, who immigrated to
the USA in the last decade. For this reason, the majority of participants are not US
citizens.
Educational Level:
Grade School = 20%
High School Diploma = 45%
Some college = 3%
BS = 31%
Unknown = 1%
Church Affiliation. 71 of the participants denied affiliation with any particular
church, and 135 reported affiliation with a church.
Other data showed that Pentecostal, Evangelical Christians and Baptists are strongly
affiliated with churches, contrary to Orthodox Christians. It is important to understand the
culture and dynamics of Russian churches in order to predict a response of the RSP to a
PHE. Those who are closely affiliated with a church are most likely to respond according
to the opinion and religious limitations of that denomination.
In addition, a large proportion of the residents of the SW Portland area are not affiliated
with a church, while a large proportion of the residents of the SE and NE Portland areas
are affiliated with churches. The same conclusions are confirmed by the map of Russian
churches. One of the leading reasons people live close to churches is that a significant
number of Russian churches forbid driving to the church on Saturday, the day of the main
weekly service. Thus, the community response will be different in different parts of the
Portland metropolitan area. Any government agency trying to reach the RSP of the
Portland metropolitan area should be sensitive to this.
2. Communication Methods the Russian-Speaking Community Currently Uses to
Disseminate Information
According to the results of the survey, the main source of information for the RSP is
television. This is true whether the person is or is not affiliated with a church.
Even though television remains the leading source of local news for the entire
community, the next leading sources differ for the RSP subgroups. For the churchaffiliated group, newspapers are the second leading source of information, followed by
pastors, family members, and friends. In the non-church-affiliated group, the second
DRAFT CSPEC Final Summary Report - 3/8/2016
12
leading source is family members and friends, and the third source is a tie between
newspapers and the Internet.
Television, direct contact, and newspapers are the three main ways that the RSP receives
information.
Television. Because television remains the main source of information for a majority of
the RSP (both church-affiliated or not), it makes sense to analyze which channels are
watched most frequently and thus have a bigger impact on delivering local news to the
RSP. The distribution of popularity of different TV channels is similar for churchaffiliated and non-church-affiliated groups.
The RSP watches local TV channels more frequently than the Russian channel. However,
if channels are compared separately, then as a single channel, the Russian channel is the
most popular. Unfortunately, the Russian channel is usually translated from New York or
California, and thus does not deliver local news in full or in a timely manner for the
Portland population. It can be used for educational and preventative programs, but the
channel has limited potential when it is necessary to quickly inform the RSP about danger
and official instructions in case of a PHE.
Considering local TV channels, channels 8 and 12 are leading channels for the RSP,
followed by channels 2 and 6. While filling out the assessment, many people reported that
in case of a PHE, they would watch local news even though they do not understand
English. One comment from a report reads as follows: “You would be surprised how
much you can get from just watching news, even without listening.”
During the discussion about possible use of local TV channels in case of a PHE, the
group of Russian-speaking seniors came up with a suggestion to have a 2-3 minute report
read in different languages on the local news instead of, or in addition to, the running line
on the bottom of the screen, which is difficult for the elderly to read.
Newspapers. Another major source of news is newspapers. Russian newspapers are much
more popular than local newspapers among all subgroups of the RSP. It is especially true
for Russian-speaking seniors who reported reading Russian newspapers only, which
makes sense considering most elderly newcomers have a low level of English reading
skills.
Thus, Russian newspapers are valuable resources for communicating with the RSP. As
with Russian television, Russian newspapers are not suited to immediate communication.
Even local Russian newspapers are published on a weekly or monthly basis, so they are
better suited to community education and preparedness planning for a PHE.
Pastors. One cannot overestimate the role of pastors in the church-affiliated group of the
RSP. Pastors are the second leading source of information for the church-affiliated group.
In a PHE, pastors would be key resources, providing information, support, and shelter as
well as food and clothes for those in need. However, the relationship between social
DRAFT CSPEC Final Summary Report - 3/8/2016
13
services or government organizations and pastors is often uneasy and few currently exist.
The lack of trust and openness is due to the fresh memory the RSP has of the Soviet
Union’s governmental persecution of pastors, religious people, and the church in general.
One can understand why the pastors are so careful and guarded in allowing outsiders to
use their churches as channels of communication. Developing a trusting, stable
relationship is still possible, but it takes a lot of time, effort, and mutual respect.
Family and friends. Church-affiliated people usually attend the same church and receive
the same information from pastors and other church members. Non-church-affiliated
people usually receive information from other family members and friends who have
better English skills who are able to receive the information through television,
newspapers and radio.
The significant role of family and friends as a source of news demonstrates once again
that the RSP has developed its own channels of information inside of the community,
where a majority of information goes from person to person via direct contact. This is
important to remember, because it also means that there is no necessity to inform the
entire community individually; it is often enough to inform its key members and rely on
the community’s capacity to spread the information among its many members.
3. Ways in Which the RSP Will Most Likely Respond to a PHE
Indicating whom they would contact first in the event of a PHE, a majority of participants
reported family members and friends.
The second contact reported was 911 services. Please note, that these 911 calls would be
informational calls, asking for the current situation and official instructions versus asking
for help. In this case 911 services could be severely overwhelmed and unable to help
those whose lives are in real danger.
Indicating where members of the RSP would go for health care in the event of a PHE, a
large majority of people said “hospital emergency rooms”, possibly overwhelming them.
Another response was “primary health care providers”, which means that many will rely
on local providers instead big hospitals.
How many of the participants have a primary health provider?
Most likely, at least 60% of the RSP would go to hospital emergency rooms or urgent
care centers of local clinics.
Know How to Provide First Aid?
No = 35%
Yes = 34%
Not sure = 31%
As one can see, educating the RSP about first aid basics can be another potential way to
protect the community in an emergency situation, as well as to decrease patient load for
big hospitals and clinics.
DRAFT CSPEC Final Summary Report - 3/8/2016
14
4. Considerations that influence their response to a PHE
When asked directly, the great majority (65%) of participants reported that they will
follow official instructions in the event of a PHE, such as a severe flu outbreak or
earthquake. 13% said it would depend on the circumstances. 10% said yes, if it didn’t
interfere with their basic life needs. 9% said they didn’t know and 3% said no. Thus, in
general, most likely the RSP can be considered compliant.
The participants were asked which considerations could potentially influence their
compliance.
The primary reported consideration is family. Many reported that they would visit their
family members despite official instructions to stay home, or would find their family
members first despite the official instructions for immediate evacuation and so on.
The second leading consideration is lack of English. Many participants expressed a
concern that they would not be able to understand the official instructions, or they would
be left out if there is a panic. If they stayed home or evacuated immediately, they are
concerned about getting updates of the situation or know about available resources/help.
The third leading concern is financial. Usually, newcomers have limited finances and live
from paycheck to paycheck without any savings or other financial resources. In addition,
many newcomers have jobs without options of flexible hours, sick leave, or vacations.
Not going to work, even for a couple of days, may put many families in such a state of
poverty that they would continue to work, even though it could be deadly dangerous for
them and their families.
The above generalities can be broken down by subgroups as follows:
The church-affiliated subgroup has strong community ties with each other and
communicates mainly in Russian. Their primary concern is lack of English, their second
is financial.
On the other hand, the non-church-affiliated subgroup places “lack of English” as a low
fourth priority concern. Financial concern ranks third.
Financial concerns are a very low fifth place for seniors, who often do not work and
receive their income from social assistance and thus won’t be as affected financially as
those who rely on their paychecks.
Family concern is high in all three groups even though it is not a primary one for any of
them. Health concern is a main concern in both non-church-affiliated (non-refugee status,
so lack health insurance) and seniors (i.e., because of their age) groups.
Another concern is lack of transportation for Russian-speaking elderly, especially for
those who live separately from their children’s family and their church community.
When asked about “gathering places” despite official instructions, the following
responses were obtained:
In an emergency situation, the church-affiliated group can be reached in their churches or
at work, and other groups will try to remain home and thus can be reached by television.
The only gathering places that may be used by all three groups are grocery stores; thus,
these might be used as an important informational channel in a PHE. It was suggested that
DRAFT CSPEC Final Summary Report - 3/8/2016
15
a multi-language flyer be given to the stores’ customers or a multi-language message be
announced over the stores’ intercoms. The stores’ willingness to cooperate is necessary
and might be difficult to obtain. unless PHE arrangements can be made with them in
advance.
The frequency of going to specific grocery stores was surveyed. The majority would buy
food from the closest grocery store, but among individual stores, WinCo was the leading
place, followed by Russian stores and Fred Meyer.
5. Emergency preparedness needs in the RSP
Only 34% of the RSP reported that they know what to do and how to protect themselves
and their families in the event of a PHE. The rest of the participants wrote that they don’t
know or are not sure what to do. This reflects a desperate need of the RSP for education
and training in emergency preparedness.
When asked about home storage of necessary medications, food and water, the
participants reported following:
38% of the participants reported having the necessary resources at home, while the rest
reported not having any resources or having only limited items. During the discussion,
while filling out the assessments, many people reported that they have enough food and
medications, but do not have sufficient water.
Asked about their awareness of an emergency plan at their children’s school or daycare,
only 20% of participants having children younger than 18 said yes.
Asked about their awareness of an emergency plan at their workplace, only 29% of them
said yes. These, again, demonstrate the need to find more effective ways to communicate
the importance of emergency planning to Russian-speaking employees and Russianspeaking parents.
Public Health Emergency Communication Plan
To develop the most efficient communication plan for the Russian-speaking population
(RSP) of the Portland metropolitan area in case of a public health emergency (PHE), it is
essential to become familiar with and understand the main traits of this diverse and
multicultural group.
2000 Census data shows that from 1990 to 2000, more people of Russian and Ukrainian
descent moved to the Northwest than to any other region in the country. Oregon is rated
second in the nation for Russian-speaking newcomers. It is estimated that there are now
over 100,000 Russian-speaking refuges and immigrants in Oregon. The majority are
Evangelical Christians, belonging to the Pentecostal, Baptist and Seventh Day Adventist
denominations. In the former Soviet Union, this group experienced many years of
governmental-sponsored religious persecution that engendered distrust of government
institutions and outsiders. Church members were punished for their religious commitment
with harsh social controls, jail time, and denial of education and vocational opportunities.
DRAFT CSPEC Final Summary Report - 3/8/2016
16
This resultant extreme social isolation has been preserved over time in order to insulate
themselves from further governmental repression.
Russian-speaking refugees/immigrants coming to America have carried this historical
background with them. These newcomers generally maintain this isolation position vis-àvis the larger society because of the class, language, and cultural and religious differences
that separate them from mainstream American culture. The Russian-speaking Evangelical
Christian community has many difficulties acculturating, a result of their unique culture
and lifestyle. Their devout religious culture is very different. For example, many live
walking distance from their church in order to follow their beliefs. Their challenges
include learning English, securing jobs that can support a family, learning American law,
rules, regulations and customs, coping with intergenerational family issues, domestic
violence, sexual assault and mental health issues. In keeping with religious beliefs,
Evangelical Christian women marry young, have large families – eight to ten children are
common – and manage the household. It is very difficult for children, parents, and entire
families to cope with the stresses of resettlement in a new country. Because of these
difficulties, it is easier for the newcomers to stay connected with each other, forming
multifamily communities with a church as its center.
Another significant group of Russian-speaking newcomers is a group of immigrants who
are not affiliated with any church. This group consists of but is not limited to Jewish
refugees, green card holders, mail order brides, those seeking asylum, and parole status
immigrants. This very diverse group of people has one thing in common – they are not
centralized around any specific church or religion. Even though they face the same
difficulties as other newcomers, they rarely join the larger community. Usually, they live
fairly isolated, communicating mostly with their family. This group often learns English
more quickly and are able to maintain stable employment easier. However, the older
newcomers from this group are often very isolated and vulnerable, have severe
difficulties learning English, and must cope with more employment and transportation
problems.
Obviously, ways of communication must vary for different groups of RSP. In the course
of the project, the assessment was conducted with representatives of different groups of
RSP in order to discover already existing informational channels that the RSP subgroups
use as well as the best way to reach the entire RSP in the event of a Public Health
Emergency (PHE). Avian or Bird Flu and pandemic flu situations were used as the
example of a possible PHE. The process of assessment, demographic information about
participants, and the results and analysis of the assessments were described in the earlier
section.
Response to PHE. According to the assessment, the large majority of church-affiliated
people will gather in their churches and workplaces. Thus, pastors will play a major role
as informational sources as well as providers of necessary help. Churches can help their
people with moral support, food and water as well as be a center for vaccinations and
medications distribution. In the event of a PHE, pastors might be more open to accept
help from governmental agencies and health care providers. The list of Russian churches,
DRAFT CSPEC Final Summary Report - 3/8/2016
17
with their exact addresses, names and phone numbers of the pastors, and number of adult
church members is in the Contacts List document.
Prevention and education. The results of the assessment clearly showed that the RSP
awareness about necessary actions in case of PHE is very low. Even though there is a lot
of information available about Avian or Bird Flu, the knowledge about these diseases
among the RSP is extremely limited, and so is their knowledge about emergency planning
in their workplaces and their children’s schools. The ability of RSP to provide basic first
aid in case of a PHE is also very limited.
Many informational channels can effectively provide a basic education to the RSP, as a
part of this public health emergency project , in order to decrease the potential damage of
the PHE and to prevent severe overload to 911 services and central health providers such
as emergency rooms and urgent care centers.
According to the results of the assessment, the most effective ways to educate Russianspeaking people are Russian television and local Russian newspapers. Culturally sensitive
Russian articles and TV programming can be an effective and relatively inexpensive way
to increase general awareness in the local RSP. While it is easy to contact local
newspapers (their telephone numbers are in the Contact list), contacting Russian
television can be more difficult because programming is translated mainly from
California and New York. However, building a relationship with Russian television may
prevent the overwhelming of our health care system in the event of a PHE.
Churches still remain a strong informational source, even though, as described above,
relationship development with them can take a lot of time.
In addition, social service providers, working with the RSP on a daily basis, have a strong
potential to increase prevention and educational efforts in the RSP. Every day dozens of
social workers help dozens of Russian-speaking newcomers. The social services already
have strong connections in the community members and leaders. Thus it would be easy
for them to use their community connections to provide PHE education for the RSP.
Regardless of the way chosen to pass the information to the RSP, one should be
extremely careful about the way the information is presented in order to avoid
unnecessary panic among the RSP. Newcomers to the U.S. can easily overreact to the
simple message of preparedness. Thus the message should be conducted in a caring
manner, as a part of an obvious educational effort.
DRAFT CSPEC Final Summary Report - 3/8/2016
18
Asian Health and Services Center (AHSC)
Assessment of the Chinese and Korean populations in Multnomah and Washington
counties
AHSC’s research indicated that although the County may have effective means of
communicating with its own internal departments, and with organizations that reach the
English speaking population, the non-Enlgish-speaking Asian community still remains in
some degree of isolation from this communication network. For example, local Asian
language (e.g., Chinese and Korean) media is primarily printed and not broadcast, which
may slow its ability to pass language-specific information during a large-scale
emergency.
Asian American Communication Methods
Public organizations historically used to transmit health information may not be preferred
resources at least partly because they have not yet sufficiently bridged the language gap.
Many County departments including health centers and libraries may carry information in
Asian languages, but their environments are predominantly non-Asian language-oriented
and therefore do not attract large numbers of Chinese-only or Korean-only speaking
individuals in the first place. Even the many Asian language materials available on the
County internet site require some amount of English proficiency to access.
One of our most significant findings was that the overwhelming majority of Asian
Americans surveyed, including those with a very high level of English proficiency, felt
that language would be a barrier to accessing health services in an emergency or disaster.
A closer examination of our survey data revealed that of the 31% of the subjects who
completed the survey in Chinese and who had the highest performance in the English
proficiency section, many still answered that they expected language to be a barrier to
accessing health services in an emergency even though they had a very high level of
reading comprehension. 23% of the subjects who chose to fill out our survey in English
also answered that they expected language to be a barrier to accessing emergency health
services for them. This data suggests an unusual lack of confidence in emergency
communication processes between the county and the non-native English speaking Asian
community.
Cultural paradigms also influence how information is spread within the Asian
community. One of the many examples of this could be that a hospital or County health
center may not be a primary health resource for a family that uses Chinese or naturopathic
medicine. Also for many elderly, disabled, retired and unemployed Asian Americans,
family, friends and social contacts play a larger role in health education which may be an
overlooked communication pattern within the community. These types of individuals in
every community depend more on the government for assistance during disasters while at
the same time having even more barriers to accessing information.
In summary, the avenues currently used to reach the Chinese and Korean communities
may not be the most effective ones in an emergency, due to linguistic and cultural
differences between the mainstream and minority populations. Our experience as a health
DRAFT CSPEC Final Summary Report - 3/8/2016
19
resource in the Asian community tells us that many County organizations are in some
communication aspects external to the Asian community itself. The data from our survey
and our observations suggest that most health information that reaches individuals in the
Asian community comes from sources within that community.
A more detailed analysis of current Chinese and Korean communication methods will
follow in the Survey Results section of this report. Finally, our proposal explains
potential ways to open emergency communication flow between the community and
County.
A total of 625 surveys were collected over a period of 1.5 months. The questions in our
final survey can be generally grouped into three categories: demographic, emergency
communication and emergency/disaster preparedness as follows:
Demographic information questions focused on natural categories that would group
survey information such as country of origin, citizenship status, age, zip code, etc.
Initially this information has given us a detailed depiction of the diversity within our
survey group, and contextualized the rest of the data to represent the condition of the
whole community. In later analysis, the information on these surveys can be divided to
represent responses from subgroups within the Chinese and Korean populations because
it includes details about each subject that would affect his or her response to an
emergency such as language, employment, disability, English proficiency, etc. In fact,
the structure is such that many different factors can be correlated by returning to the data
from the original surveys.
Emergency communication questions are designed first to examine previous and
current methods of transmitting emergency information in the community in order to
determine the most efficient communication methods in use. These questions reveal
many differences between effective mainstream emergency communication and
linguistically and culturally specific emergency communication. The information we
collected here helped us develop our emergency communication plan proposal.
Emergency Disaster Preparedness questions are designed to thoroughly assess each
individual’s personal preparedness for any kind of emergency/disaster in order to
determine the preparedness needs of the community and the immediate needs that will
arise should an emergency/disaster occur. This information may be useful to the County
and community organizations in their efforts to reduce the immediate and long term
effects of a community disaster or health emergency.
Finally we created some free response questions to provide a way for community
members to suggest their own solutions to the challenge of promoting greater awareness,
preparedness and wider circulation of emergency information.
Survey Results and Analysis
The following are responses to questions on the Emergency Communications Survey that
we found to be most reliable. A small number of the results from questions on the survey
DRAFT CSPEC Final Summary Report - 3/8/2016
20
were omitted from this report because a significant number of the subjects gave unclear
responses, or the responses rendered the question itself less pertinent.
As shown, the majority of subjects surveyed have lived in the country over 5 years and
are eligible or have already achieved citizenship. Due to the difficulty of immigrating to
the United States from Asia, and to the length of time necessary between immigrating and
being able to sponsor the immigration of another relative, we believe that the data shows
an accurate sample of the general citizenship of the entire Chinese and Korean
community.
The following information differentiates between the languages subjects consider
themselves fluent in speaking and reading. For instance, Mandarin and Cantonese
Chinese are identical in print, but are very different spoken languages. Our intention was
to examine which languages would be appropriate for printed material and verbal
communication. (For example, some Asian Americans have a higher reading
comprehension of English than confidence speaking it, although this was not particularly
substantiated by data from this survey.)
Questions to determine percentage of subjects with low income or disabilities were
worded in a culturally characteristic indirect manner:
Do you receive security supplement income?
Do you receive disability benefits?
We included a vocabulary-related question in order to be able to separate the emergency
communication responses later in the survey by the English proficiency of the subjects.
In further analysis, we will be able to see how responses differ according to individuals
ability to understand written English.
Nearly 100% of the English surveys were completed by individuals bilingual in Chinese
or Korean.
Emergency Communication Questions
The following questions were designed to determine emergency communication methods
in the Chinese and Korean communities. Some questions focus on communication
methods already in use, some which have previously been used, and anticipated
communication methods should an emergency or disaster occur in the future. The
subjects were asked to respond to the best of their ability based on their own previous
experience and expectations. Of course, analysis of this data should be undertaken with
considerations for the limitations in the ability of the survey subjects to draw on previous
experience and extrapolate about future situations.
The next two questions yielded unreliable data. (Please note that question 14 was omitted
from the survey.)
Question 13: Have you ever been involved in any of the following disasters in the
DRAFT CSPEC Final Summary Report - 3/8/2016
21
United States? Flood, hurricane, typhoon, tornado, power outage, blizzard, winter
storm, earthquake, volcano, landslide/mudslide, tsunami, fire, hazardous spill,
bombings, terrorist, chemical threat, disease epidemic, etc.
If no please skip to question 16.
Of the subjects that answered this question, 148 said “Yes,” while 276 said “No.” A
significant number of those that answered “No” continued to answer question 15 about
how they received emergency information from the government in a disaster they
experienced in the United States, even though they said in the previous section that they
had never experienced a disaster in the United States:
Question 15: How did you receive information from the government in the above
disaster/s? Circle one or more.
Therefore, we were led to assume that the answers collected for question 15 represented
methods of emergency communication that were used in the United States and in some
subjects’ native country, thus confounding the data. Unfortunately, a correct sampling of
this information would have given us great insight into current communication methods
in the United States.
Question 16 revealed that 93% of the subjects who answered this question would be
willing to comply with government instructions if they received them. This question was
also discussed in the preliminary focus groups before the final survey was developed.
There was almost no controversy on the topic of compliance with government
regulations. Many subjects who participated in the focus groups had experienced or had
relatives who experienced wide-scale health emergencies in Asian countries, including
pandemics. Government regulation was integral in those situations.
These results emphasize the prevalence of health information spreading by word of mouth
through family members and friends. Local TV and Radio are perhaps primary resources
for families with at least one English speaker. Since satellite TV was not an option, many
people may have answered “Local TV” meaning that they will find out about whatever
disasters occur in the United States via TV on a Chinese speaking channel which would
have a significantly delayed announcement about local disasters. Asian language
newspapers also seem to be an important medium, with some delay in emergencies since
many local Asian Language newspapers are printed weekly.
Question 30 asked subjects if they knew where to get information about how to prepare
for an emergency. The responses were almost evenly split with 52% saying “Yes,” and
48%, “No.” Nearly half of subjects were therefore unable to answer the next question:
Question 32 asked who would make direct contact with each survey subject in an
emergency: One less obvious result of this data shows the importance of religious
associations for the subjects who completed the survey in Chinese or Korean.
Then we asked about the ability of subjects to contact other people on their own:
DRAFT CSPEC Final Summary Report - 3/8/2016
22
Question 33: Which of these can you contact on your own?
Family members at work and Relatives in the Portland area were largest response.
Question 38: Where would you go to get info during a disaster?
Most answered family members.
Finally, two of our free response questions concentrated on emergency communication.
It is important to remember that the majority of survey subjects did not chose to write
responses to these questions. However, some of the ideas from subjects that did respond
are revealing.
Question 40: What would be the most convenient place for you to receive health or
disaster information?
The top two responses to this question were first “TV,” and second “community center”.
The next highest responses were “Hospital/Clinic,” and “Internet.” Other responses
included radio, church, newspaper, school, family, police station, Chinese market, library,
residence management office, fire station, government office, bank, phone call, post
office, mail.
Question 41: What else could the government or community do to help you access
emergency and disaster information?
The top responses to this question suggested the government could provide access to
emergency information through TV in some way, either by a 24-hour information station
or otherwise. The next most popular answers were to provide access to information
through community centers, and radio. Other answers included translating materials,
hosting citizen information workshops, establishing an emergency information phone
line, offering free emergency/disaster kits, enlisting Chinese and Korean volunteers, and
sending information by mail.
Emergency Preparedness Questions
The following questions were intended to assess the emergency preparedness condition in
the Chinese and Korean communities. They also include questions that ask subjects about
what issues they expect to deal with in an emergency. This information may be valuable
in directing the County and community leaders in their efforts to improve individual
preparedness in minority populations. It also may be useful in anticipating the needs of
the community which the government must address should a disaster occur.
Questions 19-22 asked if subjects expected certain factors to be barriers to accessing
healthcare during an emergency. The answers were:
Language: 32% yes; 40% no answer; 29% no
Insurance: 44% yes; 20% no answer; 36% no
Financial situation: 42% yes; 20% no answer; 38% no
Immigration Status: 29% yes, 18% no answer; 53% no
The placement of question 19 on the bottom of page three of the survey may have made it
more difficult to see, or for some other reason twice as many survey subjects chose not to
answer that question than the other 3 questions in the series. Therefore, the language
DRAFT CSPEC Final Summary Report - 3/8/2016
23
barrier is even larger than the data here can denote. However, this data does suggest some
amount of confidence that Chinese and Korean Americans have in their immigration
status.
Question 24 asks if subjects “expect to have access to important community health
information during an emergency,” with 84% of subjects answering affirmatively. The
English meaning of “expect to have” may have been altered somewhat in the translation
of this question. Subjects more likely were voicing that they “should have,” “hope to
have” or “feel it is [their] right to have” access to important community health
information during an emergency.
Almost as many subjects who answered that they would use their household vehicle,
answered that they would evacuate using public transportation or on foot. This could
explain why over 54% of subjects answered “Yes” to the next question:
Question 26: Do you expect transportation to be a problem for you if you need to
evacuate the city?
Fewer than half of respondents said “No.”
The next set of questions are also “Yes” or “No.” Some of these questions were also
asked in the preliminary focus groups and education seminars before the final survey was
distributed. Although the data from the responses given in those discussions is not
represented here, when the questions about 72-hour kits, first aid, emergency contacts,
safe water and emergency plans were explained more fully, many of the participants who
had initially answered “Yes,” decided to change their answer to “No.” Unfortunately we
were unable to offer the same detailed explanations to every individual who completed
our survey. For this reason we consider these percentages to be extremely optimistic
about the current emergency preparedness situation in the Chinese and Korean
communities. Also from this data we determined that there is a larger, more dangerous
problem than unprepared-ness in this County: many community members do not realize
how unprepared for a disaster or emergency they really are. If one assumes that a 72hour emergency kit is simply the recommended articles scattered in different locations
throughout the house, then perhaps they will not make an effort to make a legitimate
emergency kit, or even find out what a real emergency kit is. (The percentage of people
who did not answer these questions was in every instance below 20%, often below 15%.)
Have a complete 72-hour emergency kit, including medications? Yes = 43%; no= 57%
Know how to acceses safe water during an emergency? Yes = 49%; no = 51%
Have an out-of-state emergency contact? Yes = 43%; no = 57%
Know any first aid? Yes = 42%; No = 58%
Survive in home without outside help for 3 days? Yes = 64%; No = 36%
Survive on own for 3 days if had to leave your home? Yes = 62%; No = 38%
Still, only one third of total survey subjects answered that they knew their own household
had an emergency plan, and it is difficult to determine what that third meant by
“emergency plan.” Our small group discussions revealed “household emergency plan” to
DRAFT CSPEC Final Summary Report - 3/8/2016
24
be a very broadly defined idea, sometimes not even including an outdoor meeting place,
or a list of alternative exits in the home.
Question 39, a free response question asked subjects what would make them feel more
prepared for an emergency/disaster. The most common idea was something to the effect
of having emergency information printed or broadcast in Chinese and Korean, and
offering emergency kits. Other responses included offering disaster training and
preparedness seminars.
In conclusion, the results of the emergency preparedness questions on this survey
indicated areas where emergency preparedness is inadequate, but also underscored the
theme that the more massive inadequacy is in emergency education. Uneducated,
unprepared victims of a disaster or health emergency in any community will complicate
any government efforts to inform, warn, receive communication or coordinate relief.
Summary of Key Issues
After reviewing the responses to the survey questions, several important factors are
apparent. The following is an outline of the key issues emphasized by the results of the
survey.
Communication Issues:
1. Language-Communication in the Chinese and Korean communities occurs in Chinese
and Korean, between entities within those communities. If government or County
communication processes do not effectively make language-sensitive information
available through sources that Chinese and Korean people already use, that information
will not reach these minority populations in a meaningful way.
2. Culture-County and government emergency information must be communicated in a
culturally appropriate manner to community members who do not access conventional
informative resources. The County must not assume the sources that distribute emergency
information to the mainstream public will be effective in distributing to the minority
groups.
3. High-risk Subgroups-Disabilities, aging, low-income, unemployment and other
factors increasingly isolate individuals within minority communities. The County must
find ways to involve these vulnerable groups in the emergency communication process.
Emergency Preparedness Issues:
1. Education-Chinese and Korean residents of the County do not know how to prepare
for an emergency. They are unaware of the ways in which they are at risk if a health
emergency or disaster occurs. This problem is compounded by the fact that in many
cases, residents think they are more prepared than they actually are. The County must
take immediate measures to increase awareness and preparedness in the Chinese and
Korean communities.
2. Transportation-Many members of the Chinese and Korean communities depend on
public transportation. If a large-scale health emergency occurs, for example an epidemic
that would limit public transportation services, or a disaster which would require the
DRAFT CSPEC Final Summary Report - 3/8/2016
25
evacuation of the city, the County must develop a plan to provide transportation to these
individuals.
3. Access to Health Care-Many Chinese and Koreans either do not have insurance, or
for some cultural or linguistic reason, do not frequently access health services. The
County must ensure that health services are provided to them in the event of an
emergency or disaster, and that these individuals are made aware that health services will
be provided to them and how.
AHSC Emergency Communication Plan Proposal
The nature of Chinese American and Korean American communities is family-oriented
and group-oriented. Stronger association with family and community groups is in part a
natural reaction to the difficulties of living behind a language and culture barrier in a nonnative country. It is also due to the immigration process that allows family members to
sponsor each other’s immigration to the United States. Most Chinese and Koreans in
Multnomah county have some involvement in one or more culturally-specific community
based organization/s. If for some reason an individual is not affiliated with any
community organization, it is extremely likely that they have at least one immediate
family member who is. If information reached the leading Chinese and Korean
community based organizations, it would dramatically increase that information’s
potential to reach every individual in those communities.
Most health information that reaches individuals in the Asian community comes primarily
from sources within that community. Based on the information we have obtained though
this project we propose that the most effective way to transmit information throughout the
Chinese and Korean communities is to use a partnership with organizations already
inside those communities. These organizations have already established culturally and
linguistically appropriate relationships with members of the target communities and will
be able to act as a communication bridge between the county and the minority population.
Not only are the Asian community organizations able to breach language and cultural
barriers by operating mainly in Chinese or Korean in a culturally-sensitive manner, many
of them also currently provide services to the elderly, disabled, low-income, unemployed,
uninsured and non-naturalized groups within the Chinese and Korean communities.
Our proposal is a network structure through which the County can communicate with the
most influential Chinese and Korean community-based organizations who can then pass
information to the Chinese and Korean public. This network structure addresses key
communication issues by allowing the County to work through organizations with more
direct access to the target communities . The structure also enhances the county’s ability
to increase emergency preparedness and awareness in the key areas outlined in the
previous section.
The Asian community in Multnomah County is diverse enough to prohibit trying to
communicate with every member through just one agency. Ethnicities within the Asian
community are separated by the same factors (language, culture, etc.) that separate them
each from the mainstream population. The top Asian ethnicities in Oregon since 2000 are
Chinese (over 20,000 people), Vietnamese (nearly 19,000) and Korean (over 12,000).
DRAFT CSPEC Final Summary Report - 3/8/2016
26
These populations each have well-established community organizations with whom the
County may cooperate individually so as to utilize the very most sensitive methods to
communicate with Asian subgroups. Any further simplification or reduction of a
communication network in the Asian community would drastically reduce it’s efficiency.
The plan envisions government and county agencies contacting leaders of communitybased organizations and providing essential information to them in the event of a
widespread health emergency. The leaders will then employ the communication methods
currently used by their agencies to transmit the emergency information to the
communities they serve. The AHSC will be instrumental in compiling an initial list of
leaders of organizations who have agreed to become county emergency contacts. The
County may choose to continue to develop the communication network by meeting with
or contacting these leaders on a regular basis (at least often enough to keep contact
information and health information current), and adding new contacts to the list through
research and publicity. The goal is to have a diverse enough list of organizations to
provide access to the widest possible range of community members and will include
service agencies, churches, health centers, cultural associations, businesses, etc.
Following compilation of such a list, the County may enlist the AHSC or its own
departments in giving the leaders of these organizations more details about the
Multnomah County Health Department and the Northwest Oregon Health Preparedness
Organization’s Culturally-Specific Populations Emergency Communications Project, and
may also provide each leader with current emergency preparedness educational
information to use as a reference and to distribute. Committed leaders may provide the
County (directly or through the AHSC) with more information about the communication
methods of their organization, details about the populations they serve, and any
emergency preparedness measures already being taken by their organization. These
contacts will become an indispensable link between the County and the Asian minority
populations.
When the county-community communication network is in place, the possibilities for
transmitting and receiving information increase dramatically. County departments may
use the structure to commence more intense educational initiatives through the contact
organizations. They may more fully investigate other communication methods like Asian
language broadcasting and publishing possibilities. Leaders of the contact organizations
may be able to help involve more community resources in developing solutions to
primary and secondary emergency and disaster issues like transportation and healthcare in
the Asian community. Each organization may contribute to a registry system for
vulnerable and high-risk individuals so that the locations and special needs of these
individuals can be immediately accessed by County departments during emergencies or
rescues. Finally, drills, tests and simulations can be hosted in the target communities
using this communication plan. Together we will have created an innovative
communication bridge to the Asian community.
DRAFT CSPEC Final Summary Report - 3/8/2016
27
Immigrant and Refugee Community Organization (IRCO)
Assessment of the Cambodian, Hmong, Lao, Mien, and Vietnamese communities
Emergency preparedness and awareness and a clear communications plan for use during a
disaster diminishes the health risks to the entire public. Usually when an emergency
occurs, information and instructions are distributed to the public through television, radio,
print and internet medias or directly through local emergency and community public
health agencies. However, populations of lesser diffusion or hard-to-reach communities
such as limited-English speaking or culturally specific populations require additional
measures.
IRCO’s Assessment included focus groups, meetings and surveys within five major SE
Asian Communities in Region 1 to identify community contacts and develop a
communication plan for the emergency and public health agencies to use to improve
emergency preparedness and response among the six SE Asian communities. Region 1
includes: Clackamas, Clatsop, Columbia, Multnomah, Tillamook and Washington
counties.
The assessment was conducted among five culturally specific communities as identified
by HPO and included:
1. Cambodian
2. Hmong
3. Lao (also referred to as Lowland Lao to distinguish Lao who are not Mien or Hmong)
4. Mien (also known as Iu-Mien)
5. Vietnamese
The populations assessed included refugees, immigrants and U.S. born 2nd and 3rd
generation community members. The targeted populations included seniors, adults, and
youth, living in rural and urban centers.
This report and written communications plan for an avian flu outbreak/pandemic flu will
present some of the cultural methods among the Cambodian, Hmong, Lao, Mien and
Vietnamese communities in how they approach emergency preparedness, their levels of
preparedness and how public health agencies and individuals can contact and work with
these communities before, during and after an emergency. One caveat is that this report is
preliminary and should not be considered a comprehensive review nor a final report of
these communities as a whole. It is very difficult to present any generalizations about a
cultural group or ethnic community because they are continuously evolving. In addition,
there are always exceptions and invariably the accuracy of such generalizations can and
should be continually questioned, scrutinized and verified by the communities being
discussed. Also, because of the varying levels of acculturation and integration between
these various communities and the public in general, barriers to public health agencies
during an avian flu outbreak/pandemic, responses to avian/pandemic flu emergency
announcements and health belief systems and practices during an avian flu outbreak
/pandemic are also diverse and need more in-depth research and documentation.
DRAFT CSPEC Final Summary Report - 3/8/2016
28
IRCO conducted meetings, focus groups and surveys with community leaders and
influentials, key members, seniors and youth to assess community communication
networks and media commonly used by community members and emergency
preparedness needs in each targeted community. IRCO hired Community Outreach
Specialists for the following communities: Laotian (Lao, Hmong, Mien) and
Vietnamese. IRCO used a volunteer Cambodian Community Outreach Specialist to work
with the Cambodian community.
Assessment Tool: The IRCO Emergency Preparedness survey was a nine-page multiplechoice questionnaire. A shorter one-page survey was also developed for use in large
community gathering events and for telephone calls. The nine-page IRCO survey
included demographic questions as well as questions assessing the level of community
knowledge about emergencies and public health agencies, public emergency
communication media, pandemic and avian flu, contact information of trusted key
community influentials, and places people go to during emergencies. The one-page
survey assessed community members on knowledge of pandemic and avian flu, level of
emergency preparedness and ability to identify key community contacts that the
community members go to for information in the case of an emergency.
The shortness of this project necessitated that the information gathered be used as a
preliminary guide to more in-depth work with the targeted populations. The information
gathered was from available key community leaders and members – thus the numbers
reached were only a small though knowledgeable and credible portion of the overall
community population. Special sub-groups within the targeted populations (i.e. mentally
ill, limited-mobility/home-bound, sub-ethnic/religious groups, etc.) were not actively
assessed though seniors and youth populations were sought out for the assessment and
survey.
Data gathered focused on:
• Communication dissemination.
• Barriers that exist in communicating during an emergency.
• Trusted community influentials and contact information.
• Misconceptions when communicating with specific populations during an emergency.
• Expectations of the community during an emergency situation including pre- and postplans. IRCO SE Asian Outreach Workers augmented this by reviewing literature on the
culturally-specific populations to note findings with regard to community communication
practices and demographics from the following resources:
• SE Asian American Mutual Assistance Association Directory, SEARAC, 2000
• Directory of SE Asian American Community-Based Organizations, 2004
• Lao or Laotian, NAFEA (National Association for the Education and Advancement
of Cambodian, Laotian and Vietnamese Americans, 1989
• Transnational Aspects of Mien Refugee Identity, Dr. Jeffery MacDonald 1997.
• Cross-Cultural Understanding Training Materials provided by IRCO
• Fact Sheets Series: Laos, The Hmong, The Mien compiled by Hongsa Chanthavong
1990
DRAFT CSPEC Final Summary Report - 3/8/2016
29
Demographics
U.S. and Oregon County 2000 Census data and the 2005 U.S. Census American
Community Survey were used to assess the five targeted communities’ population size in
the six Region 1 counties. Oregon and Washington have the 5th largest (5-6% of the total
population) number of Asians in the United States. Unfortunately, the U.S. census does
not delineate the various sub-groups of Asians, except for Chinese, Filipino, Korean,
Japanese and Vietnamese and so the following information is based on U.S. Census data
that is inclusive of all “Asian groups.” Population counts specific to Cambodian, Hmong,
Lao, and Mien living in the seven counties are from local community experts who have
knowledge of their community’s size and location.
The Cambodian, Hmong, Lao, Mien and Vietnamese communities within Region 1 are
diverse, and barriers to communicating with the various sub-groups within these
populations are just as varied. The vast majority of these communities settled in the urban
centers of Clackamas, Multnomah and Washington counties with only a handful of
individuals/families from these communities in the more rural counties of Clatsop,
Columbia and Tillamook counties. Many within our target communities travel at least
once every one or two years back to their home country and have strong ties to their home
countries. Comments by community leaders and influentials agreed that those in their
communities who did live in the three rural counties received their information from
those located in the three more urban counties of Clackamas, Multnomah and Washington
and thus did not rely on their home County’s communication networks.
In general, SE Asian Cambodian, Hmong, Lao and Mien family numbers average 5
people in a household. The Vietnamese community was the only group that had census
data available for all counties in Region 1. However, community leaders/influentials in
that community do concur that the census under-represents the Vietnamese population
size, because many are reluctant to fill out census data forms. Local experts place the
Cambodian population in Clackamas, Multnomah and Washington counties at 5,500;
Hmong at 3,550, Mien at 2,500; Lao at 6,000; and Vietnamese at over 30,000.
Following is a summary of ideas and recommendations from the IRCO questionnaires,
readings and conversations with community influentials who know how to work
effectively with the targeted SE Asian community populations:
Communication Channels
Survey responders and community influentials highlighted the strong role community
networks, associations, respected persons and community centers play in disseminating
information throughout the community. However the transmission of information by
word-of-mouth was revealed to be the most effective way of communicating with the
targeted SE Asian communities – especially when the message concerned emergency
preparedness information or instructions. Word-of-mouth was usually done through oneon-one contact in person, face-to-face in a group or by telephone/cell phone. The wordof-mouth was the way our targeted communities built trust and was the most effective
DRAFT CSPEC Final Summary Report - 3/8/2016
30
tool used by community messengers in working with the communities and all their subgroups and at all levels.
Many in the communities we surveyed relied on cell-phone/telephones for giving and
receiving information from trusted sources. When cell phones/telephones were not
available, people relied on community gathering places to give and receive information.
In terms of emergency preparedness or during a pandemic or avian flu outbreak, many in
our targeted communities expected to be able to walk or travel to community gathering
centers and meet fellow community members face-to-face regardless if telephones/cell
phones were available.
The community gathering places and those within the communities who are trusted to
give and pass on information are called messengers.
Messengers
Community-based Mutual Assistance Associations(MAAs), Community Influentials, and
Community Religious Centers play key roles in the community communications networks
of Cambodians, Hmong, Lao, Mien and Vietnamese. MAAs, community influentials and
community religious centers were considered by surveyed community members as highly
credible and trusted channels for disseminating emergency communications and for
providing support and comfort. Other channels were newspaper, radio, television and
internet news sources. Messengers act as reliable and trustworthy “communication
bridges” between their community and the outside Western-based community service
agencies, institutions and other organizations and media. The use of such established
community communication networks ensures that emergency and related messages are
disseminated to community members with trust and credibility.
MAAs (Mutual Assistance Associations):
Mutual Assistance Associations or MAAs as they are more commonly referred to, are
community-based organizations that promote, protect and in many cases preserve cultural
traditional social practices and structures. Many times, they serve dual or tri-community
roles as religious institutions, community councils, and/or secular organizations such as
traditional schools.
For many SE Asian communities, MAAs were developed to either take the place of or be
the public (sic Western) face of more traditional community councils made up of elders.
For Westerners, MAAs are the best place to begin in delivering information to
Cambodian, Lao, Hmong, Mien and Vietnamese communities during a public health
emergency. Each ethnic group has had at least one MAA since the early days of SE Asian
refugee resettlement and there are many MAAs in each ethnic group at the present time.
These MAAs remain important institutions for interfacing between non-community
individuals, agencies, institutions and organizations and the community. They also
provide assistance to its members, mobilize community support and civic participation,
represent the community in the American social and legal realms, advocate for the
DRAFT CSPEC Final Summary Report - 3/8/2016
31
community, and facilitate delivery of information to their communities and provide
information back to the response organization. MAAs can also revolve around political,
tribal, or religious groupings or other community-based activities that preserve traditional
cultural practices like language or dance. MAAs can vary as to their degree of community
“clout” and ability to interface between the community and Western-based individuals,
organizations and agencies. In general, the MAAs are the best and most useful place to
begin in delivering emergency information to each community as they can help in getting
the information to their respective communities quickly and effectively. In her research
on Lao, Mien and Hmong, IRCO, 1988, Grace Merchant wrote:
For Americans, the Mutual Assistance Associations (MAAs) are usually the best place
to begin. Each ethnic group has at least one MAA and some have several. These
MAAs are primarily led by males, but there are some women’s MAAs (i.e. Lao
Women’s Association). These organizations have been formed to provide assistance
to members of their communities and serve as cultural liaisons for Westerners. MAAs
very in power and effectiveness, sometimes formed along political or religions lines,
some are created solely in response to Western demands for “leaders”. These elected
representatives are usually bicultural and fluent in English. They often serve as
guides and interpreters for the more traditional leaders who are older and not usually
fluent in English. Thus MAAs are the best and most useful link to the ethnic
communities, but do not necessarily represent the views and beliefs of the majority.”
Ms. Merchant’s research findings can also be generally applied to the Cambodian and
Vietnamese communities as well.
The Vietnamese community is considerably larger and as such more varied than the other
SE Asian groups in this report. However, even in the Vietnamese community, MAAs still
play a major role in disseminating information, but the degree to which a Vietnamese
individual will participate actively in a MAA or heed an MAA’s decree or decision
depends on their location (urban, rural), whether they are 1st, 2nd or 3rd generation and
their degree of acculturation into American society.
Community Centers (Places of Worship e.g., Temples, Churches, Mosques, etc.)
Community Centers that revolve around religious practices are other places that can help
facilitate delivery of information to the community during a public health emergency. In
the SE Asian targeted communities, such places revolve around Buddhist temples,
Christian churches, and Spiritual Leaders’ homes. Many places of worship also act as
major community MAAs. One caveat is that SE Asians who arrived as refugees tended to
adopt the religious practices of their sponsoring organizations or families. In addition,
many of these same refugees continue to keep and pass on various traditional spiritual
practices regardless of their formal religious affiliations. Thus, even though someone may
be active in a Christian church, they still may have ties to a Buddhist temple or other
traditional spiritual practice because of annual or ancestor-based rituals, healing practices
or other culturally-based belief rituals. There is little or no statistical research on the
religious make-up of community members in each of the targeted communities. Thus,
most of the information will be generalized facts rather than numbers or percentages.
DRAFT CSPEC Final Summary Report - 3/8/2016
32
Cambodian: Most of the population is Buddhist with the rest of the population gathering
in Christian churches. There is a small number who are neither Buddhist nor Christian.
There is one major Cambodian Buddhist temple, Wat Dhammarangsi, that is located in
West Linn in Clackamas County. It is more commonly known by its MAA name and not
by its formal Temple name. In fact, very few Cambodians use the proper name of Wat
Dhammarangsi and refer to it as “Cambodian Buddhist Society of Oregon,” “The
Temple” or “The Buddhist Temple.” When referred to as the Cambodian Buddhist
Society of Oregon, the Wat functions as the central point to which and from which other
Cambodian MAAs and individuals intersect and interact.
The majority of Cambodians who do not go to the Temple tend to go to a Protestant
church. The major church is the Cambodian First Baptist Church (American Baptist
Church Ministry- Portland). It is acknowledged by community leaders that there are those
who do not attend the Temple or a Christian-based church such as Cambodian First
Baptist, but community influentials state that is a very low number.
Hmong: Mainly divided between practicing Animism and Protestant Christianity, each
offers community gathering places and is used not only for religious purposes but as
places where community social networks are created, strengthened and/or maintained.
The Hmong Animists meet in several places in small groups or as individuals with the
Spiritual Leader. There is no specifically designated building that serves as a place of
worship, but the Spiritual Leader’s home or place(s) of ritual practice can and does serve
as that “Community Center.”
The Hmong also attend two main Protestant Christian denominations, each of which has
several churches in Region 1: Christian Missionary Alliance Churches (CMAs) and
Trinity Churches (Protestant)
Lowland Lao: Refers to Lao who are not ethnic Mien or Hmong. Most Lowland Lao are
Buddhist, especially those who are first generation or who are seniors/elders. The rest of
the community attend some type of Christian-based church with a few either noncommitted or practicing other religions or spiritual paths.
For the Lowland Lao, there is one major Buddhist temple, Wat Buddhathammaram, that
is located in Portland. Very few non-Lowland Lao attend the temple. In Region 1, even
those who do not consider themselves Buddhist have family members, friends or other
ties to Wat Buddhathammaram which puts them in the Wat’s communication loop for
receiving community information. The Wat also serves as a type of MAA that acts as a
central point to which and from which other Lao MAAs revolve and intersect.
Mien: More than half are traditional Mien Taoists. Those who follow Taoist Spiritual
Leaders meet in several places in small groups or as individuals. There is no specifically
designated center or place of worship as in a church or temple building; instead, rituals
take place in the homes of families needing the service. The other portion of the
DRAFT CSPEC Final Summary Report - 3/8/2016
33
population gathers at various Christian churches which also act as community
centers/places of worship.
There are several Spiritual Leaders who are very respected and influential Community
Leaders. One such Spiritual Leader is Chiemfinh Saechao who resides in Portland. Mr.
Saechao’s excellent English has in the past allowed him to act as a liaison between
English-speakers and non/limited-English community members. His language ability,
Spiritual Leader standing, and past community messaging experience will allow him to be
a community liaison between public health contacts and limited/non-English speaking
Taoists Spiritual Leaders in the community when able.
The three main churches where Christian Mien gather, in no particular order of use, are:
1. Eastside Church of Christ (Portland)
2. Iu-Mien Fellowship Baptist Church (Portland)
3. New Life in Christ (Gateway Baptist Church Ministry in Portland)
Vietnamese: The Vietnamese population is large and varied and as such, their
community centers or places of worship are just as diverse as the population. The first
wave of Vietnamese refugees was disproportionately Christian, with the majority
Catholic. Later waves have had a more Buddhist majority. This is reflected in how the
population currently centers itself around community centers of worship. The majority
Vietnamese population is practicing Catholic and attends one of several Catholic
churches/cathedrals. Another substantial portion of the population divides itself among
various Protestant denominations and affiliate churches. The remaining portion of the
population attends one of several Vietnamese Buddhist Temples. As with other SE Asian
communities, some places of worship also double as community MAAs.
A majority of Vietnamese in Region 1 are affiliated with a Catholic Church. The largest,
with a membership of over 600, Our Lady of Lavang, Southeast Asian Vicariate
(Portland).
Other Vietnamese who consider themselves Christian are Protestant. There are numerous
Protestant churches and denominations which have Vietnamese members. Some of the
main denominations are: Vietnamese Baptist (several churches in Portland and environs);
Vietnamese Assembly of God (Portland); Vietnamese Christians (several churches in
Portland and environs); and Vietnamese Evangelicals (several churches in Portland and
environs) .
More recent Vietnamese arrivals are majority Buddhist. Their centers of worship include
but are not limited to: Nam-Quang Temple (Vietnamese Buddhist Association, Portland);
Ngoc Som Tinh Xa Temple (Portland); Phat Quang Temple (Vietnamese Buddhist
Community of Oregon - Tigard). Once again, as in other SE Asian communities,
Buddhist Temples frequented by community members also act as MAAs.
DRAFT CSPEC Final Summary Report - 3/8/2016
34
Influentials (Clan Leaders/Respected Persons)
Influentials are those in the communities that have a wide sphere of influence and power
within the community. They are very useful as community contacts and in spreading
information. Most have positions of power as community council members,
Board/Advisory Board members of MAAs and/or Community Centers. Generally, social
relationships in Southeast Asian communities are hierarchical. No one is considered
“equal” to anyone else – also a stark contrast to U.S. notions of “equality”. While within
the family, social rankings are usually based upon birth order and sex; those outside the
family can rest on a combination of factors including (but not limited to): age, education,
use of wealth, mediation skills, political position, sex, religious piety and degree of
common sense/wisdom.
While this hierarchical ranking is all encompassing – everyone is ranked somewhere in
the pattern – it is not fixed. People may rise or fall in social status over the course of their
current life and (if part of their belief system) in multiple rebirths. How well a person
does – how free they are from bad luck or suffering, and how effective they are at
accomplishing what they set out to do – is in many ways linked to a combination of
Buddhism and cultural notions of “merit” and in turn, influences whether a person is
considered a Community Leader/Influential, Respected Person and/or Clan Leader.
Through their actions, people gain or lose merit. For example, when a group member
receives benefits from a person in a superior position, they enter an explicit or tacit
agreement to reciprocate with some service. How they reciprocate is influenced by and in
turn influences their degree of merit. Though many in the SE Asian communities we
focused on would not formerly label themselves as “Buddhists”, the notion of “merit” still
influences socio-cultural interactions as it is intrinsically a part of overall cultural mores
and traditional practices.
According to our survey, many also relied heavily on certain family members and close
friends as “influentials” who impart trusted information. Many of the family members
and close friends mentioned also were people within the community who had positions of
influence and others in the community also trusted their advice.
Hmong: Clan leaders play an important role in the Hmong community. Generally, the
Hmong are intensively clannish and put a great deal of trust in their clan leaders. Hmong
life is structured around the clan and all clan members are considered to be brothers and
sisters. There are 21 different clans in the Region 1 Hmong community, but 13 of them
(Cha, Xiong, Kue, Vang, Yang, Moua, Her, and Vue) are larger in number than the other
eight. Clan leaders are those who have the capacity to lead and work for the interest of
people and the community. People highly respect and trust the clan leader. Clan leaders
are also the ones who make all important decisions and keep and strengthen the unity of
the community.
Mien: Also structured by clan. The Region 1 Mien were able to maintain traditional
social structures even through the upheaval of being refugees. The largest clan locally is
the Chao or Saechao clan. For more information on the history of the Mien clans and clan
name origins, it was suggested to go to www.hilltribe.org /Mien/. For an in-depth study of
DRAFT CSPEC Final Summary Report - 3/8/2016
35
the local and national Mien community history, politics and culture, local community
leaders recommended “Transnational Aspects of Iu-Mien Refugee Identity,” by Dr.
Jeffery MacDonald, Garland Press, 1997.
Respected Persons
Respected Persons are those influentials who, because of intelligence, age, sex, integrity
or a combination of those and other traits, are deferred to when community decisions or
actions need to be made. Many SE Asian communities have MAAs made up of the
elders/seniors in their communities (i.e. Lao Senior Association of Oregon) which have
considerable influence in the community. Other Respected Persons may be those who
obtain a superior position because of their diplomacy and mediation abilities. The skills
developed during a person’s life and career and the level to which they give back to the
community also award a person a position of influence in the community. Of note is that
a person who is a Respected Person within the community may not be the same person
that interacts with Western society. They may not be bicultural nor fluent in English but
are the people with whom the Western-defined “community leaders” pass on information
to so that they can interpret that information for community consumption. A Respected
Person can be a religious figure or someone who, because of how they lived their life and
accomplished their community work, are awarded that title. Examples of Respected
Persons are (not in any order of rank):
Cambodian:
1. Monks
2. Teachers
3. Seniors/Elders
Hmong:
1. Clan Leader
2. Teachers
3. Spiritual Leader
4. Pastor
Laod:
1. Monks
2. Senior/Elder
3. Teachers
4. Community Leaders
5. Former high-ranking government/military officials
Mien:
1. Clan Leader
2. Community Leader
3. Seniors/Elders
4. Shaman/Pastor
5. High ranking former government/military officials
DRAFT CSPEC Final Summary Report - 3/8/2016
36
Vietnamese:
1. Monks
2. Teachers
3. Catholic Priests/ Pastors
4. Elders/Seniors
Media
Community-based newspapers, radio stations and various television news stations are
also important methods to communicate with the SE Asian communities. Surveys do
support the anecdotal evidence that if local programming does not reflect local
community news, community members will not rely on it for the purpose of receiving
detailed and less urgent emergency information.
According to survey responses, television news is considered a reliable source for largescale emergency information. Survey responders revealed that many community members
go between radio, television (local and cable) and community-based internet news
sources over the course of the day.
The Vietnamese community was the only targeted community that had local radio and
newspaper sources and a dedicated community cable station. Survey data did suggest that
local community-based websites and newspapers were recommended as sources for
detailed and long-term emergency preparation information, training opportunities and
instructions.
Community-based Businesses
Community-based businesses were also stated as important places to disseminate
emergency information. Many of our targeted communities did not have locally-based
business directories or internet services.
Lao/Laotian: According to the first Lao Business Directory published in 2006, there are
more than 70 Hmong, Lao and Mien businesses, mostly in Portland. In addition to
community-based businesses, mainstream major businesses where Laotian community
members work are also places where emergency information is expected to be
disseminated. These businesses include Purdy Brush Company, Intel, and Anodizing
Company through their Human Resources Department.
Vietnamese: Has a Vietnamese Business Association that is based in Clackamas County.
Hong Nhu also prints in Vietnamese, a Vietnamese businesses directory. The State Of
Oregon lists 15 Vietnamese restaurants that are active as community gathering places.
There are several internet Vietnamese businesses listing sites that connect Vietnamese
community members with local Vietnamese businesses. Examples of these sites include:
Viet Internet www.chibrow.com/yellowpage; and Viet Share at www.vietshare.com.
DRAFT CSPEC Final Summary Report - 3/8/2016
37
Internet Sites
The Internet (both websites and email sites) is a main way targeted community members
transmit and receive news and information from others in their community across the
U.S. and from their home countries. The survey revealed that educational level, religious
beliefs and income level influenced level of internet involvement and use of websites as a
reliable and trusted source of information. These sites are also another way local
information is transmitted either as a posting or via listserve/email links to the sites.
Cambodian: The main Cambodian community website is www.cacoregon.org. Written
in English and Cambodian, this is the local site that area Cambodians community
members use to transmit and receive news and information. This site is used to promote
and preserve Cambodian culture and highlights events, activities and community persons
of note.
Hmong: Local access to several Hmong websites and blogs – many based in St. Paul,
Minnesota where the largest Hmong population in the U.S. resides. The Hmong
American Unity of Oregon also has a website that is used by local community members.
Examples of websites include: www.hmongtoday.com; and www.hmongtimes.com.
Mien: Main community website is www.iumien.com. This is an English-based global site
that Mien community members use to transmit and receive news and information from a
local to a global level. This site is used to advertise services, announce life
events/festivals, notify the community about important happenings and is also used by
community members to email friends and family around the world.
Lao: Locally, there are no main Lowland Lao websites used by community members. On
a national level, there is www.vietianetimes.com which is a Laotian website giving news
and other Laotian information from around the world.
Vietnamese: The large population size of the Vietnamese community has resulted in
numerous websites, blogs and other Vietnamese and Vietnamese/English-based websites.
The diversity of the Vietnamese community is reflected in the diversity of websites
mentioned. Local community influentials suggested that for general usage to list Yahoo
(www.yahoo.com) and Google (www.google.com) as two main clearinghouse resources
for Vietnamese website listings as well as sources many in the Vietnamese community
use consistently to receive national news.
Messages
Community-based associations and community influentials are the top ways people in our
targeted SE Asian communities gave as where they received and passed on information.
Surveys concurred that word-of-mouth was the most effective way of communicating
within these communities especially with emergency information.
Of equal importance is how the message is framed. The first step and considered the most
important by those surveyed is that the person creating the message should know the
DRAFT CSPEC Final Summary Report - 3/8/2016
38
population they are sending the message to and understand the diversity of the
community receiving the message. While many of our targeted communities are viewed
as homogenous, the survey and literature suggests that these communities are quite
diverse and contain numerous sub-groups. Messages need to reflect the diversity of the
community receiving the message. Some basic guidelines for effectively communicating
with our targeted communities include (but are not limited to):
• Be simple, concise, but complete and informative.
• Use ethnic language and prepare low literacy material for people.
• Use both ethnic language and English when and where appropriate.
• Use English for younger generations and educated persons.
• Include and/or use visuals (pictures/icons) wherever feasible.
• Incorporate checklists for instructions and give examples both in text and visual form.
• Avoid needless repetition
Level of Preparedness and Language Concerns
From IRCO’s 30-years experience working with the Cambodian, Hmong, Mien, Lao and
Vietnamese populations, we know that language, literacy, and cultural differences are
major barriers to communicating with immigrant and refugee communities quickly and
effectively. Careful consideration of how to maintain and/or build good relations and
support from the communities is also critical.
Our targeted communities’ survey responses revealed that there is a low level of
emergency preparation among community members. Few community members stated
that they had a family emergency plan, that they knew whether their work or children’s
schools had emergency plans or that they knew how to keep safe and healthy during an
avian or pandemic flu. Financial constraints and lack of language accessibility were given
as main reasons for not attaining emergency kits and supplies and/or developing family
emergency plans or finding out about school emergency plans. Secondly, surveys
revealed that there is a strong cultural belief that words have power and speaking of
something considered negative like an emergency can cause it to come into being. Thus
for many of our respondents, it was difficult to actively participate in focus groups that
had direct in-depth discussions about emergency preparedness because of a
fear/unease/caution that to discuss an emergency would bring that emergency into being.
The survey also revealed that the level of preparation is tied to beliefs that being prepared
is not as important as having access to vaccines. Many stated that they could prepare all
they wanted but in the end if they did not have access to vaccines, then being prepared
becomes a moot point. Western-based public health sees preparedness as knowing when
and where to receive vaccines, who should get the vaccines, and surviving without a
vaccine. Our targeted communities generally did not link being prepared with having
access to information. This cultural difference can be attributed to differing definitions
and meanings of the word “prepared” and how “prepared” is translated into other
languages.
DRAFT CSPEC Final Summary Report - 3/8/2016
39
Though our target communities are, in general, unprepared for an avian or pandemic flu,
they do rely on television, radio and community networks to tell of urgent emergencies
and rely on community leaders and centers for providing credible and trustworthy ongoing information pre-, during and post- emergency. The most trusted non-community
entity is the County Health Department which is looked upon as being the most
responsible for telling the community leaders, centers, and individuals about health risks,
and providing them with general emergency preparedness as well as specific avian and
pandemic flu information. However, local and national television and newspaper media
are relied upon to provide information on avian/pandemic flu incidents.
Surveys also showed that in order to prepare effective emergency messages to our
targeted communities, the messages must be clear and appropriate in both written and
spoken forms and suitable to the particular ethnic group with consideration to the
audience’s generation (for example, Vietnamese is written differently for those over 50
than for the younger generation). Literacy levels in both native language, English, and
daily language use/preferences should also be considered. For example, many first
generation or elder/senior community members do not speak fluent English. If they do
speak English, they generally do not read or write English. Quite a few from this
generation or age group are also illiterate in any language. In contrast, second generation
community members tend to speak, read and/or write their native language and be
conversant in speaking, reading and writing English. Many second generation community
members and especially third generation community members may understand their
spoken home language but neither speak, read or write it.
Therefore, a combination of using word-of-mouth networks, text-based literature and
visual-based information like DVD’s, pictorial or iconographic format brochures, coupled
with spoken announcements in the native language and in English is needed. Other
solutions given by community members and community influentials was to have actual
examples of emergency preparedness kits made available at community gathering centers
and in the community’s native language as additional visual aids that are made available
to the community at little or no cost.
General Culture
Concern: Survey responses and literature review also suggested that cultural differences
in health beliefs, healing solutions and concepts of disease and how it is spread also
present potential barriers to communities responding to and/or using Western
practitioners and health agencies before, during and immediately after a health
emergency. Several of our focus group participants had concerns that their community
would be blamed for an avian flu outbreak (since it originated in SE Asia) and as such,
expressed concerns about notifying Western authorities if there was little chance of
receiving the vaccine or being guaranteed to receive the vaccine and/or help in rebuilding
their community infrastructure if needed. Past U.S. history of scape-goating nonCaucasian/non-English-speaking communities for national emergencies/crisis and the
current rise in immigrant bashing/blaming was also discussed and anxieties expressed as
DRAFT CSPEC Final Summary Report - 3/8/2016
40
there currently was little outreach from health agencies that would alleviate such concerns
and community unease.
In general, given the current U.S. attitude towards immigrants and refugees, and coupled
with cultural privacy practices, many within our targeted SE Asian focus groups placed a
high value on their health privacy in the context of an avian flu outbreak. For many
seniors and first and second generation community members, health problems and
community health practices are generally not shared with outsiders. The degree to which
information is withheld does vary from community to community and is also dependant
on one’s level of acculturation and trust in their Western practitioner or Western
healthcare system. Overall, however, many stated they would be reticent to let those
outside the community know of health problems if there was a chance it could result in
the community as a whole becoming ostracized, blamed or held responsible for an
outbreak that killed or disrupted their Western neighbors.
Solution: Knowledge of community member’s culture and level of trust is paramount as
well as knowledge of who within the community is considered a health care practitioner
(i.e. shaman, healer, nurse, EMT, etc.). Focus group participants all responded that
community members do rely on those who are established healers, doctors, nurses, etc. A
majority of respondents to our survey also listed a grandmother, mother or aunt as the
primary caregiver when they have health problems/experience illness. They also stated
that many in their community combine Western treatments with traditional healing
practices (in varying degrees) and have expectations of doing so during and after a health
emergency. However, they also agreed that community members would be more
forthcoming if Western health practitioners, health agencies and related government
officials took the time to develop a personal relationship with community influentials.
This would also diminish the level of fear that during emergencies, community members
would be denied access to cures because they do not speak English or are blamed as the
cause of an avian flu outbreak.
Concept of “Preparedness”
Concern: Another concern we learned from our community assessments is that currently,
community members still do not pay much attention to written surveys and emergency
preparedness materials with regards to planning in advance. Several community members
also stated cultural/ personal beliefs that make the preparing for an emergency the same
as invoking that emergency to happen. Other community members, because of their
experiences that led to them becoming refugees, are unable to mentally and/or
emotionally handle planning for an emergency in a place they think of as “safe.”
Solution: Offering periodic and culturally appropriate training workshops and
community outreach programs is key to helping community members see the value in
being prepared. Surveyed community members stressed their desire to have emergency
preparedness training, have their community receive training and/or have key community
members trained. Surveyed communities members demonstrated that they knew how
little they were prepared but attributed it to a lack of access to any culturally appropriate
DRAFT CSPEC Final Summary Report - 3/8/2016
41
trainings and/or emergency preparedness information that was not “alarmist” in nature or
that used scare tactics. For example, we found that emergency preparedness information
and surveys were much better received when accompanied with an avian flu
informational DVD. Of note was that community members defined “training” as the
receiving of practical information but in an efficient manner (i.e. 20-minute DVD, easyto-read visual-based brochure, etc.). When asked if they would be available for a 2-hour
or 4-hour training workshop, most declined both due to the time commitment involved
and/or suggested that such trainings would be better for a key community member(s) who
would be organizing or be the community contact during an emergency. However, we
found that we were able to hold 4-hour emergency preparedness information workshops
when they piggy-backed on an established MAA or community center meeting and
allowed at least an hour for the community to meet together to discuss community
business, included a meal, had childcare and involved a variety of activities such as
watching a DVD, doing a survey, question and answer, and interactive visual
presentations.
Trust-Building
Concern: Due to past experiences, our targeted communities acknowledged their mistrust
in how the information they gave would be used. There is also an equal amount of distrust
that the information given wouldn’t be acted upon by state and local governmental
agencies in a timely fashion and in ways that have a visible positive impact in the
community.
In addition, several community influentials brought up the issue of “community
ownership.” Many expressed their willingness to be included in the pre-planning and
implementation stages of emergency communication(s) systems and/or mentioned
community members who had the skills for such endeavors; yet they were unable to
access such positions and opportunities. One community member summed up this portion
of his focus group by saying that, “When we are only asked for information and never
asked who we want to give our information to and how we want it to be used, when we
are not shown what was done with our information, when we never get a follow-up
response, of course our trust in them is low.”
Solution: Knowing whom and where to communicate within the targeted communities
regardless of whether there is an emergency is paramount. Surveyed community members
wanted the opportunity to get to know local health agency staff and representatives
outside of being part of a community survey project or training campaign. Community
responders also wanted to increase jobs opportunities for skilled community members in
public health agencies which would help the agencies in their goals of engaging
refugee/immigrant communities in various emergency preparedness activities and
projects. Many wanted the Western representatives to take some responsibility and
initiative in coming to community gatherings with no other purpose than to get to know
community members and their culture. Having a clear, culturally appropriate and efficient
follow-up plan was said to be “essential” for building community trust.
DRAFT CSPEC Final Summary Report - 3/8/2016
42
Community Contacts
In our targeted communities, there is an acknowledged bias against giving out personal
contact information even for an acknowledged good cause like creating an emergency
contact list. Across the board, the assessed targeted communities gave the following top
reasons for reluctance in giving out contact information:
1. Past experiences where such information led to family/spouse/friend death and/or
refugee status.
2. No relationship with area community health departments wanting to use the
information and thus no trust that the departments would use the information wisely
and correctly.
3. Belief that the contact would be held responsible by county health departments for any
and all actions/activities during an emergency.
4. Contact list antithetical to culturally prescribed ways of communicating.
Some community leaders/influentials understood the Western reasoning behind wanting
contact information; however, many stated that if they had been brought into the planning
loop for the project they would have suggested better methods or alternatives to the
contact list request.
Key Findings:
1. MAAs, community influentials/respected persons and community gathering centers are
key resources for distributing/disseminating information, confirming the accuracy of
information, and translating messages from English in trusted and credible way.
2. Community-based and cultural language radio and newspapers were preferred medias
for receiving non-urgent emergency information and follow-up information.
3. Television, radio and internet were preferred ways to receive more detailed emergency
information.
4. Messages should be provided in all languages represented by the targeted communities.
5. Messages should be presented in a combination of text, visual, and oral methods that
include radio, television and internet as well as pictorial and iconographic
representation that is culturally appropriate and accessible to low-literacy and limited
English populations.
6. Messaging should be mindful of cultural modes of communicating. Information should
be imparted and developed to address the ethnically diverse audiences.
7. Cultural differences in health practices, beliefs and disease can present barriers to a
community effectively seeking and receiving care during an emergency.
8. Language is still the primary barrier to communication with individuals in our targeted
communities.
9. Past refugee/immigrant experiences can trigger additional mental and emotional
responses that result in additional barriers to receiving emergency preparedness
training and/or information.
10. Each community has special populations that have even more limited access to
information centers. Special populations include, but are not limited to: the elderly
and those with mental/emotional health issues.
11. Level of trust in targeted communities is not high and will further diminish if no
follow-up to the emergency preparedness project is forthcoming in a timely manner
DRAFT CSPEC Final Summary Report - 3/8/2016
43
and/or if communities do not see short and/or long term positive results for their
communities.
12. Each community has skilled members who need opportunities to be offered public
health jobs and/or involvement in planning and/or implementation of preparedness
systems. Having more employees from the refugee and immigrant communities that
public health agencies want to reach would increase the agencies’ level of success.
Recommendations
In reviewing the findings from the surveys and focus groups, several themes emerged
which became our basis for developing an emergency communications plan for the
targeted communities. To successfully implement this emergency preparedness plan
however, we propose that the following recommendations be carefully considered.
Message Development: Surveys and focus groups revealed that language is still the
primary barrier to communication with individuals in our targeted communities. Focus
groups and community influentials strongly recommended that interpreters and translators
be readily provided; that translation of print and visual-based media materials be the norm
and not the exception; and that public health agencies use messengers with proven
capability of communicating in the native language AND have cultural knowledge.
According to the International Language Bank Interpretation and Translation Service
which specializes in refugee languages and languages of lesser diffusion, the primary
language translations requested in Multnomah, Clackamas and Washington counties are
(in order of demand): Vietnamese, Cambodian, Lao, Hmong, and Mien. In more rural
counties, Hmong becomes more in demand than Lao.
Besides interpretation and translation, cultural influentials and focus groups
recommended that television, radio, newspaper and internet messages should be culturally
competent and include ethnically-matched role models, culturally matched examples, and
culturally rooted value messages. Many focus groups and cultural influentials said that
the Emergency and Communications Health Organization’s (ECHO) Avian Flu DVD was
a good example of a culturally competent, culturally sensitive message that incorporated
text with visual examples in a technologically accessible way that incorporated their
native language and cultural values.
Our assessment also showed that developing an effective emergency communications
plan will rely on recognizing vital cultural differences in health practices and belief
systems, how illness is defined and ways community members regain and/or maintain
their health and wellness. Cultural influentials involved in our assessment recommended
that emergency preparedness education and trainings to their communities be made a part
of the overall communications plan. By incorporating a culturally competent training
component, it was revealed that community members would participate more and thus
encourage better overall access to emergency preparedness activities and opportunities,
better opportunities to compare, contrast and interconnect their approaches to emergency
preparedness with those followed by Western public health, and enable community
members to teach non-community members about their culture.
DRAFT CSPEC Final Summary Report - 3/8/2016
44
Message Delivery: The most significant finding was that it was very important to all of
our targeted communities that any emergency preparedness messages be delivered by
persons or organizations that are knowledgeable about their communities and that know
the key community influentials who could facilitate delivery of and response to the
message. Several in our focus groups mentioned that their communities already had
established communication networks with skilled community facilitators, but rarely did
non-community messengers use them. Instead, many times individuals and organizations
unfamiliar with their communities and cultural networks created new communication
networks for disseminating information and/or disregard agencies and individuals that
could help get the message delivered in an efficient, culturally competent and respectful
manner with guarantees of follow-ups.
Those involved in our assessment had varying degrees of receptiveness to public health
and government authority figures and their public health and emergency preparedness
messages. Again, those who were known by community members/leaders/influentials,
were more likely to be well received and their messages taken more seriously. Many
focus group members discussed the varying levels of distrust and mistrust community
members have with public health workers and agencies, 911, and police and fire
emergency workers. One community influential related the story of an older woman in his
community whose house caught on fire. Instead of immediately calling 911 for the fire
department, she called him because she knew and trusted him and she could “talk” to him
about her concerns and distrust about having the fire services and police come to her
house. He told her to call 911 and request the fire department and said, “she would not
have called 911 unless I told her that it was the best thing to do and allayed her concerns
about the fire department and other authority figures.” It was acknowledged that
relationships between community members and public health, service and government
authority figures need to be strengthened, especially since community members were
putting themselves at needless risk during an emergency because they did not “know” and
therefore “trust” the authority figure giving advice, passing on valuable information
and/or offering rescue or health services. Community influentials concurred that in the
event of relaying emergency communication, using local authorities known and trusted to
the community receiving the message coupled with using community influentials should
take priority in the message relay process; using unknown and thus not trusted uniformed
figures should thereby be greatly minimized.
Media channels were also confirmed by community influentials to be an effective way to
communicate with their communities. However, they did stress that the messengers
should not solely rely on media but use a combination of media and face-to-face
communication strategies as well as incorporate nontraditional (in Western terms)
communication channels – especially when working with communities on their
preparedness levels. Non-traditional channels included using the communities alreadyestablished non-Western communication networks, festivals/events, plays, dances, comic
book literature, first tee golf events with local authority figures, etc. Non-traditional
channels were said to work best in establishing and strengthening relationships between
community members and area authority figures with whom the community would be
coordinating with during an emergency.
DRAFT CSPEC Final Summary Report - 3/8/2016
45
Emergency Preparedness: Assessed community members all pointed out that there were
three levels of emergency communication that influenced how their communities would
respond. The first was in a pre-emergency phase and the second was during an actual
emergency. The third – post-emergency – was the phase many community influentials
stated they were most concerned about as they noticed that very little of the current avian
or pandemic flu emergency preparedness literature outlined what people could expect and
how to be prepared for after the emergency happened. Many mentioned that their past
experiences as refugees made them more aware of the importance of being prepared for
life after the emergency happened as that involved the greatest financial, mental and
physical expense as well as involved constant movement from place to place to escape the
effects of the emergency.
Throughout our assessment, our respondents stated that many of their community barriers
to participating effectively in an emergency communications plan could be alleviated
through holistic emergency preparedness trainings and education that took in the pre-,
during and post- aspects of an avian or pandemic flu emergency. All of our targeted
groups mentioned that community members had low perceptions of risk with avian or
pandemic flu when it was compared to past traumas. They also mentioned that it was very
important that community members be directly involved in emergency planning AND
training for the avian/pandemic flu and other emergencies. Community-based training
was the top request from our targeted communities, but they differed on how that training
would be carried out, who would receive the training, and the training curriculum.
In general, our targeted community focus groups concurred that any community-based
training and education enacted should clarify and specify linkages between their
communities and local public health authorities and emergency communication
facilitators. The trainings should incorporate culturally establish modes of communication
and guarantee availability of interpreters and translators. Trainings should develop
message and communication system prototypes that would allow key emergency
authority communicators to assume credibility as they pass on urgent emergency
communications in the event no established way is available or there is a critical time
factor. Lastly the training and education should be holistic and include pre-, during and
post- scenarios and link those scenarios to the public health/government
figures/authorities that would be in charge.
Recommended Key Findings:
1. Fully know the population to be communicated with and understand its diversity.
2. Carefully plan and prepare effective messages that use the written and spoken
languages most suitable to the targeted group and for the emergency situation.
3. Know whom and where to communicate with in the targeted community in an
emergency as well as for other occasions and non-emergencies.
4. Word-of-mouth is the most effective tool in communicating with the communities,
their various ethnic groups and social and cultural levels.
DRAFT CSPEC Final Summary Report - 3/8/2016
46
5. Build a unified effort in developing emergency preparedness resources and build
stronger collaborations of all agencies and organizations with the targeted community
to eliminate or reduce duplication of works/activities so limited resources are used
effectively and trust and cooperation are strengthened. This will require various leaders
including County Health Department employees and community members to work
together in participating in trust-building. Key to this is a successful implementation of
the emergency preparedness program with strong and wise leadership that is credible
and trusted by the targeted communities and by the government/public health officials
and agencies.
6. Region 1 is a multi-ethnic and multi-cultural urban area with a less diverse rural area.
In Multnomah County, because of having the largest population in the state, it has
many multi-ethnic agencies providing services to refugees and immigrants in various
programs and languages. These agencies include IRCO, IRCO’s Asian Family Center,
Catholic Charities, and Lutheran Community Services among others. The increasing
number of refugee and immigrant minorities in Multnomah County as well as
throughout Region 1 is transforming community life, community associations, ethnic
identities and political alliances. These refugees and immigrant have also brought
diverse needs, interests and customs and they are developing new linguistic, cultural,
political, economic and social patterns. They are creating new modes of diverse group
interactions. It is important that the various County Health Departments work closely
with these multi-ethnic agencies and minority communities in implementing an
emergency communications plan. Supporting, promoting, enhancing, and increasing
numbers of interpreters and translators is a first step in building trust and creating
short-term and long-term communication goals.
7. County Health and State Human Service policies should be inclusive of health
programs and services. They should foster inclusion and participation of refugees and
immigrant in particular. Long-term plans should be prepared to have more minority
health planners, administrators, and policy makers. Funds should be allocated
according to the increasing needs of the growing refugee and immigrant populations.
8. Comprehensive Health Plan: County decision makers, planners, administrators and
targeted communities should think deeply, do strategic planning and work together in
organizing and mobilizing emergency communication plans and in allocating the
needed resources with a concern for the future.
9. Strategies: good strategies should be established, Following are three fundamental
steps to be considered:
a. Promote opportunities and occasions for targeted communities to interact and
work with County Health Departments with the goal of reducing the
communications and services gap between the health department and the targeted
communities and increase ease of access to health department services by targeted
community members. Community Health workers should be increased and trained
to meet the needs of the targeted communities and should be located at area health
departments, multi-ethnic agencies and community centers when and where
feasible.
b. Build a capacity for existing institutions and organizations to develop, support and
promote targeted community leadership.
DRAFT CSPEC Final Summary Report - 3/8/2016
47
c. Promote/Support/Train Leaders who will serve as messengers and provide
information back to the response organization. Intensive efforts should be devoted
to developing leadership and organizational capacity within the targeted
communities to work with the county health departments.
Recommended Research: This assessment is a preliminary report to begin
understanding how to effectively communicate with Cambodian, Hmong, Lao, Mien and
Vietnamese communities living in Clackamas, Clatsop, Columbia, Multnomah,
Tillamook and Washington Counties in Oregon in the event of an avian or pandemic flu.
Additional research with each of the target communities presented in this assessment is
recommended. Based on the findings presented here, communities receiving priority
would include rural residents, mentally ill, home-bound and children.
Community Communications Plan: Overview
Community Plan assessments revealed that the best mode of communication was word-of
mouth which has proven to successfully lend itself to phone-tree communication plans.
Though there was considerable community reluctance in giving contact names and
information, several community influentials/leaders understood the importance of this
first step and either developed compromise contacts and/or gave their own information
until the communities could have time to weigh the issues and present a contact.
The structure of the SE Asian Communication Plan is based on a primary and secondary
community contact list but is not limited to that list alone.
Communication audit: Currently there are informal but no formal communications plan
between public health emergency preparedness/response agencies and the SE Asian
targeted communities. IRCO was given the task of developing a preliminary plan that
would include a community emergency contact list that public health agencies could use
in an emergency. IRCO was charged with finding out:
 what targeted communities do in the way of communication,
 how to best coordinate community communication
 what is the most effective way to communicate with targeted communities.
To get our answers, IRCO did community assessments to:
 brainstorm with community members on their communication styles,
 talk to community influentials,
 talk to communication committee members,
 survey the community membership and
 host focus groups.
Objectives: Armed with information from our community assessment we were able to
define overall communication objectives which included contacts who could:
 improve emergency communication service to targeted communities,
 improve cultural knowledge about targeted communities,
 encourage community participation,
DRAFT CSPEC Final Summary Report - 3/8/2016
48





centralize the communication effort,
increase community-public heath teamwork,
improve communication delivery,
create visibility for the overall emergency preparedness for culturally-specific
populations, and
influence government, media, consumers, and other audiences.
Communication Plan audiences: Below is a list of all the audiences that would be
involved in a communications plan in terms of contact, attempt to influence, or serve:
 Cambodian, Hmong, Lao, Mien and Vietnamese community members;
 SE Asian targeted community influentials;
 SE Asian targeted community MAAs;
 SE Asian Business community;
 SE Asian targeted community centers;
 Region 1 public Health agencies, hospitals and clinics;
 Federal, regional, and local governments emergency preparedness/response
agencies; and
 the media.
Goal: to create a working community contact list for public health agencies to use during
an emergency. To increase community emergency preparedness awareness and
participation in emergency preparedness activities.
Tools: Targeted communities stated that a mixture of tools be used to engage the
community in the emergency preparedness plan and increase participation in emergency
preparedness activities. Tools suggested include but are not limited to:
 Emergency Preparedness example kits available to community members for
little/no cost.
 Simple, concise text in targeted community language ;
 DVD/Video-based information guides and examples;
 Visual-based sources for low-literate portions of the community;
 Culturally relevant examples and information;
 Presentations that incorporate culturally specific modes of messaging.
Evaluate the result. The proposed preliminary communications plan and contact list
should be tested in an Emergency Exercise. Periodic checks should include:
 Key community-based organizations (MAAs); maintaining updated contact lists
on behalf of the public health agencies;
 Follow-up community gatherings that update communities on emergency
preparedness activities and opportunities;
 Public Health strategic outreach plans focusing on targeted communities to
involve them in emergency preparedness workshops and leadership trainings that
also include information on area public health agencies and serves in general;
 Annual community assessment on community level of trust of public health and
other emergency responder/preparedness agencies.
DRAFT CSPEC Final Summary Report - 3/8/2016
49
Community Communications Plan: Contact List
IRCO can be used as a primary contact and immediate contact for disseminating
emergency information to refugee and immigrant communities in Region 1’s Clackamas,
Multnomah and Washington Counties. IRCO’s staff includes community influentials for
most all refugee and immigrant communities in the targeted area. IRCO includes: IRCO
Main, Asian Family Center, Mid-County Senior Office, Cherry Blossom Senior Center
and Skill Training Center for youth and adults.
Cambodian, Hmong, Lao, Mien, and Vietnamese community influentials and MAAs can
serve as messengers and provide information to the response organization in an
emergency. Community contacts in particular can help facilitate getting emergency
information to their communities during a public health emergency. They also can keep
community contact lists current and know all the MAA and community influentials and
leaders well. All speak English unless otherwise noted in the Contact List.
Community Contacts - Community Centers of Worship: In the Mien community,
Spiritual Leaders have been considered the best contacts to deliver information during a
public health emergency. The churches also have biweekly meetings not only for worship
but for educational and social services. Churches serve as the main information
dissemination centers for Christian Mien instead of MAAs.
Vietnamese: The Vietnamese community is very diverse and there is no agreed upon
identified community leader(s), although there are outstanding community members. In
general, the Vietnamese community has many sub-groups and organizations, businesses,
community centers and media - each having their own communication network. The
Contact List provided with this report is only preliminary and not inclusive of all possible
Vietnamese points of contact. Also, no community member was willing at this time to
commit to being an emergency contact for the community without further information
and training from the public health sector. More relationship-building needs to be done by
the public health agencies in order to have a more efficient list of Vietnamese community
contacts for use during an emergency. The Vietnamese Contact List, therefore, is a list of
places that emergency preparation materials and information can be disseminated.
DRAFT CSPEC Final Summary Report - 3/8/2016
50
Immigrant and Refugee Community Organization on behalf of African Community
Center of Oregon (IRCO/ACCO)
Assessment of African communities in Clackamas, Multnomah, and Washington
counties
IRCO on behalf of ACCO convened representatives from the various African
Communities in the Region 1 counties of Clackamas, Multnomah and Washington. The
main goal was to gather African Community members together to identify and develop
systems for communication with their specific communities in order to assure an effective
communication plan that includes community contacts and appropriate participation of
the African communities to an emergency. Secondly, IRCO was charged with using the
information gathered to develop a community assessment and a written communications
plan as a guide for emergency and public health agencies to use to improve emergency
preparedness and response among the African communities.
The assessment was conducted among various African communities. Since no specific
African group was identified in the contract, IRCO relied on its 20 years of experience
working with African refugees and its relationships built over that time with key African
community leaders and influentials to best organize the assessment and written plan
materials when divided by African regions and ethnic groups. The populations assessed
included mainly refugees and immigrant community members. The targeted populations
included seniors, adults, and youth, living in urban centers. Lastly, many of the African
communities lived in the same area by ethnic group making it easier for certain forms of
communication.
IRCO convened meetings, focus groups and conducted surveys with community
leaders/influentials and active community members to assess community communication
networks and media commonly used by community members as well as emergency
preparedness needs in each targeted community. IRCO worked with ACCO to hire the
Community Outreach Specialist to work with the various African Communities.
Assessment Tool: The IRCO Emergency Preparedness survey was a nine-page multiplechoice questionnaire that was translated into the most locally used African languages. A
shorter one-page survey was also developed for use in large community gathering events
and for telephone calls. The nine-page IRCO survey included demographic questions as
well as questions assessing the level of community knowledge about emergencies and
public health agencies, public emergency communication media, pandemic and avian flu,
contact information of trusted key community influentials, and places people go to during
emergencies. The one-page survey assessed community members on knowledge of
pandemic and avian flu, level of emergency preparedness and ability to identify key
community contacts that the community members go to for information in the case of an
emergency.
To enhance response to the surveys and emergency preparedness information, the survey
was combined with an Avian Flu DVD developed in Minnesota by ECHO, which
presented the information in culturally meaningful ways and in several languages. African
DRAFT CSPEC Final Summary Report - 3/8/2016
51
Community Leaders generally gave warm reception to the Emergency Preparedness
information when coupled with the DVD and gave support for the project goals. They
also gladly received a copy of the ECHO Avian Flu DVD to use at upcoming community
meetings as well as updates on avian flu incident tracking and vaccine news.
The shortness of this project necessitated that the information gathered be used as a
preliminary guide to more in-depth work with the targeted populations. The information
gathered was from available key community leaders and members – thus the numbers
reached were only a small though knowledgeable and credible portion of the overall
community population. Special sub-groups within the targeted populations (i.e. mentally
ill, limited-mobility/home-bound, sub-ethnic/religious groups, etc.) were not actively
assessed although seniors and youth populations were sought out for the assessment and
survey.
Data gathered focused on:
• Communication dissemination.
• Barriers that exist in communicating during an emergency.
• Trusted community influentials and contact information.
• Misconceptions when communicating with the population during an emergency.
• Expectations of the community during an emergency situation including pre- and postplans.
The lack of published literature on African cultures in Oregon did hamper IRCO in
collaborating findings with other research’s baseline community profile. However,
IRCO’s 20 years of work with the African refugee community gave the following
demographic information.
Demographics
The U.S. and Oregon County 2000 Census data and the 2005 U.S. Census American
Community Survey were used to assess the overall targeted communities’ population size
in three of the Region 1 counties. To assess population size of African communities not
specifically designated in either census data, credible and trusted local community experts
who have knowledge of their community size and location were asked. A main source of
African refugee community population information was taken from a February
2006 report by Dr. Jeff MacDonald (IRCO) and Djimet Dogo (IRCO & ACCO).
The Oregon African refugee community, which first began with Ethiopian refugees over
20 years ago, has now grown to an estimated 17,000 individuals due to initial and
secondary migrations. Recent community-based research by IRCO and ACCO in the
Portland area shows that the largest concentration of African refugees over the past 10
years are Somali (4000 people), Somali Bantu (1000), Oromo from Ethiopia (1100),
Eritreans (625), Congolese (600), Liberians (100), Togolese (80) and Sudanese (500).
Smaller populations are from Angola, Mozambique, Sierra Leone, Chad, Rwanda, and
Burundi. The most recent arrivals have been Somali, Somali Bantu, Liberians, Oromo and
DRAFT CSPEC Final Summary Report - 3/8/2016
52
Sudanese with many un-sponsored “free cases… The majority lives in north and northeast
Portland. With smaller numbers in southwest Portland and Beaverton... Based on
SRP arrival statistics showing 21 percent of Oregon new arrivals (551 people) from
Africa in two years, IRCO and ACCO expect that African populations of increasingly
diverse ethnicities from rural settings will grow in Oregon especially given the poor
political conditions in Sudan, Liberia, Togo, Somalia…”
African community leaders/influentials did concur that there was very limited to no
African population in the three rural counties of Clatsop, Columbia and Tillamook in
Region 1. Further comments by community leaders/influentials agreed that any in their
communities who might live in the three rural counties received their information from
those located in the three more urban counties of Clackamas, Multnomah and
Washington; thus, they did not rely on their home County’s communication networks.
Population Description
IRCO concentrated its Avian Flu Emergency Preparedness work with the diverse African
populations in the Region 1counties of Clackamas, Multnomah and Washington where
most had settled. The African communities within Region 1 are quite varied, and barriers
to communicating with the diverse sub-groups within these populations are just as varied.
Many within our target communities travel at least once every 2-5 years back to their
home country and have strong ties to their home countries. To ease categorizing such a
diverse population from the second largest world continent, IRCO and ACCO agreed to
divide the community-assessment work into continental-based regions to include:
North Africa: Geopolitically, the UN definition of Northern Africa (which coincides
with common reckonings of the region) includes the following seven territories: • Algeria
• Sudan • Egypt • Tunisia • Libya • Western Sahara (occupied/claimed by Morocco)
• Morocco
Western Africa: is the westernmost region of the African continent. Geopolitically, the
UN definition of Western Africa (which coincides with common reckonings of the
region) includes the following 16 countries: • Benin • Guinea • Nigeria • Burkina Faso
• Guinea-Bissau • Senegal • Cape Verde • Liberia • Sierra Leone • Côte d'Ivoire • Mali
• Togo • Gambia • Mauritania • Ghana • Niger
Central Africa: is a core region of the African continent often considered to include:
• Burundi • Central African Republic • Chad • Democratic Republic of the Congo
• Rwanda
East/Eastern Africa: “East Africa" commonly refers to Kenya, Tanzania and Uganda,
and sometimes Rwanda and Burundi, whereas "Eastern Africa", a UN scheme of
geographic regions, refers to 19 territories throughout the eastern part of Africa: • Kenya,
Tanzania, and Uganda • Djibouti, Eritrea, Ethiopia, and Somalia – often referred to as the
Horn of Africa • Mozambique and Madagascar – sometimes considered part of Southern
Africa • Malawi, Zambia, and Zimbabwe – sometimes included in Southern Africa •
Burundi and Rwanda – sometimes considered part of Central Africa • Comoros,
Mauritius, and Seychelles • Réunion and Mayotte – French overseas territories also in the
Indian Ocean • Geographically, Egypt and Sudan are sometimes included in this region.
DRAFT CSPEC Final Summary Report - 3/8/2016
53
Southern Africa: In the UN scheme of geographic regions, five countries constitute
Southern Africa: Southern African Development Community (SADC) • Botswana
• Lesotho • Namibia • South Africa • Swaziland
The region often includes the following: • Angola – also included in Central Africa
• Mozambique and Madagascar – also included in Eastern Africa • Malawi, Zambia, and
Zimbabwe – sometimes included in Southern Africa • Comoros, Mauritius, Seychelles,
Mayotte, and Réunion – small island territories in the Indian Ocean east of the African
mainland • The Democratic Republic of the Congo and Tanzania, though more commonly
placed in Central and Eastern Africa respectively, are occasionally included in Southern
Africa
Because there are few transcontinental associations with strong enough leadership to
speak for the whole African community, the emergency assessment was shared with the
following country/ethnic business groups: Nigeria, Somalia (including Somali, Somali
Bantu and Somali Maay peoples), Ethiopia (Including Ethiopian and Oromo peoples) ,
Eritrea, Ghana, Liberia, Uganda, Sudanese, and DR Congo.
Smaller community groups included: Mozambique, Sierra Leone, Chad and Burundi. One
caveat is that this report is preliminary and should not be considered a comprehensive
review nor considered a final report of these communities as a whole. It is very difficult
to present any generalizations about cultural groups defined by their continental home,
and as such there may be many exceptions; the accuracy of any generalizations should be
continually questioned, scrutinized and verified by the specific communities being
discussed. Also, because of the varying levels of acculturation and integration between
these various communities and the public in general, collaborations between various
African communities and community-based organizations, barriers to public health
agencies during an avian/pandemic flu, responses to avian/pandemic flu emergency
announcements and health belief systems and practices during an avian flu outbreak
/pandemic are also diverse and need more in-depth research and documentation.
Race
Many African community members expressed degrees of confusion with the term
“African” in relation to the American racial categories of “Black” or “African American.”
Those from North African may define themselves generally as Middle Eastern or Arabic
but specifically by their country of origin or tribal group. Those from West and Central
Africa, who also define themselves by country of origin and/or tribal/ethnic group, do not
necessarily define themselves as “Black” or “African American” except as a political or
social gesture. Also, many youth are experiencing difficulties in balancing their
perceptions of who they are ethnically and culturally with American racial perceptions;
this leads to family and social tensions and conflicts. Those from Eastern and Southern
African have similar viewpoints as those from West and Central but many who would be
categorized as “Caucasian” or “East Indian” also expressed frustration with not being able
to acknowledge themselves as “African” or from their African country of origin. In
general, there was annoyance with American ignorance of the peoples from Africa
especially as it influenced how community members were treated by governmental
agencies, police and emergency workers. This, in turn, created barriers and affected their
DRAFT CSPEC Final Summary Report - 3/8/2016
54
levels of access to civic opportunities such as emergency preparedness planning and
trainings.
Demographics
Unfortunately, the U.S. Census does not delineate sub-groups of people from Africa,
except for “Egyptian” and “Moroccan” for North African; “Ethiopian” for East African;
“Cape Verde”, “Ghanaian” and “Nigerian” for West African; and general categories of
“South African” and “African.” Much of the census data combines “Black” with
“African” and/or “African American.” Because of the lack of delineation of African
ethnic groups, the following information is based on U.S. Census data that is generalized
as “African” as it pertains to Oregon. Population counts specific to the various African
communities living in all three counties are from local community expert sources.
The 2005 American Community Census Survey ranks Oregon as 42nd in number of
Black/African Americans. Of Oregon’s total population, “Black/African Americans”
make up a total of 1.6% of the population or 58, 309. IRCO focused its survey work in
Clackamas, Multnomah and Washington Counties because of the high concentration of
our target groups in these counties; however census data is not available for African
ethnic groups at the county level. Thus, for the state of Oregon, the African population
and then specific population counts are according to the 2000 U.S. Census, 2005 U.S.
Census data American Community Survey. Local community expert sources gave their
population numbers as 17,000 for the entire African community.
African community leaders/influentials do agree that the census under-represents the
general African and specific African population size as there is no ethnic, country of
origin and/or tribal category for “Africans” to specifically mark when completing the
Census questions. Secondly, many community leaders/influentials all agreed that
community members tend to be reluctant to fill out census data forms for a variety of
reasons that range from limited English ability to privacy issues.
Following is a summary of ideas and recommendations from the IRCO questionnaires,
readings and conversations with community influentials who know how to work
effectively with the targeted African community populations:
Communication Channels
Survey responders and community influentials highlighted the strong role community
networks, associations, respected persons and community centers play in disseminating
information throughout the community. However the transmission of information by
word-of-mouth was revealed to be the most effective way of communicating with the
targeted African communities – especially when the message concerned emergency
preparedness information or instructions. Word-of-mouth was usually done through oneon-one contact in person, face-to-face in a group or by telephone/cell phone. Word-ofmouth was the way our targeted communities built trust and was the most effective tool
used by community messengers in working with the communities and all their sub-groups
and at all levels.
DRAFT CSPEC Final Summary Report - 3/8/2016
55
Many in the African immigrant and early refugee communities we surveyed relied on
telephones/cell phones for giving and receiving information from trusted sources. For
recent refugee communities, in-person contact was preferred and more necessary as
phones were not as common. People also relied on community gathering places and
events to give and receive information. In terms of emergency preparedness or during a
pandemic or avian flu outbreak, many in our targeted communities expected to be able to
walk or travel to community gathering centers and meet fellow community members
face-to-face regardless of availability of telephones/cell phones. Many had past caregiving and illness experiences with disease outbreaks such as cholera, malaria, and other
contagious diseases in refugee camps which tempered overall concerns regarding
avian/pandemic flu and levels of quarantine seriousness.
The community gathering places and those within the communities who are trusted to
give and pass on information are called messengers.
Messengers
Community-based Mutual Assistance Associations(MAAs), Community Influentials, and
Community Religious Centers play key roles in the African community communications
networks. Community influentials and community religious centers were considered
highly credible and trusted channels for disseminating emergency communications and
for providing support and comfort. Messengers act as “communication bridges” between
their community and the outside Western-based community service agencies, institutions
and other organizations and media. Other channels were newspaper, radio, television and
internet news sources from home countries.
MAAs (Mutual Assistance Associations)
Mutual Assistance Associations or MAAs as they are more commonly referred to, are
community-based organizations that promote, protect and in many cases preserve cultural
traditional social practices and structures. Many times they serve dual or tri-community
roles as religious institutions, community councils, and/or secular organizations such as
dance or music groups.
For many African communities, MAAs were developed to either take the place of or be
the public (sic Western) face of more traditional community councils made up of elders.
For Westerners, MAAs are the best place to begin delivery of information to local
African communities during a public health emergency. Each ethnic group has had at
least one MAA and/or community council or belongs to a more general African
community grouping. Currently there are many African community MAAs. As these
MAAs become more stable and grow, they develop into important institutions for
interfacing between the specific ethnic group and non-community individuals, agencies,
institutions and organizations. They provide social service assistance to members,
mobilize community support and civic participation, represent the community in the
American social and legal realms, advocate for the community, facilitate delivery of
information to their communities and provide information back to the response
DRAFT CSPEC Final Summary Report - 3/8/2016
56
organization. MAAs in the various African communities also revolve around political,
tribal, or religious groupings or other community-based activities that preserve traditional
cultural practices like language or dance. African community-based MAAs vary in their
degree of community “clout” and ability to interface between the community and
Western-based individuals, organizations and agencies. In general, the MAAs are the best
and most useful place to begin delivery of emergency information to each community as
they can help in getting the information to their respective communities quickly and
effectively.
The African community is considerably more varied than most other population
groupings. However, even in the African communities we assessed, MAAs play a major
role in disseminating information, but the degree to which an individual will participate
actively in a MAA or heed an MAA’s decree or decision depends on their location,
culturally defined roles, religious practices, age, and their degree of acculturation into
American society.
Community Centers (Places of Worship, e.g., Temples, Churches, Mosques, etc.)
Community Centers that revolve around religious practices are other places that can help
facilitate delivery of information to the community during a public health emergency. In
the various African targeted communities, such places revolve around Mosques or Islamic
Centers, Christian churches, and Spiritual Leaders’ places of ritual service. Many places
of worship also act as major community MAAs. Due to little or no statistical research of
the religious makeup of community members in each of the targeted communities, this
report will not present religious breakdown percentages or numbers as they cannot be
verified and would be entirely arbitrary in nature. Currently there are the following main
community centers/places of worship:
Mosques/Islamic Centers: Portland is home to 6,000 to 10,000 Muslims by conservative
estimates. There are approximately eleven mosques or Islamic centers in the greater
Portland region, with seven of the mosques or Islamic centers being Sunni of varying
ethnic backgrounds. Many Northern and Eastern Africans now residing in Clackamas,
Multnomah, and Washington counties are predominately Muslim and their Mosques
and/or Islamic Centers are also community gathering places for the giving and receiving
of social information.
Christianity: The remaining non-Islamic African population is majority Christian. The
denominational practices vary widely and range from Catholicism, Eastern Orthodox,
Coptic, and Protestantism. Each offers community gathering places and is used not only
for religious purposes but as places where community social networks are created,
strengthened and/or maintained. Some area African churches are easily recognizable
because of their use of ethic names, such as the Oromo Evangelical Lutheran Church,
Ethiopian Orthodox Church, etc. However, many African communities are small enough
that they share/rent spaces in already established churches; in these cases, use of the
church space as community gathering places is limited.
DRAFT CSPEC Final Summary Report - 3/8/2016
57
Other Religious Practices: Some in various African communities practice more
traditional religions either as stand-alones or in conjunction with their Islamic or Christian
religious practices. There is no statistical data on the numbers of traditional practitioners.
Also, as there is no specifically designated center or place of worship as in a church or
Mosque, the rituals take place in the homes of families needing the service or in other
ritually designated areas.
Influentials (Community Leaders/Respected Persons)
Influentials are those in the communities who have a wide sphere of influence and power
within the community. They are very useful as community contacts and in spreading
information. Most have positions of power as community council members and/or
Board/Advisory Board members of MAAs and/or Community Centers.
According to our survey, many also rely heavily on certain family members and close
friends as “influentials” who impart trusted information. Many of the family members
and close friends mentioned also were people within the community who had positions of
leadership and/or influence; others in the community also trust their advice.
Community Leaders/Respected Persons: “Community Leaders” or “Respected
Persons” are those influentials who because of intelligence, age, sex, integrity or a
combination of those and other traits are deferred to when community decisions or
actions need to be made. Many African communities have MAAs made up of the elder
men in their communities. However, the bulk of the African communities are between the
ages of 18-50 and many of the incoming refugee families are households headed by
women which has led to the greater influence of women associations. There are very few
in the community who are over 65 and most are under 40. Thus “Respected Persons” is
also becoming to include those in the community who have done well with acculturation
and can switch smoothly between their community and the Western community as trusted
advocates.
Other Respected Persons may be those who obtain a superior position because of their
diplomacy and mediation abilities. The skills developed during a person’s life and career
and the level to which they give back to the community also award a person a position of
influence in the community. In many of the African communities, a person who is
considered a Respected Person within the community may not be the same person that
interacts with Western society. They may not be bicultural nor fluent in English but are
the people with whom Western-defined “community leaders” pass on and interpret
information for community consumption. A Respected Person can be a religious figure or
someone who is looked up to because of how they lived their life and gave to their
community. A Respected Person can also be a Griot (Griot is a West African poet, praise
singer, and wandering musician, and considered a repository of oral tradition. Griots
today live in many parts of West Africa and there are a few in the area who carry on the
tradition), who because of their family business, relays information to the community.
There are very few who transcend cultural/ethnic/religious communities to be accepted as
spokespeople for the entire area “Africa” community.
DRAFT CSPEC Final Summary Report - 3/8/2016
58
In summary, each African ethnic group has their own version of a Respected Person
and/or Community Leader. However, currently there are very few people who transcend
ethnic/cultural boundaries to be respected across community lines. One such person is
Djimet Dogo who coordinates Africa House.
Examples of Respected Persons are (not in any order of rank):
1. Spiritual Leaders (Imams, Priests, Pastors, etc.)
2. Teachers and those with very high education
3. Griots/Community repositories of oral traditions
4. Seniors/Elders
5. Former high ranking government/military official
6. Successful business owners
7. Community leader/community council leader
Media
Community-based newspapers, radio stations and various television news stations are
also important vehicles for communicating with the various African communities.
Surveys do support the anecdotal evidence that if local programming does not reflect
African community news, community members will not rely on it for the purpose of
receiving detailed and less urgent emergency information.
According to survey responses, television is considered a reliable source for large-scale
emergency information. Survey responders revealed that many community members
quickly attain televisions and go between radio and television for information. Many of
the newer African refugees do not have cable television. Community-based internet news
sources are more widely used by those who have daily access. Some middle-aged adults
from newer refugee communities are not as computer-savvy as their children mainly due
to lower literacy rates, not having the time to learn, or not having ready access to a
computer with efficient internet access.
Currently there are no local African ethnic-specific community radio and newspaper
sources. More successful community members watch satellite-beamed stations from their
home countries and can rely on internet-based news sources from their countries or ethnic
sources that are in their native or country language. As the population becomes more
fluent in English, survey data did suggest that local newspapers start to become more
widely used as sources for detailed and long-term emergency preparation information,
training opportunities, and instructions.
Direct Mail
Many in the area African communities rely on direct mail as a means of being introduced
to information about community events, opportunities and concerns/needs. Though more
in the general public have turned to using E-mail as the preferred form of “letter writing,”
direct mail and formal letters are still ways of showing respect and introducing
information to many African Community leaders. The key with direct mail is that it must
DRAFT CSPEC Final Summary Report - 3/8/2016
59
be followed up by in-person meetings and should not be the sole means of relaying
information.
Community-based Businesses
Community-based businesses were also stated as important places to give and receive
emergency information. Currently there are no African ethnic-specific locally-based
business directories or internet services. Key community businesses are restaurants and
African food and/or Halal markets.
Messages
Community-based associations and community influentials are the top ways people in
various African communities receive and pass on information. Surveys concurred that
word-of-mouth was the most effective way of communicating within these communities,
especially with emergency information.
Of equal importance is how the message is framed. The first step and considered the most
important by those surveyed is that the person creating the message should know the
population they are sending the message to and understand the diversity of the
community receiving the message. While Africans tend to be viewed as homogenous, the
survey and literature proves time and again that this “community” is quite ethnically,
linguistically and culturally diverse and contains numerous sub-groups. Messages need to
reflect the diversity of the community receiving the message. Some basic guidelines for
effectively communicating with the community are as follows:
• Make the message specific to the African ethnic audience.
• Be simple, concise, but complete and informative.
• Consider using a community spokesperson or griot to relay the message.
• Use ethnic language and prepare low literacy material for people.
• Use both ethnic language and English when and where appropriate.
• Use English for younger generations and educated persons.
• Include and/or use visuals (pictures/icons) wherever feasible.
• Incorporate checklists for instructions and give examples both in text and visual form.
• Avoid needless repetition.
Special Concerns
In-person meetings revealed that there were at least three concerns emerging across
African communities with regards to emergency preparedness and avian/pandemic flu.
The first concern was for access to resources, especially vaccines. Community members,
including those receiving social services, wanted to know who will provide vaccines for
their communities. Second, there was concern for maintaining relationships with city and
county leadership. Community members were concerned about city and county
accountability to their communities with regards to the emergency preparedness project,
the after-planning and data collection. Third, there was concern for the public health
approach of using proxy leadership to work with the African communities. Proxy
DRAFT CSPEC Final Summary Report - 3/8/2016
60
leadership may be defined as community institutions which engage African communities
for their own objectives but eventually come to represent or act on behalf of the
community. Examples include Portland State University, IRCO, Lutheran Community
Services, etc. The concern is that as specific communities achieve a strong leadership,
public health agencies will not know who those leaders are because they have not
developed direct relationships with those communities and thus miss out on key
community opinions and concerns that a proxy many not know about or reveal due to
conflicts of interest.
Diversity: The African community’s diversity is a persistent challenge to multi-African
community organizations. For example, SARNA, historically the best organized multiAfrican Organization now lies dormant for want of leadership and a following due to the
diversity of the population it tried to represent. The diversity of the African population
which manifests itself in ethnic, tribal, religious and linguistic differences has made it
extremely difficult for an area pan-African organization to flourish. Tantamount to this is
the historic lack of a strong leadership that can transcend those barriers though that is
changing with the advent of African House. Other observable aspects of the African
communities’ diversity manifests in income and education gaps between community
members and between community groups which necessitates different messaging
styles and content for each type of community being reached.
Accountability from City/County: One of the main explanations for a low survey return
rate was the reluctance of leadership to collaborate with often less-than-accountable
partnerships and non-trivial cynicism about the benefits of emergency preparedness for
African communities. Many related past city/county projects that sought community
information but did not deliver results back to the community in terms of data
presentation or tangible community impacts. The lack of perceived city/county followthough with projects that involved community input was given as one of the reasons not
to actively participate in the emergency preparedness project by some community
members.
Community Level Reluctance: A community leader illustrated African leadership’s
reluctance to participate in this project, suggesting that; “…people have economic
burdens to respond to and have little time to take responsibility for informing their
communities in emergencies.” In addition, some community members stated perceptions
that planning for emergencies is ineffective against inescapable destiny.
Survey Length: The survey’s length and many content areas also contributed to the low
response rate. The revised one-page version received a better response rate, though much
less information about the communities’ level of emergency preparedness.
Liaison/Leadership: There are many African organizations in the target area and several
community leaders suggested a city/county African community liaison to assist city and
county leaders in staying connected to African communities. An immediate focus of the
African community liaison should be continuation of planning for emergency
preparedness. City/county leadership development in African communities also could be
DRAFT CSPEC Final Summary Report - 3/8/2016
61
a responsibility of the community liaison. In time, the liaison might operate a regular
leadership training specific to the African communities. Among the gains from leadership
development will be better greater civic participation by African communities.
Many African community organizations need competent and effective leadership that can
build bridges between community functions and those of city/county agencies and/or
institutions. Because there are very few strong leaders in the various African
communities, there are few effective community contacts for projects such as the
emergency preparedness communication project.
Level of Preparedness and Language: From IRCO’s 20 years of experience working
with various African populations, we know that culture, language and literacy differences
are major barriers to communicating with these communities effectively. Careful
consideration on how to communicate with these communities quickly and effectively as
well as how to maintain and/or build good relations and support from the communities is
critical.
Our targeted communities’ survey responses revealed that there is a low level of
emergency preparation among community members in terms of on-hand supplies.
However, there was a high rate of knowing how to use skills to create shelters, produce
food and obtain money for surviving the aftermath of an emergency. Few community
members stated that they had a family emergency plan in the Western sense but knew
which community centers they could meet at and how to learn the fate of family
members. Few knew whether their work or children’s schools had emergency plans.
Some had working knowledge of how to keep safe and healthy during an avian or
pandemic flu based on past experiences with contagious diseases. Financial constraints
and lack of language accessibility were given as main reasons for not attaining emergency
kits and supplies and/or developing family emergency plans or finding out about school
emergency plans. Survey discussions also revealed that there is a strong reticence to talk
of emergencies in the refugee communities due to the need to feel “safe” in their new
home.
The survey also revealed that the level of preparation in the communities is tied to
religious beliefs coupled with the belief that being prepared is not as important as
knowing how to live in the aftermath of an emergency and/or having a belief in an
afterlife. There was also strong concerns about having access to vaccines as several
experienced past vaccination availability problems in their home countries or in refugee
camps. Our targeted communities generally linked being prepared with having survival
skills and access to preventative services like vaccinations or information. There were
cultural and linguistic differences attributed to differing definitions/meanings of the word
“prepared” and how “prepared” is translated into the major African languages.
Though our target communities are, in general, unprepared for an avian or pandemic flu,
they do rely on television and community networks to tell of urgent emergencies and rely
on community leaders and centers for providing credible and trustworthy on-going
information pre-, during and post- emergency. The most trusted non-community entity
are the County Health Departments and community clinics which are looked upon as
DRAFT CSPEC Final Summary Report - 3/8/2016
62
being the most responsible Western-based agencies for telling the community leaders,
centers and individuals about health risks, and providing them with general emergency
preparedness, avian and pandemic flu information. However, international and national
television and newspaper medias are relied upon to provide information on avian and
pandemic flu incidents.
Surveys also showed that to prepare effective emergency messages to the various African
communities, the messages must first be clear in written and spoken forms and suitable to
the particular ethnic group with consideration to the audience’s religious beliefs and
practices. Literacy levels in both native language and English and daily language
use/preferences should also be a consideration. For example, some populations have very
low literacy rates in any language due to their past social standing and/or educational
access opportunities. The most fluent in English are also the most educated in Western
school settings. The vast majority of people in the various African communities are fluent
in two or more languages that are not necessarily Indo-European in origin. Age is also a
factor in literacy as some older generations are fluent in European colonial languages that
have not been taught in their home countries for a generation or more. Many of the
younger generation (under 25) have trouble understanding the tribal or ethnic language of
their parents and speak to their parents in the dominant language (a national language or a
widely-spoken trade language).
Therefore, a combination of using word-of-mouth networks, text-based literature and
visual-based information like DVD’s, pictorial or iconographic format brochures, coupled
with spoken announcements in the dominant language and in English is needed. Other
solutions given by community members and community influentials was to have actual
examples of culturally appropriate emergency preparedness kits available at community
gathering centers, presented in the community’s native language as additional visual aids,
as well as made available to the community at little or no cost.
General Culture
Concern: Responses given at community gatherings and in surveys suggested that sociocultural and religious differences in health beliefs, healing solutions and concepts of
disease and how it is spread also present potential barriers to communities responding to
and/or using Western practitioners and health agencies before, during and immediately
after a health emergency. Several of our focus group participants had concerns that their
community would have little chance of receiving a vaccine or being guaranteed to receive
a vaccine let alone receive help rebuilding community infrastructure if needed. Many
talked about how people were treated in the aftermath of Hurricane Katrina and also gave
examples of past U.S. history in dealing with non-Caucasian/non-English speaking
communities during national emergencies/crisis. Of particular concern were the current
high level of Islamic and immigrant bashing and the lack of outreach from governmental
agencies that would alleviate concerns and community unease.
In general, given the current U.S. attitude towards Muslims, immigrants and refugees, and
coupled with cultural privacy practices, many in the African Communities who
DRAFT CSPEC Final Summary Report - 3/8/2016
63
participated in our community assessments placed a high value on being self-sufficient in
the context of an avian flu outbreak. This “self-sufficiency” also influenced which health
information community members would withhold. Overall, however, many stated they
would be reticent to let those outside the community know of health problems if there
was a chance it could result in the community as a whole becoming ostracized, blamed or
held responsible for an outbreak that killed or disrupted their Western neighbors.
Solution: Knowledge of community member’s culture and religious-based health
practices and level of trust is paramount as well as knowledge of who within the
community is considered a health care practitioner (i.e. shaman, healer, nurse, EMT, etc.).
Focus group participants all responded that community members do rely on those who are
established healers, doctors, nurses, etc. A majority of respondents to our survey also
listed an immediate family female member as the primary caregiver when they have
health problems/experience illness. They also stated that many in their community
combine Western treatments with traditional healing practices and have expectations of
doing so during and after a health emergency. However, they also agreed that community
members would be more forthcoming if Western health practitioners, health agencies and
related government officials took the time to develop a personal relationship with
community influentials. This would also diminish the level of fear that, during
emergencies, community members would be denied access to cures because they do not
speak English or are discriminated against because of religious beliefs, skin color, and/or
wearing of traditional/religious mandated dress.
Concept of Preparedness
Concern: Another concern we learned from our community assessments is that currently,
community members still do not pay much attention to written surveys and emergency
preparedness materials with regards to planning in advance. Some community members,
because of experiences that led them to become refugees, are unable to mentally and/or
emotionally handle planning for an emergency in a place they think of as “safe.” Others,
because of acculturation issues, have more immediate concerns and survival goals.
Solution: The ability of community members to actively participate in general emergency
preparedness plans is tied closely to that communities’ mental health state. Many African
refugees self-medicate as they attempt to try to deal with past traumas, many of which are
quite horrific. There can be a mental disconnect when asked about their level of
emergency preparedness in the place they hope is and/or think of as “safe.” A mental
health component that is part of periodic and culturally appropriate training workshops
and community outreach programs is key to helping community members see the value in
being prepared for emergencies. Surveyed community members demonstrated that they
knew how little they were prepared but attributed it to a lack of access to any culturally
appropriate trainings and/or emergency preparedness information that did not use scare
tactics and was not “alarmist” in nature.
For example, we found that emergency preparedness information and surveys were much
better received when accompanied with an avian flu informational DVD. Of note was that
DRAFT CSPEC Final Summary Report - 3/8/2016
64
community members defined “training” as the receiving of practical information but in an
efficient manner (i.e., 20-minute DVD, easy-to-read visual-based brochure, etc.). When
asked if they would be available for a 2- or 4-hour training workshop, most declined both
due to the time commitment involved and/or suggested that such trainings would be better
for a key community member(s) who would be organizing or be the community contact
during an emergency. However, we found that communities were much more receptive to
longer emergency preparedness trainings if the trainings piggy-backed on an established
MAA or community center meeting, allowed time for the community to meet together to
discuss community business, included a meal, provided childcare, and involved a variety
of activities such as watching a DVD and participating in a survey, question and answer,
and/or interactive visual presentation.
Trust-Building
Concern: There is an acknowledged level of mistrust of governmental agencies,
especially in how such perceived agencies would use the information the community
members give due to past experiences and current governmental stances on immigration
and Islam. There is also an equal amount of distrust that the information given would not
be acted upon by state and local governmental agencies in a timely fashion and in ways
that have a visible positive impact in the community.
In addition, several community influentials brought up the issue of “community
ownership.” Many expressed their willingness to be included in the pre-planning and
implementation stages of emergency communication(s) systems and/or mentioned
community members who had the skills for such endeavors. However, access to such
positions and opportunities which would give the community more “ownership” of the
process are extremely limited.
Solution: Relationship-building was listed as the most important step public health
agencies could take in their emergency preparedness planning. Knowing how, whom and
where to communicate within the targeted communities regardless of whether there is an
emergency is paramount, especially if done in ways that would alleviate community
members’ fears of discrimination and/or viewing them as “terrorists.” Surveyed
community members wanted to get to know local health agency staff and representatives
outside of being part of a community survey project or training campaign. Community
responders also wanted increased jobs opportunities for skilled community members in
public health agencies in order to help the agencies in their goals to engage refugee and
immigrant communities in various emergency preparedness activities and projects.
Having a clear, culturally appropriate and efficient follow-up plan was said to be
“essential” for building community trust.
Community Contacts
In many African communities, there is an acknowledged bias against giving out personal
contact information even if there is agreement that it is for a good cause such as creating
an emergency contact list. Across the board, the assessed targeted communities gave the
following top reasons for reluctance in giving out contact information:
DRAFT CSPEC Final Summary Report - 3/8/2016
65
1. Past experiences where such information led to family/spouse/friend death and/or
refugee status.
2. No relationship with area community health departments and thus no trust that the
departments would use the information wisely and correctly.
3. Belief that the list would be used to “round up” community members as terrorists or
other unwanted group if the community did not “perform well” for the Western health
agencies.
4. Belief that the contact would be held responsible by County Health Departments for
any and all actions/activities during an emergency and thus could be deported.
5. Contact list antithetical to culturally prescribed ways of communicating. Some
community leaders/influentials understood the Western reasoning behind wanting
contact information; however, many stated that if they had been brought into the
planning loop for the project, they would have suggested better methods or alternatives
to the contact list request.
Key Findings
1. MAAs, community influentials/respected persons and community gathering centers are
key resources for distributing/disseminating information, confirming the accuracy of
information, and translating messages from English in the most trusted and credible
way.
2. Community- and language-based internet and television stations were preferred medias
for receiving non-urgent emergency information and follow-up information.
3. Television, radio and internet were preferred ways to receive more detailed emergency
information.
4. Messages should be provided in major languages regularly used by the targeted
communities.
5. Messages should be presented in a combination of text, visual, and oral methods that
include radio, television and internet as well as pictorial and iconographic
representations and through community spokespeople that are culturally appropriate
and accessible to low-literacy and limited-English populations.
6. Messaging should be mindful of cultural modes of communicating, including how
information is imparted and developed to address ethnically diverse audiences.
7. Cultural and religious differences in health practices, beliefs about disease transmission
and afterlife and aftercare can present barriers to a community effectively seeking and
receiving care during an emergency.
8. Language is still the primary barrier to communication with individuals in our targeted
communities. Some are illiterate in any language and are unable to access text-based
information.
9. Past refugee/immigrant experiences can and do trigger additional severe mental and
emotional responses that result in barriers to receiving emergency preparedness
training and/or information.
10. Each community has special populations that have even more limited access to
information centers. Special populations include, but are not limited to: the elderly,
those with mental/emotional health issues, those who are illiterate, and children under
five years.
DRAFT CSPEC Final Summary Report - 3/8/2016
66
11. Level of trust in targeted communities is not high and will further diminish if no
follow-up to the emergency preparedness project is forthcoming in a timely manner or
if no short- and long-term positive results are seen for the communities.
12. Each community has skilled members who need opportunities to work collaboratively
with public health agencies or hold jobs in those agencies. Having more employees
from the refugee and immigrant communities would increase the agencies’ level of
success and further the communities’ level of trust in the agencies’ seriousness in
helping them thrive.
13. Understand that “African” refers to people who are from a continent. Many are
experiencing difficulties in balancing their perceptions of who they are ethnically and
culturally with American racial stereotyping and perceptions.
Recommendations
In reviewing the findings from the surveys and focus groups, several themes emerged
which became our basis for developing an emergency communications plan for the
targeted communities. To successfully implement this emergency preparedness plan
however, we propose that the following recommendations be carefully considered:
Message Development: Surveys and focus groups revealed that language is still the
primary barrier to communication with individuals in our targeted communities. Focus
groups and community influentials strongly recommended that interpreters and translators
be readily provided; that translation of print and visual-based media materials be the norm
and not the exception; and that public health agencies use messengers with proven
capability of communicating in the native language AND have cultural knowledge.
According to the International Language Bank Interpretation and Translation Service
which specializes in refugee languages and languages of lesser diffusion, the primary
language translations requested in Multnomah, Clackamas and Washington counties are:
Somali, Arabic, French, Somali Maay, and Amharic.
Besides interpretation and translation, cultural influentials and focus groups
recommended that television, radio, newspaper and internet messages should be culturally
competent and include ethnically-matched and/or religiously appropriate role models,
culturally matched examples, and culturally/religiously rooted value messages. Many
community members and cultural influentials said that the Emergency and
Communications Health Organization’s (ECHO) Avian Flu DVD was a very good
example of a culturally competent, culturally sensitive message that incorporated text
with visual examples in a technologically accessible way that incorporated their native
language and cultural/religious values.
Our assessment also showed that developing an effective emergency communications
plan will rely on recognizing vital cultural and religious differences in health practices
and belief systems, how illness is defined and ways community members regain and/or
maintain their health and wellness. Cultural influentials involved in our assessment
recommended that emergency preparedness education and trainings be sensitive to
community-experienced trauma and be made available to their communities as part of the
DRAFT CSPEC Final Summary Report - 3/8/2016
67
overall communications plan. By incorporating a culturally competent training
component, it was revealed that community members would participate more and thus
encourage better overall access to emergency preparedness activities and opportunities,
better opportunities to compare, contrast and interconnect their approaches to emergency
preparedness with those followed by Western public health, and enable community
members to teach non-community members about their culture.
Message Delivery: The most significant finding was that it was very important to all of
our targeted communities that any emergency preparedness message be delivered by
persons or organizations that are knowledgeable about their communities and who know
the community influentials who could facilitate delivery of and response to the message.
Some in our community gatherings mentioned that their communities already had
established communication networks with skilled community facilitators, but rarely did
non-community messengers use them. Instead, many times, individuals and organizations
unfamiliar with their communities and cultural networks created new communication
networks for disseminating information and/or disregard agencies and individuals that
could help get the message delivered in an efficient, culturally competent and respectful
manner with guarantees of follow-ups.
Those involved in our assessment had varying degrees of receptiveness to public health
and government authority figures and their public health and emergency preparedness
messages. Again, those who were known by community members/ leaders/influentials,
were more likely to be well-received and their messages taken more seriously. Many
focus group members discussed the varying levels of distrust, mistrust or lack of
knowledge community members have with public health workers and agencies, 911, and
police and fire emergency workers and services. It was acknowledged that relationships
between community members and public health, service and government authority
figures need considerable work, especially since community members were putting
themselves at needless risk during an emergency because they did not “know” and
therefore “trust” the authority figure giving advice, passing on valuable information
and/or offering rescue or health services. Community influentials concurred that in the
event of relaying emergency communication, using local authorities known and trusted to
the community receiving the message coupled with using community influentials should
take priority in the message relay process; using unknown and thus not trusted uniformed
figures should be greatly minimized.
Media channels were also confirmed by community influentials to be an effective way to
communicate with their communities. However, they did stress that the messengers
should not solely rely on media but use a combination of media and face-to-face
communication strategies as well as incorporate nontraditional (in Western terms)
communication channels – especially when working with communities on their
preparedness levels. Non-traditional channels included using the communities’ alreadyestablished non-Western communication networks, festivals/events, plays, dances, comic
book literature, first tee golf events with local authority figures, etc. Non-traditional
channels were said to work best in establishing and strengthening relationships between
community members and area authority figures.
DRAFT CSPEC Final Summary Report - 3/8/2016
68
Emergency Preparedness
Assessed community members all pointed out that there were three levels of emergency
communication that influenced how their communities would respond. The first was in a
pre-emergency phase and the second was during an actual emergency. The third – postemergency – was the phase many community influentials stated they were most
concerned about as they noticed that very little of what they learned about avian or
pandemic flu emergency preparedness literature outlined how to be prepared for after the
emergency happened. Many mentioned that their past experiences as refugees made them
more aware of the importance of being prepared for life after the emergency happened as
that involved the greatest family upheaval, mental and physical toll, and financial expense
as well as constant movement from place to place to escape the effects of the emergency.
All of our targeted groups mentioned that community members had low perceptions of
risk with avian or pandemic flu compared to past traumas. They also mentioned that it
was very important that community members be directly involved in emergency planning
AND training for the avian/pandemic flu and other emergencies. Community-based
training was one of the top requests from our targeted communities along with public
health and clinic open houses for community members and public health workers going
out and meeting with communities.
Recommended Key Findings
1. Fully know the population to be communicated with and understand its cultural,
religious and linguistic diversity.
2. Carefully plan and prepare effective messages that use the written and spoken
languages most suitable to the targeted group and for the emergency situation.
3. Know whom and where to communicate with in the targeted community in an
emergency as well as for other occasions and non-emergencies.
4. Word-of-mouth is the most effective tool in communicating with the communities,
their various ethnic groups, and social and cultural levels.
5. Build a unified effort in developing emergency preparedness resources. This will
require various leaders including County Health Department employees and
community members working together to participate in trust-building. Key to this is a
successful implementation of the emergency preparedness program with leadership
that is credible and trusted by the targeted communities and by the government/public
health officials and agencies. However, many local African MAAs are going through
the process of learning what it means to be a non-profit and how to build stronger
leadership and intra-community collaborations so are looking at trainings and planning
programs that can meet them where they are at in their leadership capacity-building
process and help them grow.
6. County Health and State Human Services should be pro-active in learning about the
culture, religion and languages of area African communities and strive to include
African community members in their community outreach plans such as the
emergency preparedness project. Long-term plans should be prepared to have more
minority health planners, administrators, and policy makers. Funds should be allocated
according to the increasing needs of the growing refugee and immigrant populations.
DRAFT CSPEC Final Summary Report - 3/8/2016
69
7. Comprehensive Health Plan: County decision-makers, planners, administrators and
targeted communities should think deeply, do strategic planning and work together in
organizing and mobilizing emergency communication plans and in allocating the
needed resources with a concern for the future.
8. Strategies: good strategies should be established and the three fundamental steps that
follow should be considered:
a. Promote opportunities and occasions for targeted communities to interact and work
with County Health Departments with the goal of reducing the communications
and services gap between the health department and the targeted communities and
increase ease of access to health department services by targeted community
members. Community Health Workers should be increased and trained to meet the
needs of the targeted communities and should be located at area health
departments, multi-ethnic agencies and community centers when and where
feasible.
b. Build a capacity for existing institutions and organizations to develop, support and
promote targeted community leadership.
c. Promote/Support/Train Leaders who will serve as messengers and provide
information back to the response organization. Intensive efforts should be devoted
to developing leadership and organizational capacity within the targeted
communities to work with the County Health Departments.
Community Communications Plan
The structure of this preliminary African Communication Plan is based on a primary and
secondary community contact list but is not limited to that list alone.
Communication audit: Currently there is no formal communications plan between
public health emergency preparedness/response agencies and the area African
communities. IRCO on behalf of ACCO was given the task of developing a preliminary
plan that would include a community emergency contact list that public health agencies
could use in an emergency. IRCO was charged with finding out:
• what targeted communities do in the way of communication,
• how they coordinates community communication
• what is the most effective way to communicate with targeted communities.
Communication Plan audiences: Below is a list of all the audiences that would be
involved in a communications plan in terms of contact, attempt to influence, or serve:
• African community members;
• African targeted community influentials;
• African targeted community MAAs;
• African Business community;
• African targeted community centers;
• Region 1 public Health agencies, hospitals and clinics;
• Federal, regional, and local governments emergency preparedness/response agencies;
• and the media.
DRAFT CSPEC Final Summary Report - 3/8/2016
70
Evaluate the Communications Plan. The proposed preliminary communications plan
and contact list should be tested at the next Emergency Exercise. Periodic checks should
include:
• Key community-based organizations (MAAs); maintaining updated contact lists on
behalf of the public health agencies;
• Follow-up community gatherings that update communities on emergency preparedness
activities and opportunities;
• Public Health strategic outreach plans focusing on targeted communities to involve them
in emergency preparedness workshops and leadership trainings that also include
information on area public health agencies and services in general;
• Annual community assessment on community level of trust of public health and other
emergency responder/preparedness agencies.
DRAFT CSPEC Final Summary Report - 3/8/2016
71
Native American Rehabilitation Association (NARA)
Assessment of Native Americans in Region 1
Summarized Responses to Survey Questions
Ways in Which the Community Receives Information
Question #1. “Where do you most often get information?”
Television = 72.4%
Newspaper = 45.4%
Direct Personal Contact = 28.3%
Question #2 “Where do you get your local news from?”
Local Television Channel = 77.7%
Local Newspaper = 56.7%
Family Member or Friend = 51% of the responses.
Question #3 “Have you heard anything about the Avian/bird flu?”
Yes = 83.7%
No = 16.3%
Question #13, “What media sources do you consider the most reliable for providing
information on the Avian Flu or a Pandemic Flu incident?”
Local Television = 54.6%
Local Newspaper = 44.7%
Local Radio = 34.2%.
Question #34 “How do you normally communicate with others?”
Home Phone = 55.9%
In-Person Contact = 35.7%
Email = 22.4%
Work Phone = 21.7%
Discussion- The data collected on sources of information and presence of electronic
media equipment in the home indicates that the majority of the survey population has
access to television news, local newspapers and radio broadcasts. Most (98.6%) use
English as their primary language. In the area of access to mass broadcast media, the
survey population seems similar to the mainstream population in that there are no major
access barriers to receiving public information announcements on television and radio. As
we move into the next section on how the community may respond to an emergency we
will begin to see more significant barriers to initiating an effective response related to
cultural and economic differences.
Ways in Which the Community Will Most Likely Respond to a PH Emergency
Question #4 “What would you do IMMEDIATELY after hearing that a pandemic flu was
in your area?”
DRAFT CSPEC Final Summary Report - 3/8/2016
72
Stay Home = 78.9%
Go to a friend or family members home = 24.3%
Return to the reservation or tribal housing = 6.4%
Question #5 “If you had a medical emergency – How would you access medical care?”
Primary Health Care Provider = 49.4%
Emergency Room/Urgent Care = 46.8%
Call 911 = 41.7%
Question #6 “Will you comply with instructions of public health officials if there is a
crisis? You may be told to stay home, or avoid public transportation; will you do what is
recommended?”
Yes, I will do what is recommended = 59%
Yes, I will try to follow instructions = 39.1%
Not Sure = 8.3%
Question #8 “If a public emergency happened would you gather at a particular place in
the community”
Church = 38.1%
Native American Agency such as NARA, NAYA or UISIHE = 34.0%
Neighborhood School = 21.1%
Question #10 “Scenario: Avian Flu / Pandemic Flu have occurred. For general
information WHO and WHERE would you go?”
Clinic or Local Health Department = 46.4%
Hospital Emergency Room = 41.7%
Personal Doctor = 40.4%
Family Member or Friend = 29.8%
Discussion – When respondents were asked if they would comply with instructions
provided by public health officials during an emergency, 59% said Yes and 39.1% said
they would try. This seems to indicate that respondents have an appreciation of the
seriousness of such an emergency. When respondents were asked which resources they
would seek out or initiate contact with in the event of an emergency, organizations and
professionals that respondents have an established relationship with were the predominant
choices. Respondents identified their primary care physician, churches, Native American
Organizations and local schools as trusted resources. The nature of the relationship with
these institutions seems to be a greater influence than their level of specific medical
expertise.
Considerations that influence the response to a public health emergency
Question # 7 “Which of the following could influence and affect your response to a
public emergency” (Note: identifies barriers to seeking assistance)
Financial Constraints = 32.7%
Distrust in Government = 29.9%
Conflicting Advise from Trusted Sources = 26.1%
DRAFT CSPEC Final Summary Report - 3/8/2016
73
Question #9 “Which of the following affect your ability to prepare for an emergency?”
Lack of Money = 54.4%
Lack of Space to Store Things = 34.2%
Do not know how to develop an emergency preparedness plan = 24.8%
Question #11 “If you were asked the ways in which Avian Flu could be spread, what
FIRST comes to your mind?”
Being in Contact with Infected Birds = 59.3%
Unwashed Hands = 37.5%
Eating Infected Birds = 28.1%
Question #20 “Do you have a primary health care provider?”
Yes = 73.7%
No = 20.4%
Not Sure = 5.9%
Questions 23, 24 and 25 asked about marital status and the number of adults and children
in the household. Married couples and parents tend to be more connected with social
support systems such as extended family, schools and social service agencies. The
following is a summary of survey responses to these demographic questions:
Single
60%
Married
28.3%
Divorced
11.7%
One to Five Children 28%*
* 150 respondents skipped this question.
Adults in the Home
One
Two
Three
Four
Five
Six
27.8%
20.1%
12.5%
12.5%
8.3%
18.1%
Questions 26, 27 and 28 address age and disability demographics. The following is a
summary of these demographic questions:
Age 50+ = 37.4%
Disabled = 6.4%
Caring for a disabled person in the home = 7.0%
Question #35 “Who are the top three people or agencies in your community that you
relied on in the past in case of an emergency?”
Native American organization NARA = 55.0%
County Health Department = 51%
DRAFT CSPEC Final Summary Report - 3/8/2016
74
Clinic or Hospital = 49%
Other Native American organizations such as NAYA, NICWA, NIVA, North Portland
Elders = 19%
Discussion – Strengths of the survey respondents as a group include a good fund of
knowledge about how Avian Flu is spread, a significant number know basic first aid, and
a majority has a primary care physician. The strong preference for interacting with Native
American organizations is both a strength and a limitation. The availability of health care
and social services from culturally specific resources is a plus, and the level of this
preference also reveals a limitation in that Native Americans may not approach other nonNative agencies when needed in a time of emergency.
Potential limiting influences identified by respondents included Lack of Money, Lack of
Storage Space, Distrust in Government, and although there is proportion of single and
divorced individuals in the survey population, Native Americans often have close
relationships with extended family members as indicated by the majority of respondents
reporting other adults living in the home.
Emergency preparedness needs in identified Native American communities
Question #14 “Does your family know what to do in case of a public emergency such as a
pandemic flu?”
Not Sure = 59.2%
Yes = 29.3%
No = 18%
Question #15 “Do you have an emergency kit?”
No = 59%
Yes = 32.2%
Not Sure = 9.2%
Awareness of Emergency Preparedness plans prepared by institutions such as school and
places of employment was addressed by question 16, 17 and 18. The majority of
respondents reported that their school or place of employment did not have an emergency
preparedness plan or they were not sure. When asked if they knew what the Emergency
Preparedness Plan was at their local school 32.7% reported Yes, and for their place of
employment ,23.1% reported that they knew what the emergency plan was.
Question #21 asked “Do you know basic first aid?”
Yes = 77.3%
No = 14.3%
Not Sure = 8.4%
Discussion – A strength of the group of survey respondents is that most reported knowing
basic first aid, which indicates that they would be able to assist others in a time of
emergency. Data from the survey indicates there is general lack of knowledge about what
an Emergency Preparedness Plan should include, whether it is for the home, school or
DRAFT CSPEC Final Summary Report - 3/8/2016
75
workplace. Education on how to develop an emergency preparedness plan for the home
and how to learn about what is in place at school or work is needed to provide those
important first steps in responding to an emergency. Not having a plan would contribute
to confusion and panic and an inability to organize a successful response.
List of considerations and recommendations for the implementation of Emergency
planning and readiness in the Native American community.
Although not directly addressed by the survey, the ability of some individuals to interpret
and appropriately respond to information provided by the mass media may be a
significant impediment to taking appropriate action. Individuals interpret information
according to the cultural lens of their world view and attitudes shaped by life experience
Mistrust of government agencies and fears of experimental vaccines, for example, could
restrict participation in vaccination campaigns. For some individuals, a tendency to live in
the present and not fear future events may inhibit the early recognition and sense of
urgency needed to mount a timely response to a crisis. Discerning valid information from
the mix of exaggeration and myths that may be circulating could also prevent effective
action for some.
Native American organizations such as NARA could play an important role in translating
information provided by mass media. Working with the Health Department, NARA could
assist in the development of culturally specific education materials and assist individuals
with developing Emergency Preparedness Plans for their home environment.
A review of the Communication Assessment Results reveals the following needs of the
Native American Community in the Portland Metro Area:
1. Assistance with developing Emergency Preparedness Plans
2. Access to supplies such as breathing masks, disinfectant wipes and other infection
prevention supplies located in areas near their home – at schools, churches or other
community centers.
3. Food boxes for families that are not able to leave their house for extended periods.
4. Containers for water storage.
5. Assistance with caring for vulnerable Elders that may be living in the home.
Communication Plan for the Native American Community
As indicated by the data from the survey questions regarding personal communication,
the most widely used method of interpersonal communication is the telephone and
conversation in person. The initial steps of dispersing information in the event of a public
health emergency would utilize a telephone tree to contact primary and secondary
contacts followed by face-to-face contacts with members of Native American community
groups. The sequence of the initial communication response is outlined below.
1. The Health Director of the NARA Indian Health Clinic receives a call from the
County Health Department that a public health emergency is developing.
DRAFT CSPEC Final Summary Report - 3/8/2016
76
2. The Health Director calls all of the individuals on the Primary and Secondary Contact
Lists of community leaders and organizations. The instructions provided by the
County Health Department are transmitted verbally to each person on the contact lists.
3. NARA Indian Clinic outreach staff and health educators meet in person with Elders
Groups and other community organizations to give a presentation on recommended
response activities and provide accurate information and answer questions.
4. NARA Health Clinic staff appears on the Native American Hour radio program on the
KBOO radio station to present accurate information, debunk myths and answer
questions from KBOO listeners.
5. Information brochures are handed out to all patients who visit any of the four
locations of NARA health and behavioral health services.
With additional funding, a more intensive and prolonged information and referral
response could be maintained and activities such as those listed below could be sustained.
1. Additional staff may be needed to answer phone calls at the clinic and field questions
from patients and the general community during extended evening hours.
2. An Advise Nurse could be available during and after normal clinic hours to provide
information and emotional support.
3. Community Education and Individual consultation on how to develop a Family
Emergency Preparedness plan could be provided as a proactive measure before an
emergency occurs.
4. A variety of culturally specific education materials could be developed, printed and
distributed in the community.
DRAFT CSPEC Final Summary Report - 3/8/2016
77
African American Health Coalition (AAHC)
Assessment of African Americans in Multnomah County
Creating the assessment involved several hours of discussion and consultation among
peers. The AAHC Planning Team first identified their personal definitions of a natural
disaster/emergency. The discussion exposed many different perspectives that were all
appreciated and valid. The Team created a list of items that warranted a deeper level of
exploration preceding the discussion. These things were identified by the level of
intensity and the number of times the issue came up during the discussion.
After identifying possible issues, the Team reviewed other assessments used to serve a
culturally-specific population. The models consisted of open-ended questions. We
observed that the assessment used respectful language and words the target audience
could relate to. It was obvious that the tools that were clear and concise were more
engaging.
After several drafts we finally reached an agreement that our tool was culturally sensitive,
engaging, and thought-provoking. As a team, we agreed that the final product asked the
questions that would raise awareness regarding emergencies in the community. We
agreed that the tool should not be long and extensive, however it should be informative
and meaningful and adapted to each sub-population that we work with such as the youth
and refugees.
We aimed to create a tool that would provide ownership and create a need to participate
in this project. We set out to accomplish this by creating a preamble for our assessment.
The assessment discussed safety in the community and barriers that exist. It was designed
to find out who would be the best source for giving information in the midst of an
emergency.
The assessment contained 15 questions. Seven of the questions were written in a multiplechoice format. The remaining eight were short open-ended questions. The two-page
survey addressed the following subjects:
* Who to contact during an emergency
* Where to go during an emergency
* Who to take information from during an emergency
We collected demographic information on the participants.
We documented how the assessment was completed (assessment process, number of
assessment participants including basic demographic information).
Volunteers from the Healthy Options Living Longer (HOLLA) program assisted with the
assessment. The HOLLA program is a peer-to-peer education program based in three
high schools in North / Northeast Portland. The program trains high school students how
to prevent and combat cardiovascular disease. The students then conduct formal and
informal presentations to their peers family and friends. It was valuable to have youth
DRAFT CSPEC Final Summary Report - 3/8/2016
78
involved at this stage, as they have transitioned into change agents and brought the
messages back to their families, in addition to community members.
The assessment was conducted at three different locations. The first location was the local
NE Portland celebration called, “Good in the Neighborhood (Good in the Hood),” on
June 24, 2006. Good in the Hood is a two-day community festival that features live
music, food, and youth activities. It was created to promote and celebrate community
collaboration and diversity. Five HOLLA students and two beauticians who work as our
Lay Health Educators were trained by the grant coordinator in the week prior to the Good
in the Hood event. The volunteers were trained on how to conduct interviews and record
the answers on the survey tool. The coordinator stressed three important points for
interviewing community members: stay neutral; write legibly; and write answers down
verbatim without adding personal additions. The students showed up in shifts for the daylong event and conducted surveys. We collected a total of 101 surveys from community
members at this event. The HOLLA students also filled out the survey.
The second location where we conducted the survey was at the AAHC Program (LTLR)
monthly meeting in June. The LTLR Program (Lookin’ Tight, Livin’ Right), is a program
where beauty and barber shop operators are trained as lay health educators to work with
their clients on health issues affecting African Americans. The AAHC has set up monthly
booster sessions to help the stylists keep up with new information and to serve as a
refresher for past trainings; the LTLR participants are mandated to attend the booster
sessions. It was at their monthly meeting that we conducted the survey. We collected a
total of 8 surveys.
The third location where we conducted the surveys was at Portland State University in the
Multicultural Center on June 25, 2006. This meeting was actually the second meeting in a
two part series. The first meeting was conducted by Dora Asana, our Program Director,
and Steve Bullock, the Chairman of the AAHC Board of Directors. They met with
women (and a few men) from the African community 3 weeks prior to collecting the
surveys. Disaster preparedness was not an easy topic to broach since many of the refugee
men and women had previously experienced trauma. Due to the sensitive nature of the
subject, Ms. Asana and Mr. Bullock set up two meetings. The goal of the initial session
was to introduce the subject and assess the best methodology for administering the
survey. They also brainstormed about possible first steps if faced with an emergency.
The second meeting’s goal was to conduct the survey. At both meetings, interpreters were
matched for all who needed one; some interpretation was in the dialect of the participants
to help them better understand the survey and to get accurate responses. The first meeting
went smoothly and the topic was well received. Most women were moved to learn that
the government was taking time to prepare them for a disaster that has not yet happened.
The second meeting was also very successful. Ms. Asana had round tables set up and
grouped the women according to language. An interpreter was placed at each table to
walk the women through the survey and record their answers if they were unable to write
in English. This set-up helped the women feel comfortable as they were grouped with
people they already knew and trusted; they were able to assist each other with the survey.
DRAFT CSPEC Final Summary Report - 3/8/2016
79
We collected 26 surveys from this group. In addition, the women brought up several
concerns. Primarily, they were concerned about communication with their children about
disaster preparedness, due to the disconnect that many feel is increasing between
themselves and their children, as their children become more “Americanized”. They were
concerned that their children would shrug off the information that the parents were giving
them. In addition, they were nervous about communication surrounding disasters in
general because many of the parents rely on their children to communicate for them in
English with the wider community. The group also mentioned a distrust in government
from their past experiences with governments in Africa. The group brought up the issue
of discrimination and wondered if, because they were foreigners, they would be the last to
be assisted in a disaster. And last but not least, they appreciated that the government is
bringing this topic up, but wondered if the survey was just an exercise—or if it will really
be implemented. This again demonstrated their deep-rooted mistrust of government.
A lot of work went into bringing these men and women together. Volunteers were asked
to make calls and some were assigned to pick-up people for the meeting. The issue of
transportation and childcare had to be addressed as most of the refugee women do not
have transportation nor funds for childcare. Childcare was provided and incentives given
to the interpreters and those who helped to bring the women. Reaching the immigrants
and refugees requires a different approach than reaching African Americans. Both groups
had similar issues of trust and fears, but those of the refugees were compounded by lack
of good support systems and unfamiliarity with the American method of addressing
problems. For example, the immigrant/refugee group needed repetition of the information
and hands-on tools, but we were not able to accommodate that due to funding restrictions.
Demographics of the community members who participated in the survey
(Please note that there is sometimes a discrepancy in the number of respondents who
answered a question. This is because not all respondents answered all of the questions.
Our aim is to accurately reflect these numbers, which is why there are differences in some
of the data.)
 100% of respondents were African Americans or African immigrants/refugees
 Of the 115 respondents who answered the questions, 26% were men and 74% were
women
 Of the 113 respondents who answered the questions, 27% were 31-40 yrs. old; 24%
were 0-18 yrs. old; 22% were 41-50 yrs. old; 12% were 19-30 yrs. old; and 12% were
50-64 yrs. old
 Of the 94 respondents who answered the questions, 46% were married; 40% were
single; 12% were divorced; and 2% were widowed
 Of the 123 respondents who answered the questions, 58% live in NE and 21% live in
N Portland, bringing the total percentage of respondents living in N/NE Portland to
79%
Communication methods the community currently uses to disseminate information
Question 1 in the survey tool: “Please list all usual sources where you are getting local
news from”. Respondents could choose multiple answers.
 100 of 140 respondents indicated TV as a usual source of local news
DRAFT CSPEC Final Summary Report - 3/8/2016
80









72 of 140 respondents indicated The Oregonian Newspaper as a usual source of local
news
63 of 140 respondents indicated church as a usual source of local news.
62 of 140 respondents indicated the internet as a usual source of local news
59 of 140 respondents indicated a family member or friend as a usual source of local
news
54 of 140 respondents indicated the Skanner or Observer Newspapers as a usual
source of local news
54 of140 respondents indicated the radio as a usual source of local news
43 of 140 respondents indicated a co-worker as a usual source of local news
22 of 140 respondents indicated other community leaders as a usual source of local
news
14 of 140 respondents indicated ‘other’ as a usual source of local news
The TV and The Oregonian Newspaper are the most widely utilized sources where
participants are getting local news. These two sources are closely followed by media
sources based in the community as well as church, family, and friends. Community
leaders and other sources were listed as the least frequently used means for obtaining
local news.
Ways in which the community will most likely respond to a public health emergency
such as a large, severe flu outbreak (Avian or Bird Flu, Pandemic flu).
We delved into the issue of the African American community’s response to a public
health emergency, by posing several questions. The questions were:
 What would your family do in a public emergency such as an earthquake or
Hurricane?
 Where would you gather?
 Who would you listen to?
 Who would you feel comfortable meeting with?
There were many different answers to these questions. However, several patterns did
emerge, which might provide important information to the County and City in the event
of a public emergency.
In addressing the question of what their families might do in an emergency, several
answers arose repeatedly. The top two themes consisted of family concerns and need for
safe shelter. Many people mentioned that they would bring their family together and
make sure they were safe. Getting the family together, gathering together and staying
together were consistently mentioned. Others mentioned that they would stay in their
house if possible; go somewhere safe; go to a pre-arranged meeting point; go to the
nearest emergency shelter; or leave town/evacuate. Although less frequently mentioned ,
several people (7 respondents) did say that they would listen for information and
directions on radio or TV, while others mentioned that they did not know what they
would do. From these themes, it appears that issues of family and shelter are two of the
major concerns for community members experiencing a public emergency.
DRAFT CSPEC Final Summary Report - 3/8/2016
81
Another important factor in responding to a public emergency is the question of where
community members would gather. The community was given the ability to choose more
than one location. The overwhelming majority of community members (96 of 140),
indicated that they would meet at church. Following this location, community members
indicated community centers (40 out of 140 respondents) and hospitals (38 out of 140
respondents). The communities’ overwhelming choice of churches as the place they
would feel most comfortable meeting is definitely a key piece of information during a
public emergency.
Determining whom the community would listen to in an emergency is an important factor
in determining a community’s overall response to a public emergency. The community
was given the ability to choose more than one contact. The community indicated on the
survey tool that they would listen to their friends or family members (72 out of 140
respondents), followed by the police (70 out of 140 respondents), a public official (66 out
of 140 respondents) and their primary health care provider (42 out of 140 respondents).
The fact that family and friends were on top of the list of who the community would
listen to is not surprising, given that word-of-mouth is a powerful communication tool in
the community. It is interesting to note that the community identified the police as their
second choice despite repeated confirmations of police distrust.
Some community members mentioned having the experience of calling the police and not
having them respond for several hours. One comment stated, “unlikely to call the police
because afraid the police would shoot them”. If this project were extended, we would
further explore whether the police ranking indicates an incongruent relationship with the
above comment or is simply a lack of choices for help and support in the community. A
few community members that we asked suggested the latter.
In addition to knowing where the community feels comfortable gathering, it is important
to know whom they would feel comfortable meeting with. The community was given the
ability to choose more than one contact. The community chose the people at their
church/place of worship (92 of 140 respondents), as a close second to family and friends
(98 of 140 respondents). The first choice parallels the community’s answer to whom they
would listen to in a public emergency.
The data from this sample group suggests that the church, friends and family may play a
vital role in the African American community’s response to a public emergency. The
above information is consistent with historical data that indicates that African Americans
are relationship oriented.
Considerations that influence their response to a public health emergency such as a
large, severe flu outbreak (Avian or Bird Flu, Pandemic flu
The main question that we asked to discover what considerations would influence
responses to an emergency, was “What would stop you from following directions in a
public emergency?” The community was given the ability to choose more than one
response. The responses to this question are critical in determining areas that need to be
addressed prior to and during an emergency. Several of the answers reflect the
DRAFT CSPEC Final Summary Report - 3/8/2016
82
intersecting issues of race and poverty in the US, while others reflect a mistrust of
government, and a strong concern about family.
The first reason that community members listed for not following directions was the fear
of having to leave their family (52 of 140 respondents), followed closely by the fear that
it might hurt their family (30 of 140 respondents). It seems that a perceived danger to
family and the possibility of being separated may be a major consideration that will
influence behavior. The second reason given was financial reasons (43 of 140
respondents), followed by mistrust in government (41 of 140 respondents), conflicting
advice from trusted sources (41 of 140 respondents), and transportation issues (39 of 140
respondents).
As reported with Hurricane Katrina, the people who were left behind were mostly poor,
without transportation, and African American. From the above answers, there appears to
be a combination of factors present in Portland (financial reasons and lack of
transportation), that puts the African American community at-risk of the same kind of
horrifying situation that occurred after hurricanes Katrina and Rita. In addition, the
community’s mistrust of government was listed as the third reason that they would not
follow directions. Although the following answer did not rank as high as the ones above,
14% of community members surveyed listed fear of the government running medical tests
as a reason they would not follow directions. The total of these questions paints a
disturbing picture of racism, poverty and mistrust in government that would probably
influence community members’ response to a public emergency. It would be interesting
to survey individuals and determine if the lack of response in the aftermath of Katrina and
Rita influenced their responses to this survey.
Emergency Preparedness needs in the African American community in Multnomah
County
To address this question, we asked participants what they thought would help to prepare
the African American community for a disaster. The community answered this question
loud and clear: they said they need education, training, information and planning/a plan.
74 out of 136 respondents indicated answers that fell into these categories. The
respondents mentioned community gatherings and planning meetings, community drills, a
community plan/system in place for disasters, first aid classes, advertisements about
information on disasters, and awareness training. In addition, the community mentioned
the need for more resources and funds to assist in community disaster planning. Also
mentioned was the need for disaster kits and resources to purchase emergency items.
A list of special considerations, along with recommendations for implementation of
them during a public health emergency such as a large, severe flu outbreak (Avian
or Bird Flu, Pandemic flu)
Several issues came up in the survey that should be considered. 62 out of 136 respondents
who were asked what they have in their emergency kits, answered that they did not have
an emergency kit. If a disaster such as Katrina were to hit Portland and supplies were not
able to reach all affected neighborhoods, a large portion of the African American
community might be without emergency supplies. One of the suggestions that came from
DRAFT CSPEC Final Summary Report - 3/8/2016
83
the respondents, on how best to prepare the community, was to find resources for
community members to purchase emergency items. Many of the answers suggest that
offering such items free or for a reduced cost would probably enable the community to be
better prepared.
Considering that 50% of our respondents think the African American community is either
not prepared or only somewhat prepared, and only 5% of respondents think the
community is very prepared, there is a lot of work to be done. Obviously, the County,
City and State need to engage and build confidence with this community on a broad basis.
The best way to do this is to continue to expand the dialogue that the Emergency Grant
has initiated, and support the African American community in creating and building
concrete plans for public emergencies.
Create a written plan that describes how to communicate with the African American
community in Multnomah County during a public health emergency such as a large,
severe flu outbreak (Avian or Bid Flu, Pandemic flu.)
The Emergency Preparedness Grant is a first step in determining the most efficient and
culturally appropriate communication methods for the African American community.
The scope of this grant allows us to begin our research in how to put together a
communications plan and prepare the community to respond in the event of an outbreak
or disaster. However, for any plan to be effective, a concerted and coordinated effort must
be garnered to address some of the issues that came to light in the survey; this effort
would take time and adequate funding.
In the field of community development, it is crucial that the community is trusted to
participate in the effort to resolve its problems and for any outsider who wishes to assist
in the development of a community, to establish trust with that community. According to
our data, the African American community’s distrust of government is rather high. This
response suggests that Multnomah County Health Department might want to start their
communication plan by reaching out to partner with trusted members and organizations in
the community. The community response to the African American Health Coalition was
very natural and unforced because of years of relationship- and trust-building in addition
to the delivery of programs that are culturally sensitive and targeted. With adequate time
and funding, AAHC can work to ensure that the community is prepared for any
emergency by simply utilizing the opportunities that are in place through existing
programs.
Our data underscores the importance of the church’s role in the community as both a
place that the community feels comfortable gathering and as a group (the congregation)
who the community feels comfortable gathering among. It is important to note that the
church culture reaches an even more diverse segment of the African American
community because they have historically worked to gain the trust and familiarity with
African Americans. The AAHC has already established relationships and rapport with
many churches, and thus is a key in partnering with the faith community.
The Multnomah County Health department could partner with CBOs such as the AAHC
to assist community and church leaders in initiating community meetings on the topic of
DRAFT CSPEC Final Summary Report - 3/8/2016
84
emergency preparedness. The community members frequently listed community meetings
and gatherings as ways that the community could be more prepared.
Our data suggests that respondents feel that a community education and media campaign
would be helpful in preparing the African American community. This campaign could
include information about public emergencies, emergency preparedness, and information
on community safety plans and resources. This could include well-designed and culturally
appealing brochures on the subject. Although respondents indicated that TV and the
Oregonian newspaper are two city-wide media resources that they use to receive
information, they also mentioned some widely-read community media such as the
Skanner and the Observer as well as the church. These media sources would be excellent
targets for creating awareness.
Our data also suggests that there is a critical lack of knowledge surrounding the
emergency plans of local schools. Many respondents, when asked to describe their
children’s school emergency plan, listed a limited or partial answer, such as “get under
the desk” or “I don’t know”. Many of our respondents listed their family’s safety as a
major concern during a public emergency. These two pieces of information suggest that a
media campaign should probably target distributing complete information about local
schools’ emergency plans.
The respondents mentioned the creation of a newsletter, which targets emergency
preparedness information for the African American community, as something that would
be very helpful in preparing the community. It was suggested that the newsletter could
include general information about emergencies, community plans, how to prepare for
emergencies, where to get training, local organizations that could provide assistance in an
emergency, etc.
Training and drills for the community as a way to prepare for emergencies was suggested.
The respondents mentioned Red Cross and CPR trainings, as well as emergency drills.
This response suggests that Multnomah County Health Department might want to make
these types of trainings available to the community as well as set up drills on community
safety plans.
These are a few suggestions about where to start in creating a culturally appropriate
communications plan for the African American community in Portland. However, to
create an in-depth plan, more time and resources will be needed. More information needs
to be gathered from the community and they must have a buy-in about the solutions. We
must explore ways to create and establish a better relationship with the Police and
Hospitals as they are very instrumental in emergency situations.
Community leaders who will serve as messengers and provide information back to
the response organization (i.e. feedback on response plans and communication).
The following is a list of community leaders that will provide information:
Pastors
Community Center Directors
Mental Health Agency Directors
Substance Abuse Counselors
DRAFT CSPEC Final Summary Report - 3/8/2016
85
We engaged the community and community leaders through two different methods: 1)
surveys and 2) emergency preparedness presentations. We also solicited contact
information for leaders within the community (Note: Contact List is not based on primary
and secondary contacts, merely “contacts”.)
Surveys: 140
We collected a total of 140 surveys. The breakdown of this number is: 8 from HOLLA
youth; 5 from LTLR participants; 26 from African immigrant women; 101 from the Good
in the Hood event.
Emergency Preparedness Presentations: 131
We reached a total of 131 individuals through four Emergency Preparedness
presentations. The first presentation was conducted for 51 African immigrant women and
men at PSU’s Multicultural Center, on June 4, 2006 and covered many different topics,
integrating information from Multnomah County’s pocket guide and Emergency
Preparedness to information from the Red Cross. The presenters discussed the following:
 Different types of emergencies, including: pandemics and the Avian Flu; earthquakes;
Floods, etc.
 How to prepare for an emergency in the US
 What to stock in their homes in case of emergencies (food, water, medical supplies,
etc.)
 Who to contact in case of an emergency (the AAHC, African Women’s Coalition, and
other agencies dealing with refugee issues)
 Help to start putting together a family emergency preparedness plan
The second presentation was conducted for 13 African American school-aged youth at the
Blazers Boys and Girls Club, on July 25, 2006. The presenter was Linda Swift,
Emergency Preparedness Manager from the local American Red Cross chapter. The
presenter discussed the following:
 What is an emergency kit?
 Supplies to put in your emergency kit (water, food, medicine, etc.)
 Earthquake safety
 The importance of making a family plan for emergencies
 The importance of arranging for a meeting place for your family in emergencies
 Making sure your family has an out-of-state emergency contact whom everyone can
contact to be able to get in touch with one another
The presenter also handed out emergency and disaster preparedness pamphlets to the
older children and coloring pages (about emergency/disaster preparedness) to the younger
children.
Presentations were held at SEI (for youth) on October 24th and for the African American
Alliance at Irvington Covenant Church on September 21, 2006. The SEI presentation
reached 17 students. The African American Alliance presentation reached 50 community
members. Linda Swift presented to the African American Alliance and two Americorps
volunteers from the Red Cross conducted the presentation for youth at SEI. The
presentation for youth at SEI covered the same or similar topics that were presented for
DRAFT CSPEC Final Summary Report - 3/8/2016
86
youth at the Blazers Boys and Girls Club. The presentation for the African American
Alliance covered several additional topics, including: how to shelter-in during an
emergency; fire safety; Tsunamis; the importance of having a family member trained in
CPR and first aid, and where to sign up for training.
The last two presentations were held at two of our annual events. Steven Bullock
presented emergency preparedness information at both the Wellness Conference and
Wellness Village. Mr. Bullock discussed the community’s lack of readiness for an
emergency. He also explored the need for safety plans at home, school and work. He
encouraged people to think about whom they would call and who they would trust in the
case of an emergency. Mr. Bulllock addressed 200 people at the Wellness Conference on
October 19, 2006. The same message was heard by 150 people at the Wellness Village on
October 20, 2006.
Emergency preparedness materials and resources distributed
We distributed emergency preparedness materials and resources in a number of ways. At
the presentation to the African immigrant community, Dora Asana, with help from the
women volunteers, distributed several materials from the Office of Emergency
Management. Linda Swift from the Red Cross distributed emergency and disaster
preparedness pamphlets and coloring sheets, emergency contact cards and band-aids to
the children at the Blazers Boys and Girls Club. In addition, she presented information on
emergency and disaster preparedness. This included information on the importance of
having an emergency kit, what to put in the kit; how to prepare your family for various
types of emergencies (earthquake, tsunami, etc); fire safety; the importance of having an
out-of-state contact; the importance of having a family emergency plan and meeting
location; and where to get more information, emergency kits and training.
Finally, we distributed Pocket Guides to Safety at both the Wellness Conference and
Wellness Village. The guides provided the following information:
 Safety plan
 Who to contact
 Different types of emergency
 Safety kits
200 hundred people received this valuable information at the Wellness Conference. 300
people received the pocket guides at the Wellness Village. Knowledge is the most
valuable resource to have in an emergency situation and by far the most important
resource we could have distributed.
DRAFT CSPEC Final Summary Report - 3/8/2016
87
Latino Collaborative: Catholic Charities/El Programa Hispano (EPH), Latino
Network (LN) and Hacienda CDC (HCDC)
Assessment of Hispanic community in Clackamas, Clatsop, Columbia, Multnomah,
Tillamook, and Washington Counties
Catholic Charities/El Programa Hispano was among the three Latino agencies
involved in this project for the Hispanic community. El Programa Hispano (EPH) was
responsible for providing the printed materials to support the information to be presented
at workshops for the Hispanic community.
In meetings with representatives of the three agencies (EPH, Latino Network, and
Hacienda CDC), EPH created brochures that utilized less text and more illustrations to
communicate a clear message about health and safety. This was done to reach the target
population for these materials - monolingual Spanish speakers who have varying levels of
formal education. These brochures were designed in comic book format, which
represented narratives to communicate in a simple and clear style.
A total of 5 brochures were created, dealing with the following themes:
 Bird flu
 Regular flu
 How to prepare for emergencies (earthquake, flood, volcanic eruptions, terrorist
attacks)
 Steps to take to reduce the danger of a fire in the home
 How to create a plan of escape in case of a fire in the home
It was time-consuming to create these materials since they had to be drawn by hand and
they were reviewed several times by the various agencies involved. Through this process,
many corrections were made to the text and format of the comics. Community input
enriched these comics and resulted in an excellent final product for community education
forms.
Additional time was spent in planning meetings between the agencies and community
partners involved. In addition to the initial planning meeting noted above, there were two
general CBO meetings at the Multnomah County Building, four meetings with the
promotoras de salud, two meetings with the Latino agencies involved in the project, a
CBO meeting at the City of Portland, and a planning meeting to come up with a
presentation of our involvement with the project.
Overall, this project resulted in a creative partnership between several of the Latino
CBO’s in the County. El Programa Hispano’s development of the comic strips to educate
the community will provide materials and information to many community members
seeking information on health issues affecting them or their families.
The Latino Network developed a full educational curriculum on avian flu, the common
flu, house fires and risk reduction in collaboration with El Programa Hispano. These
DRAFT CSPEC Final Summary Report - 3/8/2016
88
materials were tested for effectiveness and used by CHWs at community events and
community gatherings.
In collaboration with El Programa Hispano and Hacienda CDC, Latino Network created a
strategy to increase community capacity to respond appropriately to a public health
emergency using tools/curriculum.
 Trained 20 grassroots community leaders on emergency preparedness. Specific topics
included avian flu, pandemic flu, house fires, risk reduction
 Made home visits to families of each leader and created emergency evacuation plans
with families
 20 community leaders received basic supplies to create emergency kits
 Assisted community members in putting together tool kits.
Latino Network also conducted or participated in community events or community
gatherings to increase emergency preparedness by:
a. Engaging the community and community leaders
b. Distributing emergency preparedness information and resources
Events/Trainings
Latino Network conducted 3 trainings with residents of Cully neighborhood.
Date of Trainings: August 4, August 18 and September 1.
Attendees
8/4: 14 attendees
8/18: 13 attendees
9/1: 15 attendees
An additional 5 attendees were trained on all topics during home visits.
Resources Distributed
 Brochures on emergency preparedness – topics specific to training
 Emergency supplies/boxes with which to make kits
Hacienda CDC completed the Assessment and Plan for the Latino Collaborative. An
assessment was conducted from April through October 2006 to better understand how to
communicate with Latino community members during emergency situations. A
communications plan, including key contacts in the communities assessed, provides local
contacts to help disseminate Latino-specific messaging to community members in Area
Trauma Advisory Board (ATAB) Region 1. ATAB Region 1 is made up of six counties:
Clackamas, Clatsop, Columbia, Multnomah, Tillamook, and Washington.
It is important to acknowledge that the assessment process and communications plan were
part of a larger effort to educate, through popular education techniques, Latino
community members in ATAB Region 1. Three Latino community-based organizations
(CBOs) worked closely to develop the assessment, interpret and share preliminary results,
develop educational materials, and conduct workshops to educate members of the Latino
community. Each of the CBOs was charged with a distinct task as follows: Hacienda –
assess how to communicate with members of Latino communities during an emergency
and conduct educational outreach in outlying counties (Tillamook and Clatsop); Latino
DRAFT CSPEC Final Summary Report - 3/8/2016
89
Network – develop educational materials and conduct educational outreach in Multnomah
County; and Programa Hispano – collaborate with the Latino Network to develop
educational pamphlets for outreach in Multnomah County. Partners met on a monthly
basis to receive programmatic updates, exchange lessons learned and barriers
encountered, and develop strategies for continued implementation. This partnership was
facilitated by Noelle Wiggins, Multnomah County Health Department (MCHD) liaison
for Latino CBOs, who provided technical assistance and followed up on partner’s
questions and concerns.
Need for Latino-Specific Emergency Communications Plan
The Latino population in the state of Oregon has doubled in the last 10 years with 42% of
the population living in the tri-county Portland Metro area. This growth mirrors that of
Latinos across the country and reflects a population of fairly new immigrants from many
Latin American countries, especially rural Mexico. The percentage of Latinos/Hispanics
in Region One counties varies from 2.5% to as high as 11.5 percent.
The need for a Latino-specific emergency communications plan based on a
comprehensive community-based assessment is essential to communicating critical public
health and emergency response messages to a growing segment of the U.S. population
and ATAB Region 1 in particular. A report by the National Council of La Raza expresses
this need clearly in stating:
This dramatic growth of the Latino population…stresses the importance of
recognizing the ethnic, cultural, and economic makeup of a given region in order to
assess the prospective needs and challenges of those in a potential disaster area
….Should a public health crisis occur, such as an outbreak of a communicable
disease, the public’s confidence and cooperation would be critical to containment.
Latinos, especially immigrants, should know that coming forward to government
authorities during a crisis, whether it is natural or man-made, is in their best
interest. If the government and private relief agencies fail to convince a segment of
the nation’s largest minority that they are not a safe source of preventive care and
treatment or credible information, they have effectively undermined their ability to
keep the country safe and healthy. - NCLR, In the Eye of the Storm, 2006
Assessment Process and Results
The assessment development process was administered in four phases:
1) Literature was searched for culturally-specific emergency communications
assessment processes and tools as well as potential barriers;
2) Key informant lists were created by county to contact informants for assistance
in assessment tool development and implementation;
3) Key informant meetings were scheduled to receive input into the development of
the assessment tool and implementation plan; and
4) Assessment tools and implementation plan were finalized.
Literature search: The existing literature was searched to better understand past
experiences conducting culturally-specific emergency communications assessments.
Examples of culturally-specific emergency communications assessments in the literature
DRAFT CSPEC Final Summary Report - 3/8/2016
90
were scarce at the time of the review. However, studies were found that provided valuable
initial guidance and insight into assessment tool development, implementation strategies,
potential barriers, and recommendations for assessment and communications plans. An
additional literature search was conducted to collect content related to avian/pandemic flu
for educational purposes.
Key informant lists: A list of key informants was created to receive assistance in
understanding the local context of Latino communities within each county. Key
informants were identified through online search, recommendation by Latino-serving
CBOs and follow-up communication in person or via phone or email. Each informant was
asked if there was anyone else who worked closely with the Latino population in the
county and should be included on the key informant list. Key informants involved in the
assessment development and implementation process, and willing to share their contact
information, are presented as “Primary Contacts” by county in the Contact List document.
Key informant meetings: Meetings were arranged with key informants and held during
an initial windshield tour through four counties (Clatsop, Columbia, Tillamook and
Washington). These four counties were selected because the Latino CBOs involved in the
project did not have programmatic activity in the counties prior to this project and
therefore needed to establish new relationships. In addition to meeting with key
informants to describe the project’s goals and objectives, the windshield tour allowed for
informal observations and an inventorying of community assets (stores, churches,
apartment complexes, etc.) that would inform the assessment process. Meetings with key
informants in the remaining two counties (Multnomah and Clackamas) were scheduled
following the windshield tour.
Meetings with key informants provide a process to receive feedback on the project’s
goals and objectives, drafts of the survey and focus group guides, and identify survey and
focus group participants.
Assessment tools and implementation plan: The assessment tools consisted of a 3-page
survey and a 2-page focus group guide that underwent revisions through a feedback
process to ensure cultural relevancy. Those contributing to the survey and focus group
guide development included Latino CBO partners, the MCHD, and key informants.
The implementation plan was developed in consultation with key informants and,
whenever possible, prioritized targeting existing groups over recruiting participants
without organizational affiliations. This was done for convenience and to maximize ease
of educational follow-up with participants. Additionally, it was determined that existing
groups would be better positioned to provide an organized response and support to
communication efforts during an emergency situation. The vast majority of survey and
focus group participants were affiliated with community colleges, churches and programs
run by social/health agencies.
Assessment Implementation Description: The use of surveys and focus groups for the
purposes of the assessment allowed for the collection of both quantitative and qualitative
DRAFT CSPEC Final Summary Report - 3/8/2016
91
data. Therefore, the assessment would establish breadth (quantitative) and depth
(qualitative) information by eliciting participant responses through two different
assessment tools. In other words, surveys would allow for analyzing how many
participants answered questions in a particular way and focus groups would allow for
analyzing the descriptive detail that participants provided while answering questions.
Surveys: A total of 318 surveys were conducted across the six-county ATAB Region 1.
The number of surveys collected by county varied but was generally proportionate to the
size of the Latino population in each county. When possible, a facilitator was present to
answer questions participants had while filling out the survey. Surveys were in Spanish
and efforts were made to increase usability by considering the potential for loweducational attainment participants. Surveys were collected either in person by the
program coordinator or mailed to the program coordinator for duplication and submitted
to the data analyst for cleaning, entry and analysis.
Focus Groups: Six focus groups were conducted across ATAB Region 1. One focus
group was conducted in each county and a total of 85 participants attended the focus
groups. Three focus groups were conducted with members of faith-based organizations,
two with English as a Second Language (ESL) classes at community colleges and one
with participants of a program run by a social/health agency. Focus groups were
facilitated in Spanish, tape-recorded, transcribed into Spanish and analyzed to identify
salient themes and descriptive findings. Focus group size varied from 9-18 participants
and lasted between 45 minutes and 75 minutes. Personal identifying information was not
gathered from participants to maintain anonymity, however individuals who were
interested in assisting with communication efforts in case of an emergency were asked to
sign a form and include their contact information. These individuals are listed as
“Secondary Contacts” by county. Anecdotally, a relative balance between male and
female participants was observed by the facilitator and ages ranged from approximately
17 to 65 years. Hispanic/Latino ministry leaders, teachers and program managers were
integral in granting permission for and scheduling focus groups. Food and refreshments
were provided at all focus groups in an effort to increase attendance. Additionally,
educational information on emergency preparedness and avian flu were provided to
participants and participants received a safety tube donated by the American Red Cross
containing basic survival supplies.
Assessment Results: The assessment was designed to gather information from
participants to identify the following:
1. Communication methods the community currently uses to disseminate information;
2. Ways that the community will most likely respond to a public health emergency;
3. Considerations that influence their response to a public health emergency;
4. Emergency preparedness needs in the Latino community; and
5. A list of special considerations, along with recommendations for implementation of
them during a public health emergency.
Region Overview: A total of 291 completed surveys (27 with missing data) were
conducted throughout the six counties in the region. Surveys completed by county
DRAFT CSPEC Final Summary Report - 3/8/2016
92
included 96 in Washington County; 47 in Clackamas; seven in Clatsop; 2 in Columbia
county; 30 in Tillamook and 109 Multnomah. Due to the low number in some counties
we have aggregated data results here. Survey participants had lived in Oregon for varying
lengths of time: 11% less than one year; 37% 1-5 years; 28% 6-10 years; and 23% more
than 10 years. 93% of survey participants were between 19-45 years old: 24% were
between 19-25 years old; 46% were between 26-35 years old; 23% were between 36-45
years.
Communication Methods: Of those surveyed, 87% preferred to receive information in
Spanish during an emergency while 13% expressed no preference between Spanish and
English. When asked to list sources of information received on a daily basis, almost twothirds, 64%, reported that they receive information via Spanish-language radio. Of those
respondents, 46% listened to KGDD 1520, 17% listened to 1450 La Grande and 15%
listened to KWBY 940 La Pantera. 19% of respondents mentioned receiving information
daily via English-language radio. Of those respondents, 29% listened to KXJM 95.5, 17%
listened to Z 100 100.3 11% to KLDZ 103.5, another 8% to1330 K-Praise. 8.5% of
respondents stated that they receive information via Spanish-language newspaper on a
daily basis. Of those, 75% read El Latino de Hoy and 25% read The Hispanic News.
English-language newspaper was listed by 15% of respondents as a medium by which
they get information on a daily basis. 96% of these respondents listed The Oregonian as
the newspaper from which they received information. 47% of respondents stated that
Spanish-language TV is a source of daily information. Of those respondents, 66.7%
reported watching Univision and 27% reported watching Telemundo and 4% watched
Azteca. English-language TV was reported by 32% of respondents as a source of daily
information and 29% watched KGW (NBC), 28% KPTV (FOX), 10.5% KOPB (PBS) and
11% KOIN (CBS). Only 8.5% of respondents mentioned they use the Internet as a source
of daily information.
When asked what source of information respondents would trust, the response was mixed
and had low results. The top two response included churches 7% (specific churches
mentioned) and internet sites at 3%.
Potential Community Response: When respondents were asked where they would go to
receive medical attention during an emergency, 48% said the hospital, 24% the Health
Department and 8% said a doctor’s office. Of those that said they would go to the
hospital, 4% listed St. Vincent Hospital, 4% listed Tuality Hospital, 3.5% Virginia Garcia
and 3% Kaiser Permanente. NOTE: Individual county’s hospital rose when data were
disaggregated.
Survey respondents were asked which instructions they were willing to follow during an
emergency. In an attempt to better understand how willing the Latino community would
be to recommendations of social distancing (avoiding situations where one comes into
close contact with others), the survey asked what measures respondents were willing and
unwilling to take to protect themselves and others from a communicable disease. Of those
responding to a question about physical contact with others, 19% reported they were
willing to avoid contact with family members (81% were not willing to avoid physical
DRAFT CSPEC Final Summary Report - 3/8/2016
93
contact), 23.5% were willing to avoid physical contact with friends (76.5% were not
willing to avoid physical contact), 24% were willing to avoid physical contact with work
colleagues (76% were not willing to avoid physical contact), and 33% were willing to
avoid physical contact with strangers (67% were not willing to avoid physical contact).
In terms of self-limiting their mobility, 15.5% of participants stated they were willing to
avoid going to stores, (84.5% were not willing to avoid going), 17% were willing to avoid
work (83% were not willing to avoid going), 20% were willing to avoid school (80%
were not willing to avoid going), 19% were willing to avoid social events (81% were not
willing to avoid going), and 24% were willing to avoid restaurants (80% were not willing
to avoid going).
In terms of self-care sanitation measures, 59.5% stated they would wash their hands
several times a day (41.5% would not) to avoid a communicable disease and 38% said
they would only wash their hands after sneezing or coughing.
Following instructions of public officials:
o 53% state that they would evacuate their home, in the case of an emergency, if a
public official asked them to. Of those that would not evacuate their home, 25%
would not because they do not have means of transportation. 22% stated that they
would not evacuate their home because they would have nowhere to go.
o 55% state that they would attend a public community health event to receive a
vaccination. Of those that wouldn’t, 49.5% stated that they would be afraid of
getting sick from another person, 24% stated they would be afraid due to their
undocumented status, and 20% stated they would be afraid to get sick from the
vaccine.
o 44% state that they would take refuge at a shelter. Of those that wouldn’t 43%
state that they would have to pick up all their family members first, 28% would
have to buy food first, and 16% wouldn’t because they have to work, and 11%
said they wouldn’t because they had to go to church.
o 70% state they would be present to receive food and water. Of those that would
not, 4% stated that they would be afraid to get sick from another person, 44% state
they would be too afraid due to their undocumented status.
o 33% would not go to work. Of those that would go to work, 47% state they would
go to work because they didn’t want to lose their jobs, 38% state that they would
go to work because they’re paid hourly and they didn’t want to lose their hours,
12% said they do not get personal/sick days off.
o 64% state they could avoid taking public transportation. Of those that could not,
22% state that they had no other means of transportation.
(The following data is from 16% of respondents.)
 Do you have emergency materials (water, flashlight etc) at your house?
- 42% yes
- 27% no because I haven’t thought of it
- 20% no because I don’t have the money
 Is there an Emergency Plan at the following locations:
Place of work- 36% no.
DRAFT CSPEC Final Summary Report - 3/8/2016
94
Their children’s school- 53% no
Your apartment complex? -70% no.
Your house? 51% no.
Communication Plan
As described in the previous section, respondents described how they get information and
in a limited sense, how they will make decisions around a pandemic flu outbreak. While
we focused on the pandemic flu, many respondents were interested in learning about
emergency planning for other natural events, including tsunamis and earthquakes. For a
communication plan we have identified specific means by which to communicate during
an emergency but also encourage communication before an event. Those are listed in the
recommendation and next steps section.
1. To best meet the needs of Latinos currently residing in Oregon, emergency
information needs to be translated into their native language; at the very least, it
needs to be translated into Spanish. Respondents may have some basic
understanding of English but the importance of emergency information and
direction requires clarity for respondents to follow directives given by emergency
officials.
2. Utilize existing Spanish language specific media outlets.
a. Radio
Our survey indicates that respondents listen to Spanish radio stations across
the region. Spanish Language radio stations are increasing in number and
popularity. In addition several stations have community-focused health
information programming. Prevention education can be delivered now. In
emergencies these radio stations would be critical to sharing information
quickly. The stations include BUT are not limited to:
KGDD 1520
KWBY 940 La Pantera
KXMG 1150
1450 La Grande
KWIP 880, La Campeona
KKSL 97.1
KTIL 94.3
b. Television
Although most respondents indicated they watched national Spanish stationsUnivision, Telemundo, etc., they indicated that in an emergency, they were
concerned that these stations would not carry local information. NOTE:
National stations such as Univision are based out-of-state and would need to
have local information scrolling to direct viewers to local stations.
Respondents suggested they would watch local English stations, however they
would encourage the use of Spanish language information in the bottom of the
scroll screen.
For prevention efforts, current local Spanish language, culturally-specific
programming should be utilized. This includes such cable programming as
Cita con Nelly (Conversation with Nelly). This program is a talk show format;
based in Portland, it welcomes local speakers as guests. We would encourage
DRAFT CSPEC Final Summary Report - 3/8/2016
95
prevention education to use this and other public television to share
information.
c. Newspapers/Print Material
There are several Spanish language newspapers in this region. They
include:
Latino de Hoy
El Hispanic News
Spanish yellow Pages NOTE: several respondents noted they use
the emergency pages in this book for help in contacting fire and
police.
Local newsletters and postings
d. Community message boards
The information needs to be available in the community. Rural and urban
communities both identified local community businesses – laundromats,
grocer stores’ bulletin boards-etc, as key places in which they get
information. Rural communities identified specific businesses – Wal-Mart,
Winco, etc., as the one place they frequent often and where they seek
information.
3. Utilize existing community-based organizations that are trusted and used by the
Latino community.
a. Churches- Several religious institutions were identified as places where
respondents seek information and advice. They include local Catholic,
Jehovah Witness halls, and evangelical congregations
b. Educational institutions: (1) the community colleges or schools that offer
ESL classes. (2) The children’s school. Most Latinos are young and there
are many school-aged children in the schools. Most schools have
emergency plans but parents are not aware of these plans. This can be one
way to communicate prevention information and instructions for
emergencies.
c. Social and health serving organizations. Local health departments
(specific programs such as Women, Infant and Children (WIC), clinics)
were ranked as the first or second place that respondents would access
information and help. Health departments are key leaders in prevention
efforts and in sharing culturally and linguistically appropriate information.
In addition, welfare office or other service organizations were identified as
key contact places.
d. Latino serving community-based organizations. There are varied
organizations that provide social, health, education and other services to
Latinos. These Latino serving organizations tend to be small and
grassroots in nature. Many have strong connections to the varied Latino
communities in the region. In addition, many mainstream organizations
have culturally-specific programs within their organization. Key personnel
can share information and serve as a resource during an emergency.
e. Latino serving businesses. Many respondents identified local businesses
such as grocery stores, discount stores, etc., as places where they
congregate, meet others, garner and share information through community
DRAFT CSPEC Final Summary Report - 3/8/2016
96
board posted at the stores. It is crucial to engage these businesses early on
as they will eventually be selling prevention materials. One suggestion was
to contact the Hispanic Chamber of Commerce in Portland, Oregon.
4. Issues of immigration and fear of deportation are high among this population.
Decreasing this fear is crucial as rumors that INS will be called if you seek help
keeps many respondents from asking for help. By engaging community
organizations early in the emergency response process will increase the comfort of
respondents to seek and accept help during an emergency.
5. Closely tied to previous point, respondents stated that while they fear getting into
problems with immigration, in an emergency they would call the police or fire
department and listen to them for instruction. Therefore, it’s critical that police,
fire and rescue personnel have some basic capacity to give instructions in Spanish.
6. Use existing institutions to share critical emergency information to families.
There are many parent meetings that occur in schools throughout Oregon. Latino
parents attend many of these meetings (migrant education, head start, etc.).
Understanding the school process for caring for children during an emergency is
critical to parents during an emergency.
Contact List: The Contact List is composed of community leaders who have agreed to
be available as a contact in their community in case of emergency. We strongly
encourage confidentiality of the names and contact information provided. Institutions
that helped us distribute surveys and recruited focus group participants included: Latinoserving churches, community-based organizations, English as a Second Language (ESL)
classes at local community colleges and others recommended to us.
Conclusion and Next Steps
It is clear that Latino families are interested in learning about safety planning and
emergency preparedness. More work is needed in this area. Respondents are eager to hear
and learn more about this issue. For our organization, we will continue to work on this
issue. For the counties, here are our recommendations for the future:
1. Continue and increase education and training throughout the community. These
trainings need to be in Spanish and available on weekends or in the evening
during weekdays. The current education consists of Emergency Preparednessincluding emergency kit preparations and disease prevention.
2. Bring the police/fire department and the community members into trainings, so
they can feel comfortable with them, if seen in the community.
3. Teach the difference between different levels of emergency: for example, how to
prepare for earthquakes and tsunamis and what skills are the same/different in
each emergency.
4. Practice with the community. Several Community Development Corporations
such as ours develop and provide affordable housing to Latinos and other minority
populations. Once an emergency plan is developed around pandemic flu or
another emergency incident, it would be important to train and educate
community members and then practice the skills. We encourage such a practice at
a housing complex.
DRAFT CSPEC Final Summary Report - 3/8/2016
97
CSPEC Project Recommendations






It became apparent that this pilot project will require continuation funding to
maintain, update, and expand community activation plans; community
preparedness is an ongoing and evolving effort, subject to changes in
demographics, community leadership, and community needs/issues.
Communities should be involved in front-end EP planning processes, not only
back-end processes (i.e., grassroots involvement in infrastructure building and
allowing communities’ needs/wants to inform how EP dollars are spent;
communities shouldn’t be “done to”) to assure that we plan for the right things
that will positively impact people in their daily lives.
EP planning should be integrated into business continuity planning issues.
Improve the process for requesting funds. Most CBOs had to wait far longer than
the 3 weeks promised them. It was difficult for them to hire people and conduct
surveys and other events in a timely manner in order to meet project deadlines.
Most CBOs had to dip into their own, often limited, funds while waiting for
OAHHS and the State to approve and send the contracted funds to the CBOs.
We have begun work with certain communities, but have not reached pockets of
these communities in other parts of the Region. In addition, there are many
community groups that still need to be reached, such as:
o Filipinos – Pia de Leon of Metropolitan Alliance for the Common Good
(www.macg.org) said that some cultures don’t have CBOs, e.g., Filipino
culture. She has 20 primary contacts that reach 800 instantly. Filipinos use
more informal forms of communication and coming together.
o Middle Eastern (mainly Arabic & Farsi speaking)
o Caribbean (mainly Cuban or Haitian) communities
o Central and South Americans
o Somali
o Ethiopian
o Oromo
o Romanian
o French-speaking Africans
o Africa is a continent. Can’t lump Africans together, too many diverse
groups/languages/cultures that don’t trust each other… and therefore won’t
trust you if they know you are working with other groups they don’t get
along with.
o Polish, Czechoslovakian and other European refugees
o Homeless
o Mentally ill
o Elderly
o Non-citizens
o Unemployed
o Need to reach the employed because they are often the people who make
decisions in families/communities
Mental Health and Developmental Disabilities units need to create and exercise
Safety Plans for their special populations. Expanding efforts to cover homeless,
mentally ill, elderly, etc may take away from the ethnically-specific focus of this
DRAFT CSPEC Final Summary Report - 3/8/2016
98






project when there may already be an infrastructure and/or bureaucratic advocacy
groups in place to address the needs of these other populations.
How do we begin to integrate community emergency planning with the broader
agency emergency planning efforts?
How do we keep the momentum of this project’s efforts moving forward
continuously?
Citizen Corps (via Cathy Harrington of City of Gresham) has $130k that can be
used to provide community resource materials. CBOs would be happy to help
distribute materials if they can also help create the materials so that they are
culturally appropriate to those they disseminate them to.
Encourage community engagement around preparedness, maintain/update lists,
outreach to more of their group/s plus other related groups by a continuous and
timely feedback loop between communities and EP agencies. Periodically test and
exercise these lists/outreach activities by getting out health education info as well
(EP can be a subset of the bigger category of health education).
CBOs should not be asked to broaden their efforts with less money over more
time. It doesn’t seem feasible given the time intensive nature of community
organizing, nor does it respond to the concerns of the current partners that they
need more time in the communities they are working with on this project to
develop relationships with key stakeholders in their communities who do not have
emergency preparedness on their radars.
Maintain our relationships with the current communities by building continuous
funding into EP budgets so that current CBOs can continue to meet and develop
their leadership role in the area of emergency preparedness – and seek additional
dollars to expand and deepen their work and the pool of community organizations
involved in emergency preparedness. (Note: if funding is scarce or non-existent,
we may need to be realistic about thresholds for engagement. Part of that will
hinge on population size, but may also be a function of how dispersed some of
these populations are and whether there are some natural organizational
“structures” where we can engage them. However, not committing to continuous
funding to continue the efforts begun by this project runs the risks of increasing
mistrust and non-participation of community groups that we need to stay
connected to in case of emergencies.) Sample comments by two CBOs include:
o Asian Health & Service Center (AHSC): has started to reach most of the
leaders of target groups in the last few months. However, due to time
constraints, most of the outreach was preliminary and needs further
follow-up. AHSC would like to continue their efforts to establish an everwidening network system among the Chinese and Korean communities.
The network system would connect sub-groups, faith organizations, and
other community associations. They estimate the target population in the
Portland Metro area is about 30,000 and most of them are connected to
some sub-groups. In addition, during initial phase, AHSC successfully
outreached to the general public including the elderly population. As the
project was still new and might have aroused additional stress to the
mentally ill group, they didn’t focus their outreach to that sub-group.
DRAFT CSPEC Final Summary Report - 3/8/2016
99
However, if funding was available and the system further defined, would
like to make special efforts to reach the mentally ill and the isolated
elderly sub-groups. This could include setting-up a registry system that
pre-identifies clients’ special needs in case of emergencies. Continuation
funding would also enable AHSC to have regular community workshops
around EP, use Chinese and Korean medias to disseminate emergency
information, participate in drills to test systems/lists, and train
staff/volunteers to set-up a neighborhood emergency response team.
o Russian Oregon Social Services (ROSS): Initial efforts resulted in
outreach to mostly women and seniors. More time is needed to reach a
broader cross-section of the community, including more churches and
pastors, community leaders, Russian-speaking press. Would also like to
expand outreach to populations in Clackamas and Washington counties.
Would like quarterly meetings, exercise participation,
maintaining/updating of contact lists. Would like to set-up a data registry
for people with special needs during an emergency. Would also like to do
preventative education around different kinds of emergencies.




Continuation funding has been granted until August 2007. All current CBOs have
indicated interest in continuing in 2007. UASI funding may also be available for
certain specified uses (details are currently being worked out). Contracts for
HRSA/OAHHS and UASI funds are expected to be ready for signing in January
or February. New contracts will use the new group name chosen by the CBOs:
Cultures Uniting for Emergency Preparedness.
This overview/synthesis/recommendations report will be complemented by a
synthesis chart of project findings by CBOs. CBOs will be asked for feedback on
accuracy of both the report and chart before they are disseminated.
Quarterly meetings will be open to any interested persons in 2007 so that CBOs
can begin relationship-building with agencies/organizations and vice versa.
Dissemination issues/parameters still need to be worked out. Confidentiality
protocols for Contact Lists need to be decided by the CBOs at a meeting in 2007.
Report submitted by:
Valerie Katagiri, MPH; Valerie.Katagiri@co.multnomah.or.us; 503-988-4633
H drive:/HPO/CSPEC Final vk.doc
DRAFT CSPEC Final Summary Report - 3/8/2016
Updated: 1/31/07
100