摘要：Surges in demand for professional mental health services occasioned by disasters represent a major public health challenge. To build response capacity, numerous psychological first aid (PFA) training models for professional and lay audiences have been developed that, although often concurring on broad intervention aims, have not systematically addressed pedagogical elements necessary for optimal learning or teaching. We describe a competency-based model of PFA training developed under the auspices of the Centers for Disease Control and Prevention and the Association of Schools of Public Health. We explain the approach used for developing and refining the competency set and summarize the observable knowledge, skills, and attitudes underlying the 6 core competency domains. We discuss the strategies for model dissemination, validation, and adoption in professional and lay communities. The beginning of the 21st century has seen considerable attention devoted to improving emergency response capabilities at the national, state, and local levels of the US public health emergency preparedness system. A daunting challenge has been planning for the disproportionally high volume of psychological (vs physical) casualties that attend natural, technological, and intentional hazards. 1–7 Evidence suggests that many disaster survivors fail to receive the care they need 8 and that care deprivation under such circumstances is associated with mental health morbidity and increased rates of suicide. 9,10 The difficulty of managing disaster-occasioned surges of demand for mental and behavioral health services is further compounded by the shortage of able and willing responders. 11–14 An increasingly popular idea for enhancing surge capacity during disaster scenarios is to develop cadres of potential responders trained in mental and behavioral health management, including psychological first aid (PFA). 15–19 The American Red Cross 20 and the World Health Organization 21 provide PFA training programs, and the National Child Traumatic Stress Network and National Center for PTSD (posttraumatic stress disorder) distribute PFA field operations manuals for both general audiences and specific fields. Specialized PFA curricula have been developed for people working with the homeless, 22 those working in nursing homes, 23 Medical Reserve Corps volunteers, 24 faith and lay community leaders, 15,16,25,26 and public health workers. 27 Despite the virtual cottage industry of PFA training activities and previous efforts to identify core competencies 16,26–28 and trauma intervention principles, 29 current PFA training programs have significant shortcomings, including variability of content, format, and emphasis (with little motivation for standardization); learning objectives and outcomes defined in nonobservable constructs that preclude meaningful measurement; little external accountability for quality; and no in-depth analysis of the pedagogical principles for optimal learning and teaching of PFA competencies. The result is a dearth of qualified PFA-trained responders available for call-up during public health emergencies 11,13,30 and no widely accepted model for training public health workers in PFA competencies. We describe the development of a PFA training curriculum based on sound pedagogical principles applicable to a broad range of learners, including midtier public health professionals and lay community members. The product is a component competency set of the Public Health Preparedness and Response Core Competency Model, 31 a proposed national standard of behaviorally based, observable skills for the workforce to prepare for and respond to all-hazards scenarios. The project was conducted as part of a larger effort by 14 Preparedness and Emergency Response Learning Centers (PERLCs) in accredited schools of public health. These centers, funded by the Centers for Disease Control and Prevention (CDC), aim to develop knowledge, skills, and attitudes (KSA) content for each of the competency statements in the model. 32 The project could serve as a basis for enhancing consistency in preparedness training curricula and fulfilling mandates in the Pandemic and All-Hazards Preparedness Act 2006. 33
