摘要：Community resilience (CR)—ability to withstand and recover from a disaster—is a national policy expectation that challenges health departments to merge disaster preparedness and community health promotion and to build stronger partnerships with organizations outside government, yet guidance is limited. A baseline survey documented community resilience–building barriers and facilitators for health department and community-based organization (CBO) staff. Questions focused on CBO engagement, government–CBO partnerships, and community education. Most health department staff and CBO members devoted minimal time to community disaster preparedness though many serve populations that would benefit. Respondents observed limited CR activities to activate in a disaster. The findings highlighted opportunities for engaging communities in disaster preparedness and informed the development of a community action plan and toolkit. THE NATIONAL POLICY enthusiasm for re-envisioning the preparedness agenda around community resilience (the ability to prevent, withstand, and mitigate the stress of a disaster) raises questions among local health departments (LHDs) about how to build or strengthen community resilience and how to integrate the “whole of community approach” (a community-integrated model to involve a diverse set of stakeholders) in usual disaster-planning activities. 1–6 In the past 3 years, all federal agencies that oversee and fund state and local emergency preparedness and response developed requirements and some guidance to establish more of a focus on inclusion of communities in emergency planning and response activities, and as part of the Public Health Emergency Preparedness Cooperative Agreement, the Centers for Disease Control and Prevention now requires a set of capabilities in the area of community preparedness and resilience. 2,4,7,8 The purpose of this focus is 2-fold. There is a recognition based on previous disaster experience domestically and internationally (e.g., Hurricane Katrina, Joplin tornado, Hurricane Sandy) that greater partnership between government and a diverse set of nongovernmental organizations (NGOs; both for-profit and nonprofit) is necessary for more effective response and recovery. 9–12 Furthermore, there is new acknowledgment that the principles of community engagement used in other aspects of public health promotion, including those employed for daily stressors (e.g., community violence), may serve the best strategy for engaging historically vulnerable populations, leveraging existing community assets, and integrating routine and disaster activities. 13 Moreover, the principles of community resilience (e.g., strengthening social connections, finding dual benefit opportunities between routine public health and disaster preparedness) address many of the social and environmental issues that aid communities to withstand and mitigate overlapping disasters. 12,14,15 This new approach requires very different levels of partnership compared with the traditional top-down disaster response approach that has pervaded the past decade. 3,5,9,16–18 Yet, even though all LHDs must address community resilience capabilities as part of their public health emergency preparedness cooperative agreement, 7 key questions remain as to how LHDs can operationalize and measure this broader approach, and there are few examples of how to address these expectations. The Los Angeles County Community Disaster Resilience (LACCDR) Project is a comprehensive, community-based approach to answer these questions through both strategy and tactical activities, moving community resilience from conceptual (national policy and associated literature on community resilience) to operational (identifying and testing resilience-building activities in actual communities). The structure of the partnerships, the Los Angeles County Department of Public Health (LACDPH) design strategy, and the community engagement approaches used are described elsewhere in this issue. 6,13 This article summarizes findings from a baseline survey of governmental public health and community organizations to document initial capacities and practices regarding community resilience and describes the initial logic model for the LACCDR project. The LACCDR builds on a conceptual framework for community resilience that emphasizes the engagement, education, and interconnection of governmental and NGO partners considered essential to a community’s ability to mitigate vulnerabilities and recover from stress. 5,12,19
