Community Assessment for Public Health Emergency Response (CASPER): Role of the Epidemiologist

1. Community Assessment for Public Health Emergency Response (CASPER):Role of the Epidemiologist Health Studies Branch, National Center for Environmental Health Division of Environmental Hazards and Health Effects LCDR Sara J. Vagi, PhD U.S. Public Health Service

2. CASPER Definition • Epidemiologic technique designed to provide quickly and at low cost, household-basedinformation about an affected community’s needs after a disaster in a simple format to decision-makers.

3. Critical Post-Disaster Needs • Water • Food • Shelter • Sanitation • Medicine • Solid Waste • Electric Power • Heat • Transportation • Communication

4. Goals of CASPER • Determine the general and health needs of the community • Produce population- based estimates for decision-makers • Inform response efforts and planning for future disasters

5. CASPER Methodology • Multi-stage probability sample • 30 clusters (census blocks) • 7 households • Questionnaire development • Household-interview • Data weighted to obtain population estimates • Report generated within a day or two of data collection • Report shared with partners in response and recovery efforts

6. Use of CASPER • Man-Made • Deepwater Horizon Gulf Coast Oil Spill, 2010 • Hurricanes • Hurricane Ike, Galveston, TX, 2008 • Hurricane Katrina, New Orleans, 2005 • Hurricanes Charley & Ivan, Florida, 2004 • Hurricane Isabel, North Carolina, 2003 • Hurricane Andrew, Florida and Louisiana, 1992 • Earthquakes/Tsunamis • American Samoa, 2009 • Izmit, Turkey, 1998 • Ice storms • Kentucky, 2009 • Maine, 1998 • Volcanic activity • Mexico, 1998

7. CASPER phases • Prepare for the CASPER • Determine objectives • Determine assessment area • Develop questions and create questionnaires • Conduct the CASPER • Select sample • Organize and train assessment teams • Conduct household interviews • Analyze the data • Determine sampling weight • Calculate weighted frequencies and percentages • Write the report and share results

8. The role of the epidemiologist is to bring sound epidemiologic principles and practices into all phases of the CASPER!

9. The Preparation Phase • Prepare for the CASPER • Determine objectives • Not always the role of the epi • But epi must see that the appropriate tool is being used to meet the objectives • Determine assessment area • How do we define the “affected” or “exposed”? • Assumption: All households in sampling frame are similarly affected • Develop questions and create questionnaires • Household-based • Action-oriented data

10. Map of sampled area

11. The Preparation Phase • Prepare for the CASPER • Determine objectives • Not always the role of the epi • But epi must see that the appropriate tool is being used to meet the objectives • Determine assessment area • How do we define the “affected” or “exposed”? • Assumption: All households in sampling frame are similarly affected • Develop questions and create questionnaires • Household-based • Action-oriented data • Pilot

12. Conducting the survey • Conduct the CASPER • Select sample • Obtaining an adequate sample size (n=210) • Avoiding the convenience sample • Organize and train assessment teams • Conduct household interviews • Reducing interviewer bias • Balancing the ideal with the real world situation

13. Response Rates, Kentucky ice storm

14. Final phases • Analyze the data • Determine sampling weight • Calculate weighted frequencies and percentages • Write the report • This begins in the preparation phase • Know your data and its limitations

15. Conclusions • Planning early for later steps • “Start with your table shells!” • Maintaining sound epidemiology • Balancing the ideal with the real-world situation

16. Thank you National Center for Environmental Health Division of Environmental Hazards and Health Effects