Lessons Learned From an Epidemiologist-Led Countywide Community Assessment for Public Health Emergency Response (CASPER) in Oregon

Context: Conducting a large-scale Community Assessment for Public Health Emergency Response (CASPER) in a geographically and linguistically diverse county presents significant methodological challenges that require advance planning. Program: The Centers for Disease Control and Prevention (CDC) has adapted methodology and provided a toolkit for a rapid needs assessment after a disaster. The assessment provides representative data of the sampling frame to help guide effective distribution of resources. Implementation: This article describes methodological considerations and lessons learned from a CASPER exercise conducted by Washington County Public Health in June 2016 to assess community emergency preparedness. The CDC's CASPER toolkit provides detailed guidance for exercises in urban areas where city blocks are well defined with many single family homes. Converting the exercise to include rural areas with challenging geographical terrain, including accessing homes without public roads, required considerable adjustments in planning. Adequate preparations for vulnerable populations with English linguistic barriers required additional significant resources. Lessons learned are presented from the first countywide CASPER exercise in Oregon. Evaluation: Approximately 61% of interviews were completed, and 85% of volunteers reported they would participate in another CASPER exercise. Results from the emergency preparedness survey will be presented elsewhere. Discussion: This experience indicates the most important considerations for conducting a CASPER exercise are oversampling clusters, overrecruiting volunteers, anticipating the actual cost of staff time, and ensuring timely language services are available during the event.