{"title":"这不仅仅是培训的问题：还要重新思考加强全球应急队伍的战略。","authors":"Mays Shamout, Adela Hoffman, Sonya Panjwani, Mariama Tejan, Cassandra Boutelle, Claire Corkish, Tasha Stehling-Ariza, Hannah Lofgren, Coralie Giese, Dante Bugli, Ashley Lauren Greiner","doi":"10.1136/bmjgh-2024-017454","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Public health rapid response teams (RRTs) are critical to timely and effective emergency response. The US Centers for Disease Control and Prevention (CDC) has trained country-level public health emergency managers on RRT programme design, management and operations. However, countries continue to face challenges in RRT programming, requiring further elucidation of the supportive and challenging factors.</p><p><strong>Methods: </strong>In April 2021, 86 CDC-trained participants on RRT programme management were sent an anonymous online survey with questions regarding their country's RRT programme capacity (fully functional (FF-RRT) vs partially functional (PF-RRT)) and factors that affected programme implementation. Descriptive analyses were conducted; factors were stratified by respondent-reported RRT programme capacity and gross national income (low-lower middle (L-LM) and upper middle-high (UM-H) using a χ<sup>2</sup> test.</p><p><strong>Results: </strong>55 (64%) participants from 24 countries responded, most from the African region (75%) and 46% from L-LM countries. Most participants (82%) reported an RRT programme in their country, 65% PF-RRT and 35% FF-RRT. The greatest supportive factors for RRT programme implementation included a dedicated RRT management team (65%) and leadership understanding (65%). The major challenge was lack of funding (68%). L-LM countries cited greater challenges with funding (74% vs 38%; p=0.04) and equipment (46% vs 0%; p=0.01), while UM-H countries cited poor standard operating procedure development (50% vs 11%; p=0.04) and leadership understanding (50% vs 11%; p=0.01). Available funding was a more supportive factor for PF-RRTs than for FF-RRTs (48% vs 19%; p=0.004). More FF-RRTs (100% vs 62%; p=0.005) cited the lack of RRT surge staff as a challenging factor.</p><p><strong>Conclusion: </strong>Training RRTs is not enough. Addressing foundational factors such as sustainable funding and leadership support is essential for the long-term success of RRT programmes. With the challenges elucidated here, future global health initiatives can consider tailoring support based on RRT country capacity status and income level to ensure effective emergency response capacity.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 9","pages":""},"PeriodicalIF":6.1000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481407/pdf/","citationCount":"0","resultStr":"{\"title\":\"It is not just about the training: rethinking strategies to strengthen the global emergency response workforce.\",\"authors\":\"Mays Shamout, Adela Hoffman, Sonya Panjwani, Mariama Tejan, Cassandra Boutelle, Claire Corkish, Tasha Stehling-Ariza, Hannah Lofgren, Coralie Giese, Dante Bugli, Ashley Lauren Greiner\",\"doi\":\"10.1136/bmjgh-2024-017454\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Public health rapid response teams (RRTs) are critical to timely and effective emergency response. The US Centers for Disease Control and Prevention (CDC) has trained country-level public health emergency managers on RRT programme design, management and operations. However, countries continue to face challenges in RRT programming, requiring further elucidation of the supportive and challenging factors.</p><p><strong>Methods: </strong>In April 2021, 86 CDC-trained participants on RRT programme management were sent an anonymous online survey with questions regarding their country's RRT programme capacity (fully functional (FF-RRT) vs partially functional (PF-RRT)) and factors that affected programme implementation. Descriptive analyses were conducted; factors were stratified by respondent-reported RRT programme capacity and gross national income (low-lower middle (L-LM) and upper middle-high (UM-H) using a χ<sup>2</sup> test.</p><p><strong>Results: </strong>55 (64%) participants from 24 countries responded, most from the African region (75%) and 46% from L-LM countries. Most participants (82%) reported an RRT programme in their country, 65% PF-RRT and 35% FF-RRT. The greatest supportive factors for RRT programme implementation included a dedicated RRT management team (65%) and leadership understanding (65%). The major challenge was lack of funding (68%). L-LM countries cited greater challenges with funding (74% vs 38%; p=0.04) and equipment (46% vs 0%; p=0.01), while UM-H countries cited poor standard operating procedure development (50% vs 11%; p=0.04) and leadership understanding (50% vs 11%; p=0.01). Available funding was a more supportive factor for PF-RRTs than for FF-RRTs (48% vs 19%; p=0.004). More FF-RRTs (100% vs 62%; p=0.005) cited the lack of RRT surge staff as a challenging factor.</p><p><strong>Conclusion: </strong>Training RRTs is not enough. Addressing foundational factors such as sustainable funding and leadership support is essential for the long-term success of RRT programmes. With the challenges elucidated here, future global health initiatives can consider tailoring support based on RRT country capacity status and income level to ensure effective emergency response capacity.</p>\",\"PeriodicalId\":9137,\"journal\":{\"name\":\"BMJ Global Health\",\"volume\":\"10 9\",\"pages\":\"\"},\"PeriodicalIF\":6.1000,\"publicationDate\":\"2025-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481407/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Global Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjgh-2024-017454\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Global Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjgh-2024-017454","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
摘要
简介：公共卫生快速反应小组（RRTs）对于及时有效地应对突发事件至关重要。美国疾病控制和预防中心（CDC）对国家一级的突发公共卫生事件管理人员进行了RRT规划设计、管理和操作方面的培训。然而，各国继续面临着RRT方案编制方面的挑战，需要进一步阐明支持性和挑战性因素。方法：2021年4月，86名接受过疾病预防控制中心RRT规划管理培训的参与者接受了一份匿名在线调查，调查内容涉及其所在国家的RRT规划能力（全功能（FF-RRT） vs部分功能（PF-RRT））以及影响规划实施的因素。进行描述性分析；采用χ2检验，根据被调查者报告的RRT项目能力和国民总收入（中低（L-LM）和中高（UM-H））对因素进行分层。结果：来自24个国家的55名（64%）参与者做出了回应，其中大多数来自非洲地区（75%），46%来自L-LM国家。大多数参与者（82%）报告其所在国家有RRT计划，65%为PF-RRT， 35%为FF-RRT。RRT计划实施的最大支持因素包括专门的RRT管理团队（65%）和领导理解（65%）。主要的挑战是缺乏资金（68%）。L-LM国家在资金（74%对38%，p=0.04）和设备（46%对0%，p=0.01）方面面临更大挑战，而UM-H国家则在标准操作程序制定（50%对11%，p=0.04）和领导理解（50%对11%，p=0.01）方面面临更大挑战。可获得的资金是PF-RRTs比FF-RRTs更支持的因素（48% vs 19%; p=0.004）。更多的FF-RRTs （100% vs 62%; p=0.005）认为缺乏RRT快速响应人员是一个具有挑战性的因素。结论：仅仅训练RRTs是不够的。解决诸如可持续供资和领导支持等基本因素对于恢复生殖能力方案的长期成功至关重要。鉴于这里阐明的挑战，未来的全球卫生倡议可以考虑根据难民回流国家能力状况和收入水平来调整支持，以确保有效的应急能力。
It is not just about the training: rethinking strategies to strengthen the global emergency response workforce.
Introduction: Public health rapid response teams (RRTs) are critical to timely and effective emergency response. The US Centers for Disease Control and Prevention (CDC) has trained country-level public health emergency managers on RRT programme design, management and operations. However, countries continue to face challenges in RRT programming, requiring further elucidation of the supportive and challenging factors.
Methods: In April 2021, 86 CDC-trained participants on RRT programme management were sent an anonymous online survey with questions regarding their country's RRT programme capacity (fully functional (FF-RRT) vs partially functional (PF-RRT)) and factors that affected programme implementation. Descriptive analyses were conducted; factors were stratified by respondent-reported RRT programme capacity and gross national income (low-lower middle (L-LM) and upper middle-high (UM-H) using a χ2 test.
Results: 55 (64%) participants from 24 countries responded, most from the African region (75%) and 46% from L-LM countries. Most participants (82%) reported an RRT programme in their country, 65% PF-RRT and 35% FF-RRT. The greatest supportive factors for RRT programme implementation included a dedicated RRT management team (65%) and leadership understanding (65%). The major challenge was lack of funding (68%). L-LM countries cited greater challenges with funding (74% vs 38%; p=0.04) and equipment (46% vs 0%; p=0.01), while UM-H countries cited poor standard operating procedure development (50% vs 11%; p=0.04) and leadership understanding (50% vs 11%; p=0.01). Available funding was a more supportive factor for PF-RRTs than for FF-RRTs (48% vs 19%; p=0.004). More FF-RRTs (100% vs 62%; p=0.005) cited the lack of RRT surge staff as a challenging factor.
Conclusion: Training RRTs is not enough. Addressing foundational factors such as sustainable funding and leadership support is essential for the long-term success of RRT programmes. With the challenges elucidated here, future global health initiatives can consider tailoring support based on RRT country capacity status and income level to ensure effective emergency response capacity.
期刊介绍：
BMJ Global Health is an online Open Access journal from BMJ that focuses on publishing high-quality peer-reviewed content pertinent to individuals engaged in global health, including policy makers, funders, researchers, clinicians, and frontline healthcare workers. The journal encompasses all facets of global health, with a special emphasis on submissions addressing underfunded areas such as non-communicable diseases (NCDs). It welcomes research across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialized studies. The journal also encourages opinionated discussions on controversial topics.
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