Characterizing hospital workers' willingness to report to duty in an influenza pandemic through threat- and efficacy-based assessment

Ran D. Balicer, Daniel J. Barnett, Carol B. Thompson, Edbert B. Hsu, Christina L. Catlett, Christopher M Watson, Natalie L. Semon, Howard S. Gwon, Jonathan M. Links

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background. Hospital-based providers' willingness to report to work during an influenza pandemic is a critical yet under-studied phenomenon. Witte's Extended Parallel Process Model (EPPM) has been shown to be useful for understanding adaptive behavior of public health workers to an unknown risk, and thus offers a framework for examining scenario-specific willingness to respond among hospital staff. Methods. We administered an anonymous online EPPM-based survey about attitudes/beliefs toward emergency response, to all 18,612 employees of the Johns Hopkins Hospital from January to March 2009. Surveys were completed by 3426 employees (18.4%), approximately one third of whom were health professionals. Results. Demographic and professional distribution of respondents was similar to all hospital staff. Overall, more than one-in-four (28%) hospital workers indicated they were not willing to respond to an influenza pandemic scenario if asked but not required to do so. Only an additional 10% were willing if required. One-third (32%) of participants reported they would be unwilling to respond in the event of a more severe pandemic influenza scenario. These response rates were consistent across different departments, and were one-third lower among nurses as compared with physicians. Respondents who were hesitant to agree to work additional hours when required were 17 times less likely to respond during a pandemic if asked. Sixty percent of the workers perceived their peers as likely to report to work in such an emergency, and were ten times more likely than others to do so themselves. Hospital employees with a perception of high efficacy had 5.8 times higher declared rates of willingness to respond to an influenza pandemic. Conclusions. Significant gaps exist in hospital workers' willingness to respond, and the EPPM is a useful framework to assess these gaps. Several attitudinal indicators can help to identify hospital employees unlikely to respond. The findings point to certain hospital-based communication and training strategies to boost employees' response willingness, including promoting pre-event plans for home-based dependents; ensuring adequate supplies of personal protective equipment, vaccines and antiviral drugs for all hospital employees; and establishing a subjective norm of awareness and preparedness.

Original languageEnglish (US)
Article number436
JournalBMC Public Health
Volume10
DOIs
StatePublished - Jul 29 2010
Externally publishedYes

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Pandemics
Human Influenza
Emergencies
Protective Agents
Psychological Adaptation
Antiviral Agents
Vaccines
Public Health
Nurses
Communication
Demography
Physicians
Surveys and Questionnaires
Health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Characterizing hospital workers' willingness to report to duty in an influenza pandemic through threat- and efficacy-based assessment. / Balicer, Ran D.; Barnett, Daniel J.; Thompson, Carol B.; Hsu, Edbert B.; Catlett, Christina L.; Watson, Christopher M; Semon, Natalie L.; Gwon, Howard S.; Links, Jonathan M.

In: BMC Public Health, Vol. 10, 436, 29.07.2010.

Research output: Contribution to journalArticle

Balicer, Ran D. ; Barnett, Daniel J. ; Thompson, Carol B. ; Hsu, Edbert B. ; Catlett, Christina L. ; Watson, Christopher M ; Semon, Natalie L. ; Gwon, Howard S. ; Links, Jonathan M. / Characterizing hospital workers' willingness to report to duty in an influenza pandemic through threat- and efficacy-based assessment. In: BMC Public Health. 2010 ; Vol. 10.
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abstract = "Background. Hospital-based providers' willingness to report to work during an influenza pandemic is a critical yet under-studied phenomenon. Witte's Extended Parallel Process Model (EPPM) has been shown to be useful for understanding adaptive behavior of public health workers to an unknown risk, and thus offers a framework for examining scenario-specific willingness to respond among hospital staff. Methods. We administered an anonymous online EPPM-based survey about attitudes/beliefs toward emergency response, to all 18,612 employees of the Johns Hopkins Hospital from January to March 2009. Surveys were completed by 3426 employees (18.4{\%}), approximately one third of whom were health professionals. Results. Demographic and professional distribution of respondents was similar to all hospital staff. Overall, more than one-in-four (28{\%}) hospital workers indicated they were not willing to respond to an influenza pandemic scenario if asked but not required to do so. Only an additional 10{\%} were willing if required. One-third (32{\%}) of participants reported they would be unwilling to respond in the event of a more severe pandemic influenza scenario. These response rates were consistent across different departments, and were one-third lower among nurses as compared with physicians. Respondents who were hesitant to agree to work additional hours when required were 17 times less likely to respond during a pandemic if asked. Sixty percent of the workers perceived their peers as likely to report to work in such an emergency, and were ten times more likely than others to do so themselves. Hospital employees with a perception of high efficacy had 5.8 times higher declared rates of willingness to respond to an influenza pandemic. Conclusions. Significant gaps exist in hospital workers' willingness to respond, and the EPPM is a useful framework to assess these gaps. Several attitudinal indicators can help to identify hospital employees unlikely to respond. The findings point to certain hospital-based communication and training strategies to boost employees' response willingness, including promoting pre-event plans for home-based dependents; ensuring adequate supplies of personal protective equipment, vaccines and antiviral drugs for all hospital employees; and establishing a subjective norm of awareness and preparedness.",
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