76 - Creating prepared, resilient, and equitable services and systems: Multilevel approaches to preparing for and responding to disasters

Chair(s)

• AD

  Alex Dopp, Ph.D.

  Behavioral/Social Scientist
  RAND Corporation
  Santa Monica, California
• VB

  Vivian Byeon, M.A.

  University of California, Los Angeles
  Los Angeles, California

Discussant(s)

• SH

  Stanley Huey, Ph.D.

  Associate professor
  University of Southern California
  Los Angeles, California

Presenter(s)

• EM

  Elizabeth McGuier, Ph.D.

  Assistant Professor of Psychiatry
  University of Pittsburgh School of Medicine
  Pittsburgh, Pennsylvania
• 

  Courtney Wolk, Ph.D.

  Assistant Professor
  Perelman School of Medicine at the University of Pennsylvania
  Philadelphia, Pennsylvania
• TL

  Taylor Loskot, PhD

  Pacific University
  Hillsboro, Oregon
• VB

  Vivian Byeon, M.A.

  University of California, Los Angeles
  Los Angeles, California
• BW

  Blanche Wright, M.A.

  Doctoral Candidate
  University of California Los Angeles
  Cambridge, Massachusetts

Disasters, such as natural disasters, acts of terrorism, and public health crises, are major disruptions to society that cause widespread losses and have serious, population-level impacts on mental health and substance use problems (Joint Commission, 2019). These include direct impacts (e.g., traumatic stress) and secondary effects from disruptions to home, school/work, social networks, and physical health (Goldman & Galea, 2014). To counter disaster impacts, behavioral health and related service systems must be prepared to maintain essential services, expand services to meet sudden influxes of need, and adapt to rapidly changing demands (Bonnett et al., 2007; Therrien et al., 2017). Systems should also promote equitable access and delivery of services following disasters to avoid exacerbating behavioral health disparities. 

In this symposium, behavioral health experts will discuss approaches to building resiliency and equity for responding to disasters in diverse service systems, drawing on foundational knowledge of implementation science, disaster preparedness theories from public policy, and health equity research. Presentations will be framed within the “four S’s of surge capacity” – Staff, Stuff, Structure, and Systems (Barbisch & Koenig, 2006). This framework helps operationalize disaster preparedness and parallels major domains of determinants for evidence-based practice implementation: individuals, intervention, inner setting, and outer setting (Damschroder et al., 2009). The first two presentations address Staff capacity. Presentation 1 will describe adaptation and pilot testing of an intervention to improve teamwork skills in multidisciplinary professionals, equipping them to coordinate work across complex systems. Presentation 2 will describe a lay mental health coaching model developed to respond to a surge in healthcare worker stress and burnout during the COVID-19 pandemic. Presentations 3 and 4 consider Stuff capacity, specifically how to maintain services during disaster responses. Presentation 3 describes a brief intervention for improving social connection in older adults during disasters (such as wildfires in the western U.S. as well as the pandemic), and Presentation 4 describes shifting delivery of evidence-based mental health treatments from in-person to telehealth in response to COVID-19. Presentation 4 also highlights elements related to Structure (e.g., technology, organizational support), and Presentation 5 bridges Systems and Structure capacities. It will discuss states’ efforts to sustain an evidence-based treatment for adolescent substance use problems during the pandemic, using data from state agencies and their provider organization networks. 

All five presenters will highlight equity-related considerations in the implementation and effectiveness of the discussed approaches. Finally, our symposium Discussant is a leading expert on improving cultural responsiveness of evidence-based behavioral health treatments, who will share perspectives on promising future directions to maximize the impact and equity of disaster responses through improved service and system capacity.

Presentations:

• (Sym 76) Adaption and Pilot Testing of a Team Training Intervention for Multidisciplinary Cross-sector Teams: Implications for Disaster and Crisis Responses
  

  Presenter: Elizabeth A. McGuier, Ph.D. – University of Pittsburgh School of Medicine

  Co-author: Jamie Feldman, BA – University of pittsburgh medical center

  Co-author: Mikele Bay, BA – Children's Advocacy Center of McKean County

  Co-author: Sue Ascione, MS – Northeast Regional Children's Advocacy Center

  Co-author: Mary Tatum, MPA, ACFI – Child Advocacy Center of Clearfield County

  Co-author: Eduardo Salas, PhD – Rice University

  Co-author: David J. Kolko, Ph.D. – University of Pittsburgh School of Medicine
• (Sym 76) Increasing Access to Mental Health Supports for Healthcare Workers During the COVID-19 Pandemic and Beyond Through a Novel Coaching Program
  

  Presenter: Courtney Wolk, Ph.D. – Perelman School of Medicine at the University of Pennsylvania

  Co-author: Matteo Pieri, PhD – Perelman School of Medicine at the University of Pennsylvania

  Co-author: Michal Weiss, B.S. – Perelman School of Medicine at the University of Pennsylvania

  Co-author: Emily M. Becker-Haimes, Ph.D. – University of Pennsylvania
• (Sym 76) Adapting a Brief Intervention for Older Adults to Bolster Social Connection in Response to Disaster and Isolation
  

  Presenter: Taylor Loskot, PhD – Pacific University
• (Sym 76) Lessons Learned from Community Mental Health Providers in the COVID-19 Crisis: Resources for Delivering Evidence-based Teletherapy in Los Angeles County
  

  Presenter: Vivian Byeon, M.A. – University of California, Los Angeles

  Co-author: Ashley Flores, BA – UCLA

  Co-author: Stephanie H. Yu, M.A. – University of California, Los Angeles

  Co-author: Julia Cox, PhD – University of California, Los Angeles

  Co-author: Lauren Brookman-Frazee, Ph.D. – University of California, San Diego

  Co-author: Anna S. Lau, Ph.D. – UCLA
• (Sym 76) States' Policy and Practice Responses to Sustaining Evidence-based Treatments in the COVID-19 Pandemic: Evidence from the Adolescent Community Reinforcement Approach for Substance Use Disorders
  

  Presenter: Blanche Wright, M.A. – University of California Los Angeles

  Co-author: Alex R. Dopp, Ph.D. – RAND Corporation

  Co-author: Grace Hindmarch, B.S. – Research Assistant

  Co-author: Isabelle González, PhD – RAND

  Co-author: Sarah Hunter, PhD – RAND Corporation

  Co-author: Chau Pham, M.S. – RAND

  Co-author: Mark Godley, Ph.D. – Chestnut Health Systems

  Co-author: Jonathan Cantor, Ph.D. – RAND

  Co-author: Rosanna Smart, Ph.D. – RAND

  Co-author: Jonathan Purtle, DrPH, MSc – New York University