The Role of Educators in Public Health Emergencies - Transcript

Moderator: Haley McCalla
Presenters: Judy Kruger, PhD; Jessica Franks, MPH, CHES
Date/Time: July 25, 2018, 1:00 – 2:00 pm ET


>> Good afternoon, everyone. I’m Hailey McCalla [assumed spelling] from CDC’s Office of Public Health Preparedness and Response Division of Emergency Operations. And I’d like to welcome you to
today’s EPIC webinar titled, The Role of Educators in Public Health Emergencies. Today, we will hear from CDC’s Dr. Judy Kruger [assumed spelling] and Jessica Franks.
If you do not wish for your participation to be recorded, please exit at this time. You can earn continuing education for completing this webinar. Please follow the instructions linked
in the invitation you received. The course access code is EPIC 0725 with all letters capitalized. To repeat the course access code to receive continuing education
is in all caps E-P-I-C 0725. Today’s webinar is interactive. To make a comment, click the chat button on your screen and enter your thoughts. To ask a question, please use the Q&A button.
The Q&A session will begin after both presenters have presented. We will now transition to our presenters, Dr. Judy Kruger has worked at CDC for 17 years. Within the division of state
and local readiness, her work aims to advance emergency preparedness, planning and response, and recovery efforts at the national, state and local levels. She has supported CDC’s emergency
response efforts for Ebola and Zika and hurricane recovery efforts in Puerto Rico. Judy’s research on vulnerable populations has been published in “The Disability and Health Journal,” “MMWR
Report” and many others. Jessica Franks is a CDC fellow and health communication specialists for the Children Preparedness Unit. Her work aims to advance children’s
inclusion in emergency preparedness planning and response efforts at the national, state and local levels. She has participated in emergency response efforts for Flint, Zika,
and Hurricanes Matthew, Harvey, Irma, and Maria. She’s a certified health education specialist and public health researcher. Thank you both for joining us. Please begin.

>> Thanks Hailey. Can everyone hear me?

>> Hold on a second. Jessica is having some audio issues, so just give us a moment.

>> Okay, can everyone hear me now? Wonderful. Sorry for the delay of technical difficulties. And thank you Hailey for the introduction. As she said, my name is Jessica Franks
and I’m a health communications fellow for the Children Preparedness Unit in the National Center on Birth Defects and developmental Disabilities. I’ll be co-presenting with my colleague
Dr. Judy Kruger from the Office of Public Health Preparedness and Response. And I’m glad we have the opportunity to speak with you all today, because as educators, you’ve also chosen a profession
to care for and protect children. And you may have a larger role in emergency preparedness, response and recovery than you realize. Next slide.
I’m going to start with some background about the group I work with, The Children’s Preparedness Unit. Then I’ll discuss how emergencies affect children
and why preparedness for children is so important. I’ll pass the mic over to Judy to share key findings from the School of Health Policies and Practices Study and preparedness
objectives from Healthy People 2020. To wrap it up I’ll share some specific examples of educator’s activities and efforts in collaboration with CDC during emergency response.
And finally, discuss some of the resources we have for educators in planning response and recovery phases of emergencies. Next slide. This is a key message we promote with our work.
More than 22% of the population are children under 18 years old. That’s more than one in five people of the US population. And they’re 100% of our future,
which is why emergency preparedness for children is so important. Next slide. Starting with a brief background of the group I work with,
The Children Preparedness Unit, or CPU. Next Slide. CPU sits in the Division of Human Development and Disability. And we’re unique in that we’re the
only group at CDC solely focused on the needs of children in emergencies. We base our mission to champion the needs of children in emergency preparedness and response around four main pillars.
To build an evidence-base. To increase awareness. To offer technical assistance. And to develop partnerships. Next slide.
When CPU is activated for an emergency response, we’re known as the Children’s Health Team. The idea of this team started in 2009, when our current division director, Dr. Georgina Peacock helped staff
the first Children’s Health team in the Emergency Operations Center, or EOC, during the H1N1 response. Between 2009 and 2016, the Children’s Health Team has participated in or contributed
to the emergency responses listed here. And most recently, The Children’s Health Team was activated to the EOC for the 2017 hurricane response. Next slide.
Since children make up almost 1/4 of our population, we know they will undoubtedly be affected by all major disasters and emergencies. Next slide.
As you know, public health emergencies can take many forms; infectious diseases and outbreaks, natural disasters, chemical disasters, nuclear and radiological emergencies, and man-made terrorist events.
In any type of disaster, children have unique physical, biological, developmental, and behavioral differences that we must be aware of to help keep them safe. These are just a few examples, starting
from the top and going clockwise. Children absorb harmful materials from the air more readily because they breathe in more air for their size than adults. So, there’s something toxic in the air,
they’re going to breathe in more of it. They spend more time outside, are lower to the ground and put their hands in their mouths more often than adults. This gives them more exposure to dangerous
agents or toxins in their breathing zones. They may not be able to communicate symptoms or feelings. So, if they become separated from parents or caregivers, they may not be able
to communicate medical history of symptoms. And they need vaccines, medications, and specially designed pediatric equipment for emergency situations. Much of what we try to promote
in our key messages is that children are not just little adults. And I want to highlight children with special health care needs here because they represent approximately one
out of every five children in the US. Caring for children with special healthcare needs is often more complex because of their various health conditions and extra care requirements.
Planning for educators includes addressing how to get kids with mobility needs out of harm’s way or how to address understanding of disasters and coping for kids with cognitive delay.
Judy will explain more in her presentation about the gap between the Healthy People 2020 benchmark and the percentage of school districts reporting
preparedness plans for students and staff members with special needs. Next slide. So, it stands to reason that children will be affected during and after a disaster.
These are a few photos of children in Puerto Rico in the aftermath of Hurricane Maria. Next slide. Public health emergencies can further disproportionately affect pediatric populations.
The photo on the left is from the 2010 polio outbreak. Even children who seem to fully recover can develop new muscle pain, weakness or paralysis as
adults 15 to 40 years later. On the right, the Zika virus outbreak was an example of the disproportionate impact of a public health emergency on children. An adult Zika virus infection may cause
mild symptoms or even no symptoms at all. But if infection occurs prenatally, there’s a risk of a baby being born with congenital Zika syndrome, microcephaly being the most apparent symptom
of infection in utero. Next slide. Children may be more severely affected. The photo on the left shows a classroom after the 2011 earthquake and subsequent meltdown
at the Fukushima Nuclear Power Plant in Japan. The students from the school pictured at left, did not return after the disaster spread deadly radiation by land and sea. The photo on the right is of an infant grave
from the 2014 Ebola outbreak in West Africa. During the outbreak, all schools in Guinea, Liberia and Sierra Leone close because of the epidemic. By the time the schools reopened in 2015
students had lost approximately 1848 hours of education due to school closures, ranging from around 33 to 39 weeks. Next slide. And now I’m going to turn it over to
my colleague Dr. Judy Kruger to explain about the school health policies and practices study.

>> Good afternoon. My name is Judy Kruger and I’m going
to add to Jessica’s presentation. I’d like to share some research findings so that you can get a better sense of where the improvements and gaps exist in school preparedness.
Next slide. First of all, an estimated 50 million children in the US are localized in K-12 schools for about six hours a day. And as Jessica mentioned, children have
unique psychological, physiological, and developmental attributes that make them dependent on educators to direct their activities and support the response recovery efforts.
Nationwide, approximately five of seven school districts have used materials from the US Department of Education to develop a plan. However, more than one out of five school
districts lack a comprehensive plan to respond to natural disasters, epidemic disease or emergencies. Next slide. A number of threats, hazards and disasters
can disrupt normal school operations. And there are several types of emergencies that need to have specific plans. For example, school facility related emergencies such as a gas line leaking
in the school building. A medical emergency, such as the sudden death of the student or even a teacher. And weather-related emergencies such as a severe storm.
Whether you work within the community or in a for-profit or nonprofit organization, you may be called upon at some point in your career to respond during an emergency
on a short notice. It’s key to have a plan and know how to respond. Next slide. Emergency alerts are becoming more and more common.
There they are used to help bring professional emergency responders to the school’s doorsteps within 5 to 10 minutes. and there is growing technology that can be
used to help with notifying you in the school. So, for example, a notification that can help with school operating status would be a text for school closures, delayed openings, or possibly even a phased release.
Facilities would also be indicated when there’s a notification need to close for hazardous weather or for other situations which require a shelter in place notification. There are a number of text alert message
systems that you need to sign up for and register your cell phone to receive these emergency alerts. And in the event of an emergency alert, they can help you to promote family reunification
with your family through an integrated public alert warning system. There’s something called the Reunite App. And of course, existing school rosters can be used to help reunite families.
Next slide. The whole community approach is important to consider before disaster occurs. And it includes a unified as well as a collaborative approach
in the unfolding of it an emergency. So, for example, school-based preparedness plans need to be coordinated with interdisciplinary partners and health departments as well as law enforcement,
first responders, mental health, and social service agencies. As well as families, to make sure that children are as safe as possible. Cross training of teachers, school staff and
administrators can help everyone to learn how to implement emergency preparedness plans. Having conversations with your emergency managers before a disaster strikes is really helpful because then you’ll know who to call.
Next slide. Now, I’m going to share with you some research findings that can help us identify areas for improvement that school districts can consider adding
to their school emergency preparedness plans. Next slide. The School Health Policies and Practices Study, also known as SHPPS, is a national survey periodically conducted
to assess school health policies and practices at the state, district, school, and classroom level. We use data from the Healthy and Safe Schools Environment Module.
And this was collected at the district level. We use SHPPS data collected from three different survey time points; 2006, 2012 and 2016. And self-reported data were collected through pen and pencil and paper method
as well as online through the web. Across the survey years, the response rate ranged for the districts from 64% to 66.5%. Next slide. The Healthy and Safe Schools Environmental
Module has questions specifically rate related to the Healthy People 2020 topics on school-based preparedness. Also included are some information at the school district level.
So, we can actually help to characterize the school districts. This includes who the school district is partnered within the community. We can also look at the U.S.
Census regions in terms of where the Midwest, Northeast, South, or West. The responses are clustered. We can also look at the level of urbanicity, school enrollment size,
in terms of the number of students per class. And if the district provided funding for training or offered education within the school system. Next slide.
So, I’d like to share with you some findings from the study. This specifically came from a report that was published last year in 2012 data were used. And specifically, among the district
partners that were listed we noted that more urban collaborations occurred than rural collaborations. We also noted that, on average, districts partnered with local law enforcement.
And that 92% coordinated with fire officials. We also noted that 66 of districts partnered with local health departments, and 41% collaborate with local hospitals. Another finding was that only 43% of
districts collaborated with families to develop their preparedness, response and recovery plan. Next slide. We see here in this slide where
were looking at 2016 SHPPS data. We see that the Northeast districts were more likely to include special topics in their crisis preparedness plans. And we also noted that provisions of
post-disaster mental health services in their crisis preparedness plan was a high overall in each of the census regions. Next slide. In terms of looking at level of urbanicity,
in this slide we see different outcomes by urbanicity in the districts that required crisis plans. In general, large urban areas, cities included family reunification procedures and procedures
for influenza and other infectious diseases in their plants. However, a larger proportion of school districts included special topics in their crisis preparedness plans.
In general, a lower proportion of rural and smaller area school districts included all of the requirements in their plans. Next slide. For school enrollment size, we
see that almost 80% of medium and large school districts met provisions for students and staff members with special needs in their crisis preparedness plans. We also see that smaller school
districts, school enrollment size less than 4900 students, to lag behind. Next slide. Most of the training of school districts was provided to school faculty and staff.
We also see that large school districts were more likely to provide training on crisis preparedness for school faculty and staff and student families compared
to smaller districts. Next slide. Healthy People 2020 is supported by Health and Human Services Office of the Disease Prevention and Health Promotion.
And Healthy People provides 10-year objectives for improving the health of all Americans. Reports are available from 1990, 2000, and 2010. The work is a result of multiyear activities and it contains more
than 42 topic areas with more than 1200 objectives. These objectives prompt measurable change at the national, state and local levels. Next slide.
Healthy People 2020 has specific preparedness objectives. PREP stands for preparedness. And PREP-5 is specific to the preparedness objectives and it is one of 5
out of 20 specific objectives that we’re going to be looking at. So, the objective specifically is to increase the percentage of school districts that require schools to include special topics
in their crisis preparedness, response and recovery plans. Next slide. There are four targets of this PREP-5 objective. The reason these are so important is
because by adopting strong emergency preparedness policies school districts can help protect and support school employees as well as students and their families. So, specifically the four objectives are
family reunification procedures and plans. Introduction of procedures for flu or other infectious diseases. Provisions of mental health services for students, faculty and staff after a crisis.
As well as provisions of mental health services for students and staff. So, SHPPS data are used to help measure progress. And next, I’m going to show you some results
from a study that looked at 10 years of data. Next slide. Specifically, here what we’re looking at is the objective 5.1, which is a reunification of children, families and caregivers.
And we can see that there’s been some improvement from 2006 to 2016. And in 2016, we came very close to meeting the target of 74.6. Next slide.
The second target here is to encourage procedures for responding to pandemic influenza or infectious disease outbreaks. And we see in two data points
that were collected, the 2016 data point was lower than the target goal of 75.9. Next slide. For the preparedness objective 5.3, plans for
students and staff members with special needs, we see that in 2016, school districts did not meet the Healthy People objective of 87.9. Next slide. And finally, for preparedness objective
5.4, school plans to include provisions of mental health services after a crisis, we see that data indicate that in 2016, we met the objective of 76.2 and actually surpassed it.
Next slide. In terms of implementation, creating a district level emergency preparedness and crisis response plan can help educators prepare to withstand
and recover from a storm or disaster. Disaster preparedness activities at the school and in collaboration with the community and parents, helps to foster confidence and community resilience.
During the time of crisis, school functions may be temporarily taken on by those who are working in the school. And you may have to be required to stay up to 72 hours if needed.
Next slide. Next to the child’s parents, teachers are often the most influential adult in the life of a child. And there are many opportunities
to gain leadership skills and make improvements in school preparedness. Here are some key guidance documents that you can use to help educate yourself in the unfolding of a public health emergency.
Such as a hurricane, flood, or tornado. Jessica will now present some additional information.

>> Thanks Judy. Now a few key activities I’d like to highlight
from some of the responses I’ve been part of. Show the great efforts, educators and schools took to keep children safe. Next slide. The first was the Flint water
contamination crisis, which began in 2014, when the drinking water source for the City of Flint Michigan was changed from Lake Huron and the Detroit River to the less expensive Flint River.
Due to insufficient water treatment, over 100,000 residents were exposed to high lead levels in the drinking water. A federal, state of emergency was declared in January 2016,
when studies confirmed lead contamination was present in the water supply. And CDC activated its emergency operations center on February 1, 2016. One of our key objectives during the Flint
response was to work with the US Department of Education to ensure schools in Flint received CDC’s information on the key issues they were facing with the crisis.
We relied on educators as trusted sources in the community to help disseminate this information to families. One of the materials was the frequently
asked questions document on the left. And they also helped us distribute 20,000 Ready Wrigley children’s preparedness books that you see pictured on the right. We developed these activities to help kids
learn about emergencies and preparedness. This particular one about water contamination safety. Next slide. We activated the Children’s Health Team
to CDC’s Emergency Operations Center for the Zika virus outbreak response on May 23, 2016, just a few months after deactivation of the Flint response.
We found that there was no guidance for schools and we were hearing stories of schools unnecessarily stopping activities, like recess, in attempts to prevent Zika
transmission in students. So, we develop guidance pictured at the left, and released it with a letter from former Secretary King from the US Department of Education.
Educators and schools help to continue disseminating clarifying messaging to family that there were no CDC recommendations to one, remove children from school. Two, isolate or quarantine children at school.
Or three cancel physical education classes, recess, outdoor activities, sporting events, or afterschool extracurricular activities. Another Ready Wrigley book we created for this response focused
on mosquito bite prevention pictured on the right. We worked again with the US Department of Education to get these into classrooms and educators are helping distribute these still
today for the aftermath of the 2017 hurricanes. This provided us more opportunities to share mosquito prevention messages and dispel myths to school and childcare audiences. Next slide.
For the 2017 hurricane response to Harvey, Irma and Maria, the Children’s Health Team activated to the emergency operations center on August 31, 2017 as part of the at-risk task force. HHS defines at-risk individuals as those with
access and functional needs that may interfere with their ability to access or receive medical care before, during or after a disaster. Our main focus was on children, but we collaborated with experts across the agency
to address the needs of other at-risk populations such as pregnant women and infants, older adults, persons with disabilities, and those who have chronic medical disorders. This was the first time there was
an independent at-risk task force, as part of a CDC response structure. Our key objectives throughout the response were to maintain situational awareness of the impact on at-risk populations, to collaborate with key
partners for at-risk populations, to identify, create, review and disseminate materials relating to diverse populations, and to triage and answer inquiries as needed for at-risk populations.
Next slide. The task force also works to provide resources specifically for children, such as the Ready Wrigley “Flooding and Mold” book on the left.
Educators welcome CDC into their classrooms and continued to help distribute materials including the “Flooding and Mole books to help us get 145,000 books into the hands
of children and families in affected areas. Next slide. After a disaster, schools also serve as a space for comfort and support. Schools help to maintain
routines students are used to that can be disrupted by a natural disaster. And educators have an important role to play in helping children, not just prepare for, but also recover after an emergency.
The next few slides include some resources we have available for teachers to help children prepare for and cope with disasters. Next slide.
This is our tools and resources page, which is located on CDC’s caring for Children in a Disaster site. You can see we have a tab especially for teachers and childcare
that includes many resources available to you. Next slide. A disaster can have long-term effects on the mental and emotional health of children. Children who have serious emotional and
behavioral problems are at particular risk for stress after a disaster or traumatic event. So, it’s important that educators understand how to help children cope after an emergency to support their health and well-being.
We have many free resources available on CDC’s website to help you do that. The graphic on the left is another Ready Wrigley but we recently finished about coping after disaster.
We also have a webpage on our caring for children in just in a disaster site about helping children cope with emergencies, which you see pictured on the right. It discusses factors that influence the
emotional impact on children in emergencies. What you can do to help children cope. And common reactions which vary by age and developmental stage. Next slide.
We will release a CDC feature in a few days about returning to school after a disaster and tips for educators to help students cope. This will give some ways for educators to learn when and how to help your students cope
and continue to recover from a disaster when returning to school. I listed a few of the key reminders here, but there are many more ideas on our website. The first is to provide students with
opportunities to talk about what they went through or what they think about it. Encourage them to share concerns and ask questions. Talk to students about what happened
in a way that they can understand. Keep it simple and appropriate for each child’s age. Children react, in part, from what they see from adults around them.
When educators deal with the disaster calmly and confidently they can provide the best support for their students. Be aware of behavior changes in children resulting from the event that may worsen
or return if they see or hear reminders of what happened. It’s important to know what resources are available at your school for children and families, should you need to report concerns
to the appropriate people at your school. This goes for educators as well. After a disaster, educators may be struggling with stress and personal losses. It’s important to take care of yourself
first and seek help from a professional if you feel overwhelmed or unable to cope. Next slide. We have other materials to help educators talk about emergency preparedness.
The backpack card pictured on the left is for kids to learn the three steps to protect them through the school day. It walks kids through questions to help them think about what they might need in an emergency
and could also be used as a classroom activity. Another interactive tool we have, helps families make an emergency kit. We have a general checklist for families and another checklist, especially for families
with children with special health care needs. It’s also a fun tool to use in the classroom with the treasure hunt approach, by discussing what’s included in the classroom emergency kit and why.
Next slide. Parents, educators and childcare providers who can recognize the physical, developmental and emotional characteristics of children that make them more vulnerable,
will be able to help them stay safe in emergencies. To wrap up, I hope you’ve learn something about how emergencies affect children and are able to use some of the materials
and stories we’ve shared. Next slide. And before we finish, I went to leave you with some of our key resources from this presentation.
As I mention, you can find many more on our website. And on behalf of Judy and myself. We’d like to thank everyone for their attention. And thanks to the EPIC team for the opportunity
to present some of the work we do with children, educators and schools in emergencies. Our contact information is on this slide. And we’ll open it up to questions.

>> Thank you so much Judy and Jessica
for that wonderful presentation. We will go ahead and transition to the Q&A session. Monica, do we have our first question?

>> Thanks a lot Hailey, we have some
great questions here [inaudible] would like to know regarding the statistic of 43% collaboration of families. What are some examples of how that was done and how might that percentage be increased.

>> Read that question again.

>> Regarding the statistics. Regarding the statistic of 43% collaboration with families, what are some examples of how that was done and how might
that percent be increased?

>> Thank you for that question. So, the question was asked as part of a I hear back. So, the question was included in a
survey that we got a year or two ago. Sorry about that technical difficulty. What I wanted to share is that people could have responded to a number of the different collaborators and at that point
in time, in 2012, 43% of the respondents said that they collaborated with families. So, it’s not suggesting that at this current point in time that that would be, that it would have changed.
But to possibly increase collaboration with families, opportunities like this, webinars, sharing resources can really help families learn more about how to prepare and get engaged within their community and
at the school district level. We’ll be able to share those resources with you once again on the screen if you’d like.

>> Okay we will choose another question now. So what text alert apps do you recommend, or
which ones have you used for communication?

>> So, in the presentation, I think I mentioned there were a few. I don’t have them on site. But they were embedded in
the; or were they embedded, I thought they were embedded in the information. What we can do is if you would like to know a list of some apps, if you were to send an email specifically
to epic@cdc.gov then we’d be able to send you specifically those apps that you could use. But there are a number of them that are supported by, I believe FEMA has one,
Department of Education has one, and there are others available within different communities.

>> Thanks Judy. Donna Leck [assumed spelling] has a question. Do you have any suggestions or words
of wisdom for substitute teachers?

>> I can probably answer that. I would definitely look at some of the resources that we did offer in that last slide, there
are more on our website. There’s a lot of activities you can do, I think it’s based off of what your lesson plan is or curriculum. But there are some fun activities you can do
in the classroom related to preparedness and recovery. So, and again like Judy said if you want to reach out to us we can we can send
you another list of those with a more comprehensive list of resources.

>> Thanks, Jessica. We have another question from Kathleen Webb. She says as a public librarian, I
know we often have teen or tweens in a library building without their parents. Beyond contacting the local police, what would you recommend for reunification with their families, especially if they need
to shelter in place for an extended time.

>> I could start if you want to throw anything in. I know each school, plans are based on the school district.
So, it’s really, reunification is whatever the school is going to plan. I know that a lot of parents will try to run to the school and try to find their kids. And that’s ideally not what they want to happen.
But you are, as a parent, or educator, able to check into that plan and see what is in place for the particular school. We also have some resources specifically for reunification on our website,
if you do want to check on that and sheltering in place. Judy, I don’t know if you want to add anything.

>> Sure, I’ll just say that typically, schools have a roster, like a list,
a call down list, but specifically for kids. Because when kids are registered, you have to identify the parent or the person who’s in charge of the child. And so, there is a list with contacts that could
be used as a librarian, to engage with people in the community if needed to call down from.

>> All right. Thank you very much for those responses. We also have another question from Alma.
Can we have access to materials in Spanish. I’m interested in what materials are for Puerto Rico. And can you describe more about some of the efforts
that were done during the hurricane season.

>> So, I can’t speak for if the CPU has any translated documents. But I believe that CDC has a number of translated documents on our website.
And again, if you were to email epic@cdc.gov, we would be able to identify some translated document specifically related to Zika and Ebola. In terms of activities that were conducted in Puerto Rico, there were a number of activities
that were started and there was a specific unit that was in charge of connecting with schools and the community. So, I can’t speak in detail to that, but I can say that there was a tremendous amount of effort
at the community level to help get people prepared for hurricane season before the school year started.

>> And I’ll just add to that, on our
Caring for Children in Disaster site, we do try to translate as many materials as we can to Spanish. So, the particular document you might be speaking about, Alma,
it’s a fact sheet for parents, specifically in Puerto Rico about children coping after the hurricane. And then, we do have a number of our webpages that are also in Spanish.
Many of those Read Wrigley books that I mentioned are also in Spanish. and if you want to reach out to me, I’m happy to send all of those to you as well.

>> Thank you.
We have another question. What should teachers do if they are working with children who need professional psychological care, but whose parents cannot afford it?

>> Great question. There are resources available. As I mentioned, I would check with what resources and systems are in place in your particular school because there might be
some school-based programs or services available to children in whatever situation. But there’s also the last bullet on our resources slide is for the Disaster Distress Helpline.
And that’s from SAMHSA which is the Substance Abuse Mental Health Agency, or Service Agency. And they have a disaster helpline and they also have a lot of resources available around mental health and coping
beyond what we have at CDC.

>> All right. thank you. So, our next question is from Sheldon. You cited partnerships with
police, public health, and others. Do you provide guidelines on how to create these partnerships? Do you have any feedback on the quality of these partnerships?
Do they exist in the area, or have they proved to be functional?

>> Excellent question. And there’s no real evidence to say which relationship is more important than the other.
Because really, in a community, there needs to be engagement at all levels, because all different groups come together to respond to a school disaster. So, you’re going to have emergency groups
come in, emergency management groups. You’re going to have people coming in from Public Health and from Social Services and so on. And they all need to be at the table in
the planning phase so that they can help to develop a stronger plan, know how to respond. Because it’s not just one group that’s going to be taking on the full weight of dealing with the scenario.
So, the resources, again, in the slide that I had I think it was slide 31, there were some documents there that did specifically address schools and responders. And I know that at the local level,
all states have an emergency management division that may offer training. So, you might want to look into working with them further within your state.

>> Thank you, Judy.
Do you have any recommended strategies for reaching out to school districts to begin a partnership with them in order to educate them on what local health departments do?
And does this start with the principle, the superintendent, their emergency management coordinator? What advice could you give?

>> I’ll start, but you can continue.
So, absolutely. I think it’s really important to start that dialogue. Because schools are often required to have a plan if their state mandates it,
it often starts with the school or the superintendent who is connected with an emergency manager or others in the community. So, you can take that initiative
and approach the principal or superintendent in your school of interest. And have that dialogue. That would be very reasonable to do. Jessica?

>> Yeah, I would just add your State Department of Education is also very helpful. We do connect with them a lot. The National Department of Education, but I would definitely suggest reaching out to them
as well for some more resources or help connecting.

>> Thank you, both. My next question that I have is do emergencies cause some children to become bullies?

>> I don’t know if I get officially answer that, if it’s one thing causes another. I think there are a lot of emotional reactions that children can have that might play out in different ways, whether
that’s bullying or isolating. But I would, as a parent or educator, pay attention to what you’re seeing. And if it does deviate a lot from their typical behavior, I would definitely reach
out to either the SAMHSA group or if there are any programs or services in place at school to see what’s available.

>> And to my knowledge, there is no evidence in the literature of the association
between bullying and being involved in a disaster. But the literature is growing. But at this point, I think that would be a very strong statement that would not be valid.

>> Thank you. Our next question comes from Carol. She asks, in the future, will you be collaborating with the US DHHS administration on children and families in collecting data
on childcare centers, family childcare, afterschool program requirements to have emergency operations or response plans. And work with registered families to have preparedness plans.

>> I think that’s certainly a wonderful idea. And my particular team, we don’t have that planned. But can definitely take it into consideration. I don’t know Judy, if your team has
anything going on related to that.

>> We definitely want to be involved if the opportunity was there. Thank you for that awareness.

>> Thank you.
And our last few questions refer to Ready Wrigley. Can you give more information about that character, the creation, maybe the new coping book as well?

>> Sure. So, the Ready Wrigley books, well it’s actually Ready Wrigley materials. There’s an app. There’s a couple of different things, but we work mostly on the books with the Office
of Public Health Preparedness and Response to develop these. And they’re basically targeted to children 2 through 8. I know that’s a pretty large range.
And it’s for children, really targeted to the kids to help them sort of take charge of their own emergency preparedness. But it teaches kids about on natural disasters. So, we have an extreme heat book, a winter
weather book, tornadoes, earthquakes. We have a flooding and mold book that we created like I mentioned during the 2017 hurricane response. And they go through just learning
the basics of what that emergency is. How do you prepare yourself, how do you prepare your family and they’ve been really popular throughout the US and we do try our best to get them as quickly
as possible to places that are affected specifically during emergency response? And I’m happy to provide more resources if you’d like to reach out.

>> Well, thank you very much Jessica
and Judy for the wonderful presentation. We are close to time, so I would just like to thank everyone for joining the webinar and for your questions. If you have any questions
that weren’t answered today, you can please email them at epic@cdc.gov. As a reminder, today’s presentation has been recorded and you can earn continuing
education for your participation. So, please follow the instructions linked in the invitation you received. And the access code is E-P-I-C 0725, in all capital letters.
Thank you again. Goodbye.

>> Goodbye.

Page last reviewed: February 20, 2019