The Center for Public Health Practice (OH CPHP) at The Ohio State University College of Public Health held several community engagement meetings on controversial subjects related to pandemic planning: social distancing and mass fatality management. These community engagement meetings were planned prior to the emergence of H1N1, yet most of them were carried out when H1N1 was becoming present in communities across Ohio and the United States. Jurisdictional workgroups representing each area where meetings were held actively contributed to planning, implementing, and recruiting participants; this helped to ensure that local needs were met and that a diversity of perspectives were represented.
Community engagement meetings addressing the topic of social distancing were held in two urban areas of Ohio. In Cuyahoga County, the dialogue centered around social distancing within faith-based organizations, and in Franklin County, discussion focused on school and daycare closures. These meetings were held in June and July, 2009. One of the issues that provoked strong feelings from community members was the issue of wording. People felt strongly that social distancing measures should be expressed in terms of "guidelines," rather than "mandates" or "policies." Community members also expressed their wishes that social distancing guidelines be equitable and phased in gradually over a period of time, rather than implemented suddenly and drastically. Also important to community members was the maintenance and continuance of essential programs, such as education, childcare, and social services, during a period of social distancing.
Four community engagement meetings occurred exclusively with rural communities and stakeholders around the issue of mass fatalities planning. These meetings were held from March to May 2009. Along with partnering agencies, OH CPHP planned extensively for these meetings in northwestern and southeastern Ohio, recognizing that their difficult subject matter might deter many people from participating. Community members expressed strong opinions about how mass fatalities should be addressed and advocated that all management of remains occur in the local community. Not surprisingly, people also expressed their desire that remains of loved ones be treated with care. Ways in which care should be shown included the use of trained professionals to handle remains, prompt and accurate identification, and respect for religious and cultural traditions surrounding death. Community members also expressed a preference for having a single, local authority available to provide information on mass fatality management.
Although these meetings were held just as public health agencies were addressing the outbreak of novel H1N1 within the U.S., opinions gathered from community members were used to form or change existing guidelines. One notable change included revising the name of the facility used to provide comfort to families during a mass fatalities emergency. Initially called the "Family Assistance Center," participants felt that it sounded like a center for substance abuse assistance and suggested that it should be re-named the "Family Bereavement Center." Other changes were made to the state mass fatalities guidance as a result of closely discussing the issue with people who had a high emotional stake in the outcome.
Opinions from the urban community engagement meeting about social distancing also affected several public health policies surrounding H1N1. For instance, public health planners used data from the meetings to draft risk communication messages, choose trusted messengers, and identify schedules and locations for vaccine delivery that would best meet the needs of the urban population.
The use of several community engagement meetings that were structured around a single topic enabled members of the public to voice their opinions about issues before they were turned into policies or guidelines. The participating public health agencies used these opinions to inform their handling of an ongoing emergency, demonstrating the real-time usefulness and applicability of community engagement.
