The Lean On Me Project design and implementation resulted in approximately 15 trained LOM volunteers. The volunteers attended 16 community outreach events to promote the program and increase participation. The volunteers conducted 101 home visits of vulnerable community members. During each visit, they executed the curriculum, gathered information from the client, and left them with a specific, tailored emergency plan. Along with the emergency plan, each client was provided a sturdy file box to keep their plan and emergency documents in. They received first aid kit, flashlight, and a NOAA weather radio. The planning team identified multiple areas for improvement in the curriculum and marketing. Areas for improvement included adding additional check lists, assisting clients with Special Needs Shelter registry, and obtaining the clients' feedback on the forms. Upon return from the visit, client information was entered into a database that ensured LOM volunteers had contact information on each client. This information is essential, so volunteers can conduct emergency call-downs and relay crisis emergency risk communication and tailor messaging per acuity level of each client.
During discussions with the clients, they declared a reduction in fear of emergencies after the visit and generally felt more prepared. The clients displayed immense appreciation to the volunteers and took comfort in knowing someone was available to help them. The clients bonded with the volunteers in the short hour or two visitation. The program became popular and word began to spread, the LOM coordinator began getting calls requesting the service from a referral of a LOM client. There was sufficient evidence to conclude we successfully met the objective of Phase 1; to build a project that was informative and well desired.
Targeted Marketing and Scale-up included utilizing the United States Census Bureau individual income and disability data from the 2012-2015 American Community Survey estimates. Analysis identified pockets of vulnerable populations that would most benefit from the project. The data was analyzed by percentage of total population within every census tract in Okaloosa County. Data analysis included the following steps:
Ranking of the percentages of individuals among each variable in all Okaloosa census tracts from highest to lowest.
From that ranking, identify the top 10 census tracts with the highest percentage of each variable measured.
Collecting and entering those top 10 census tracts into a cross-matrix along with the top 10 census tracts from all the other variables. The matrix was used to compare all census tracts with all 8 variables analyzed.
Based on the rankings and number of variables, a vulnerability score was determined.
Lastly, each census tract received a score based on how many of the 8 variables was each census tract within the top 10 percentages.
The more variables a census tract scored in the top 10 percentages, the more vulnerable they were considered.
Targeted Marketing and Scale-up is in progress and will lead to future work. Analysis of the United States Census Bureau data in the 47 census tracts in Okaloosa County resulted in the following:
# of Census Tracts
A county census tract map was created to visually identify the concentrations of vulnerable populations within Okaloosa. Based on the vulnerability score, the map reflects the color-coded areas of vulnerable populations.
The greatest concentration of Severely and Moderately Vulnerable census tracts were targeted first. A significant area of vulnerability is located within Ocean City, Wright, and Fort Walton Beach areas. These areas are densely populated and have been high risk areas in other DOH-Okaloosa disease risk analyses. The LOM team will begin advertisements and promotion within each of these census tracts identified, beginning with the most vulnerable to the least. Utilizing asset mapping, communal areas are identified that are assumed community members living within each census tract likely frequent. Volunteers will utilize these locations to advertise and conduct outreach activities. They will also leverage the County EMS, City police, and Fire Districts that service that specific census tract to engage them in assistance for promotion.
The Project is widely accepted and popular. Word of mouth has been a successful marketing technique among the vulnerable populations. Clients maintain linkage and build bonds with the volunteers. This creates trust and relationships to the vulnerable populations to ensure crisis risk messaging reaches them. Ocean City, Wright, Fort Walton Beach and Crestview are among the most vulnerable. The targeted messaging will begin in Ocean City and work outward using the vulnerability scale. Targeted marketing and promotion will be conducted in communal areas within the most severely vulnerable census tracts. Community partners have expressed an interested in this program, because they can envision the impact that it is making individually to better the resiliency throughout Okaloosa County.
Limitations of the project including the passive recruitment in social settings, vulnerable populations with social restrictions may go unreached. The 2012-2015 American Community Survey is a 5-year estimate based off 2010 Census data and some data was limited or missing. The impact of income on the data may bias data and was not accounted for in this study. Focusing on debilitating variables biased the data for age. Younger, vulnerable populations may not have been identified. Lack of baseline data for vulnerable populations to compare preparedness and response before and after LOM interventions limited measuring success.
The purpose of this project was to implement a community resiliency education project among vulnerable populations in Okaloosa County focused on disaster preparedness.
Future work of the LOM project includes a deeper strategic analysis to control for income and or age. Another analysis that combines census tracts into to commonly known communities might be helpful to increase the impact of targeted messaging.
As a preparedness education program, the planning team has future plans to scale up. Increasing quantitative measures by increasing clientele through marketing and promotion. Increasing functional scope by including annual Influenza immunization clinics to new and existing LOM clients that qualify for the adult vaccine program. The team is exploring options to deliver TDAP as well. Leadership is working with the Community Health Improvement Programs' Injury Prevention work groups to include safety inspections to reduce falls at home. Volunteers are conducting mosquito abatement to reduce arbovirus transmission in LOM client homes. Increasing political coverage of the project will include collaborating with organizations such as County EMS, Fire and Rescue Services (City and Special Fire Districts), Okaloosa County Sheriff's Office to promote dissemination of LOM flyers in their response vehicles. Fort Walton Beach Medical Center and the Andrews Institute are interested including a LOM referral upon discharge from the hospitals. At an organizational level, leadership is working on sustainability plan to include funding sources for continued resources and training community leaders to utilize and promote LOM referrals for their encounters
The LOM program builds resiliency and increases communication channels within vulnerable populations. Building resiliency improves emergency outcomes and empowers vulnerable populations to make educated decisions during an emergency for survival, thus reducing the burden on the response healthcare system. The project increases volunteerism by providing energy toward an immediate and achievable positive impact on the community.