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INTRODUCTION: The Texas A&M Health Science Center School of Rural Public Health, a member of the Training and Education Collaborative System Preparedness and Emergency Response Learning Center (TECS-PERLC), has long-standing partnerships with 2 Health Service Regions (Regions) in Texas. TECS-PERLC was contracted by these Regions to address 2 challenges identified in meeting requirements outlined by the Risk-Based Funding Project. First, within Metropolitan Statistical Areas, there is not a formal authoritative structure. Second, preexisting tools and processes did not adequately satisfy requirements to assess public health, medical, and mental health needs and link mitigation strategies to the Public Health Preparedness Capabilities, which provide guidance to prepare for, respond to, and recover from public health incidents. METHODS: TECS-PERLC, with its partners, developed a framework to interpret and apply results from the Texas Public Health Risk Assessment Tool (TxPHRAT). The 3-phase community engagement-based TxPHRAT Mitigation Planning Process (Mitigation Planning Process) and associated tools facilitated the development of mitigation plans. Tools included (1) profiles interpreting TxPHRAT results and identifying, ranking, and prioritizing hazards and capability gaps; (2) a catalog of intervention strategies and activities linked to hazards and capabilities; and (3) a template to plan, evaluate, and report mitigation planning efforts. OUTCOMES: The Mitigation Planning Process provided a framework for Regions to successfully address all funding requirements. TECS-PERLC developed more than 60 profiles, cataloged and linked 195 intervention strategies, and developed a template resulting in 20 submitted mitigation plans. DISCUSSION: A public health-focused, community engagement-based mitigation planning process was developed by TECS-PERLC and successfully implemented by the Regions. The outcomes met all requirements and reinforce the effectiveness of academic practice partnerships and importance of community engagement in mitigation planning. NEXT STEPS: Additional funding has been approved to expand the Mitigation Planning Process to all counties in Texas with local health departments.

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INTRODUCTION: The lack of formal public health infrastructure and trained health professionals in rural areas has a deleterious impact on rural populations for various health issues. The purpose of this article is to: (1) suggest a strategy regularly used by the authors that encourages relationship building and serves as a catalyst for rural communities to work together to initiate and make changes based on the local assets and dynamics; (2) provide a descriptive overview of this strategy; and (3) provide an illustrative case, using the Rural Ready Communities project, in which this strategy has been used. METHODS: The Rural Health Roundtable strategy includes identifying relevant topics and stakeholders; using specific methods to ensure stakeholder attendance; creating an informal, social environment where participants feel comfortable sharing; utilizing targeted questions to engage participants and empower local ownership; and following up with the participants through communication and evaluation. RESULTS: The Rural Health Roundtable strategy can result in short-term, intermediate and long-term outcomes using various evaluation tools and methods. CONCLUSIONS: The Rural Health Roundtable strategy has demonstrated its value as an effective tool in working with rural communities. With fewer human and financial resources at their disposal, this strategy can aid rural communities in identifying and utilizing their unique strengths to overcome resource deficits when responding to public health emergencies and natural disasters. Initiated in 1999, the methodology has been refined and enhanced over the past 8 years to more effectively reach stakeholders, ensure attendance and participation, promote sharing and discussions, build stakeholder networks and encourage continued communication and collaboration. The Rural Health Roundtable strategy has significant potential for replication and application to all areas of rural public health.

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Recognizing the need to prepare the broader workforce of responders to plan and respond to the consequences of public health emergencies, the School of Rural Public Health at Texas A&M University Health Science Center launched a self-supporting, continuing education initiative in March 2003, designed to offer training to individuals throughout Texas with responsibility for emergency planning, preparedness, and response. The Texas Training Initiative for Emergency Response (T-TIER) fosters the integration and collaboration of key organizations and disciplines, using the Centers for Disease Control and Prevention-identified competencies by focus area. T-TIER is designed as a three-module training initiative that builds upon the knowledge, skills, and abilities that participants acquire in each preceding module. To increase efficacy, T-TIER uses multiple training methodologies, including live presentations, hands-on practical activities, tabletop exercises, and on-site or televideo conference technology. This unique, multidisciplinary approach enhances respect and collaboration among the various disciplines, limiting unilateral emergency preparedness planning and response at the national, state, and local levels. The next step in disseminating this training curriculum is the adaptation of materials using distance education technologies to reach a broader audience, both in Texas and other states across the nation.

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