Informal Networks in Disaster Medicine.

Bdeir, Fadl; Crawford, John W; Hossain, Liaquat

OBJECTIVE Our study of informal networks aimed to explore information-sharing environments for the management of disaster medicine and public health preparedness. Understanding interagency coordination in preparing for and responding to extreme events such as disease outbreaks is central to reducing risks and coordination costs. METHODS We evaluated the pattern of information flow for actors involved in disaster medicine through social network analysis. Social network analysis of agencies can serve as a basis for the effective design and reconstruction of disaster medicine response coordination structures. This research used new theoretical approaches in suggesting a framework and a method to study the outcome of complex inter-organizational networks in coordinating disease outbreak response. We present research surveys of 70 health professionals from different skill sets and organizational positions during the swine influenza A (H1N1) PDM09 2009 pandemic. The survey and interviews were designed to collect both qualitative and quantitative data in order to build a comprehensive and in-depth understanding of the dynamics of the inter-organizational networks that evolved during the pandemic. RESULTS The degree centrality of the informal network showed a positive correlation with performance, in which the ego's performance is related to the number of links he or she establishes informally-outside the standard operating structure during the pandemic. Informal networks facilitate the transmission of both strong (ie, infections, confirmed cases, deaths in hospital or clinic settings) and weak (ie, casual acquaintances) ties. CONCLUSIONS The results showed that informal networks promoted community-based ad hoc and formal networks, thus making overall disaster medicine and public health preparedness more effective. (Disaster Med Public Health Preparedness. 2017;11:343-354).