Lessons Learned from a Community Assessment for Public Health Emergency Response (CASPER) in a Frontier County — Dawson County, Montana, 2013

Brief Summary:
Community Assessment for Public Health Emergency Response (CASPER) is an epidemiologic technique that uses a two-stage cluster sampling design to provide household-based information. CASPERs are most commonly used during disasters, but the CASPER methodology can be used for other purposes, such as community health assessments. Previous CASPER assessments have been conducted primarily in urban, suburban, and rural areas. The Montana Department of Public Health and Human Services (DPHHS) and Dawson County Health Department worked collaboratively to administer a CASPER in a frontier county with 3.8 persons/mi² and 4,233 housing units (HUs). A frontier county is defined as an area with <6 persons/mi². The purpose of the CASPER was to exercise the technique, practice the technique in a frontier county, measure household preparedness, and gain an understanding of the perceived impacts of the Bakkan oil boom on Dawson County. To account for a low density of HUs in remote areas, adaptations to sampling methodologies were made to the Centers for Disease Control and Prevention’s (CDC) recommended methodology found in the CASPER toolkit. The CASPER technique was successfully conducted in a frontier Montana county and its utility demonstrated in a frontier setting. Successful collaborations occurred among local, state, and federal partners, and relationships were strengthened. Adaptations are needed for the sampling scheme in frontier areas. Challenges encountered included volunteer management, use of introduction and consent forms, and use of stock questions from the toolkit. Lessons learned during this CASPER will help refine the technique for use in other frontier counties in Montana.