Interlocal collaboration and emergency preparedness: A qualitative analysis of the impact of the Urban Area Security Initiative program

Objective: Horizontal intergovernmental coordination, or interlocal collaboration, is an ongoing strategy to enhance public health emergency preparedness in the United States. This study aims to understand the impact of interlocal collaboration on emergency preparedness, and how the Urban Area Security Initiative (UASI) program, a federally administered grant program to promote regional preparedness capability development, has influenced perceptions of this relationship.Design: Semistructured interviews were conducted and recorded in early 2014. Transcribed data were coded and iteratively analyzed. A purposive and snowball sampling strategy was used.Setting: Interviews were conducted in person or by phone.Participants: Twenty-eight key informants were interviewed during 24 interviews. Individuals were selected as key informants due to their knowledge of a UASI region(s) and its governance structures, investment strategies, and challenges, as well as knowledge of the UASI program’s history and goals.Main outcome measure(s): Interviews were used to identify, describe, and characterize perceptions of interlocal collaboration, national emergency preparedness, and the UASI grant.Results: Impacts, challenges, incentives, facilitators, and disadvantages to interlocal collaboration were identified. Interlocal collaboration was found to impact preparedness by promoting the perceived dissolution of geopolitical boundaries; developing self-reliant regions; developing regional capabilities; promoting regional risk identification; and creating an appreciation of interlocal collaboration importance. The UASI program was thought to have a profound and unique impact on the development of interlocal collaboration infrastructure and on national preparedness.Conclusions: Interlocal collaborations contribute to overall national preparedness. Grant programs, such as the UASI, can incentivize and foster interlocal collaboration in preparedness.