We Can Wait Until the World Changes Us or We Can Change with the World
Open Access DepositedCommunity Health Center Employees’ Experiences of Learning to Build Resilience to Climate Change
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1) How do community health center employees describe learning to build resilience to climate change? 2) What are the factors that influence the learning of community health center employees as they build resilience to climate change? Using Thematic Network Analysis, the following three global themes emerged from the study
2) Learning Processes
Learning led to both organizational and systemic actions. Organizational initiatives (e.g., heat alerts) tended to be agent-centered and adaptive, reflecting single-loop learning. In contrast, community and systems-level actions (e.g., policy advocacy, whole of community coalitions and actions) were often collectively driven and transformative, reflecting double-loop learning. The findings suggested that to community health center employees learning to build climate resilience is a deeply social process positively and negatively influenced by factors inside and outside the organization. The study resulted in the creation of a conceptual model that highlighted the findings and categorized resilience actions as employees navigated the resilience capability continuum, from absorbing disturbances to taking more transformative, whole of community approaches. For practitioners, this dissertation offers actionable practices showcasing how community health center employees can advance resilience by engaging in social learning (or learning as participation) and integrating climate considerations into existing emergency preparedness and patient care workflows or community-wide efforts. For researchers, the study led to recommendations for an agenda for future research that expands beyond individual experiences to investigate organizational-level dynamics, the effectiveness of different leadership models, and the long-term impact of resilience initiatives on patient health outcomes through longitudinal and community-based participatory studies.
and 3) Resilience Actions
Employees learned primarily through social participation, including internal working groups, peer-to-peer networks, and community-wide coalitions. Participants also described individual learning through self-education and certificate programs
A vast body of literature has revealed that climate change poses widespread and irreversible threats to human health. Climate change is defined as long-term shifts in weather patterns, largely attributed to anthropogenic activities, leading to increased frequency and severity of storms, heat waves, food supply disruptions, and vector-borne diseases. Even though this issue represents an existential threat to human health and wellbeing, the US healthcare sector remains underprepared to manage its impacts. Community health centers serve as a critical component of the health sector, providing primary health care services to over 52 million patients, with the majority representing marginalized and medically underserved groups that are disproportionally impacted by climate change. Despite the well-known issues posed by climate change, there is a dearth of research on building resilience to climate change in the US public health and primary healthcare sectors. Further, community health center representatives have indicated their need for practical resources to learn to build resilience to climate change.To address the gaps in research and practice, in-depth interviews with ten community health center executive leaders, clinicians, and programmatic staff from various regions were conducted and documents were analyzed to understand the experiences of community health center employees as they learned to build resilience to climate change, addressing the following research questions
Learning was shaped by internal factors such as leadership support, staff motivation, funding, and competing priorities. External factors included exposure to specific climate threats (e.g., hurricanes, wildfires), political and regulatory environments, and partnerships with external stakeholders
1) Factors Influencing Learning
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