Understanding the Role of Informal Communication to Combat Communicable Diseases - A Network Analysis of the United States Border Health System

Authors

Andrew D. Klevos, Florida International UniversityFollow

Document Type

Dissertation

Degree

Doctor of Philosophy (PhD)

Major/Program

Public Health

First Advisor's Name

Timothy Page

First Advisor's Committee Title

Committee co-Chair

Second Advisor's Name

Alejandro Arrieta

Second Advisor's Committee Title

Committee co-Chair

Third Advisor's Name

Jessica Adler

Third Advisor's Committee Title

committee member

Fourth Advisor's Name

Richard Olson

Fourth Advisor's Committee Title

committee member

Keywords

Border health, egocentric network analysis, network analysis, global health security, port of entry public health

Date of Defense

6-21-2023

Abstract

The United States (U.S.) Border Health (BH) system consists of multiple partner agencies that coordinate their efforts to prevent and mitigate the threat of imported infectious diseases. The BH system must coordinate their efforts within a dynamic environment of high volume of passenger traffic arriving to the U.S. and unintended stowaways of infectious disease they must identify and respond to. The purpose of this research aims to understand the role of informal communication among a multi-partner public health system and how it can be used to improve performance.

This research utilized a survey to conduct a cross-sectional social network analysis of individuals who work within one of four port-of-entry agencies who play key roles in cooperatively responding to communicable disease reports. That data was used to conduct egocentric network analysis to understand how the respondent (ego) use advice from their network connections (alters) to augment their job performance. The first study evaluated the network characteristics of the BH system including identifying the agency that respondents rely upon for BH knowledge evaluating statistical significance of network centrality. Results suggest that external agencies play a key role in supporting BH agencies as a public health resource. The second study used a multi-level Poisson model regression model to examine the association between the probability of BH Responses and the density of public health experts alters as well as the density of network ties between each of the alter’s the ego named. Results suggest a higher density of connection an ego has to public health experts as well as the density of connections between alters, increases the number BH responses an ego performs. The third study used a multi-level Poisson model regression model to examine the association between the probability of BH Responses and the ego’s network density of alter supervisors. Results suggest a higher density of connections an ego has to supervisors increases the number BH responses an ego performs. The results provide insight for future interventions to improve BH performance by leveraging informal information flow and the connections ego’s possess within their internal and external networks.

Identifier

FIDC011142

Recommended Citation

Klevos, Andrew D., "Understanding the Role of Informal Communication to Combat Communicable Diseases - A Network Analysis of the United States Border Health System" (2023). FIU Electronic Theses and Dissertations. 5433.
https://digitalcommons.fiu.edu/etd/5433