Mona Arora

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Courses

Scholarly Contributions

Chapters

• Iyengar, M. S., Merchant, N., Ernst, K., Rains, S., Arora, M., Ngaybe, M. G., & Gonzalez, M. (2024). Resilience Informatics for Public Health. In Ebook Series: Studies in Health Technology and Informatics. IOS Press. doi:10.3233/shti231170
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  Resilience research is attracting increasing attention as stressors such as pandemics and climate change impact normal life worldwide. Informatics tools can play an important role in enhancing resilience of people, communities, and organizations. We present Resilience Informatics as a sub-discipline of resilience research and propose a conceptual framework for Resilience Informatics to aid in the development and effective deployment of informatics systems for resilience.

Journals/Publications

• Arora, M., Luri, I., & Helm, S. V. (2025).

  Retail Businesses’ Commitment to Public Health: Lessons From the COVID-19 Pandemic

  . Business & Society, 64(40).
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  This study investigates how essential retailers responded to the COVID-19 pandemic through stakeholder communications. Based on a comprehensive text analysis of the corporate websites of the 20 largest U.S. essential retailers during the first 19 months of the crisis, we categorize the public health measures communicated by these retailers and assess how these retailers adapted their messaging to address the concerns of different stakeholders over time. This analysis allowed us to create a framework for understanding the flow of retailer/stakeholder communication during a health crisis, highlighting the important role businesses can play in alleviating stakeholder concerns when public health is on the line. We discuss the implications of our findings for retailers and public policy, aiming to enhance preparedness and response for future health emergencies.
• Iyengar, M. S., Ngabe, M. B., Gonzalez, M., & Arora, M. (2024). Resilience Informatics: The role of Informatics in enabling and promoting public health resilience to pandemics, climate change, and other stressors. . Interactive Journal of Medical Research. doi:10.2196/54687
• Koch, B., Arora, M., Rooney, B., Thompson, A., Scott, B., Gomez, D., Galindo, M., Ward, K., Wightman, P., & Derksen, D. (2024). Promoting Equitable Access to COVID-19 Vaccinations in Rural and Underserved Arizona: Experiences From Three County Health Departments. American Journal of Public Health, 114(Issue). doi:10.2105/AJPH.2024.307714
• Ngaybe, M., Sierra, L. A., McNair, A., Myla, G., Arora, M., Ernst, K. C., & Iyengar, M. S. (2024). Resilience Informatics in Public Health: Qualitative Analysis of Conference Proceedings. JMIR Formative Research. doi:10.2196/63217
  More info

  AbstractBackground: In recent years, public health has confronted 2 formidable challenges: the devastating COVID-19 pandemic and the enduring threat of climate change. The convergence of these crises underscores the urgent need for resilient solutions. Resilience informatics (RI), an emerging discipline at the intersection of informatics and public health, leverages real-time data integration from health systems, environmental monitoring, and technological tools to develop adaptive responses to multifaceted crises. It offers promising avenues for mitigating and adapting to these challenges by proactively identifying vulnerabilities and fostering adaptive capacity in public health systems. Addressing critical questions regarding target audiences, privacy concerns, and scalability is paramount to fostering resilience in the face of evolving health threats.Objective: The University of Arizona held a workshop, titled Resilience Informatics in Public Health, in November 2023 to serve as a pivotal forum for advancing these discussions and catalyzing collaborative efforts within the field. This paper aims to present a qualitative thematic analysis of the findings from this workshop.Methods: A purposive sampling strategy was used to invite 40 experts by email from diverse fields, including public health, medicine, weather services, informatics, environmental science, and resilience, to participate in the workshop. The event featured presentations from key experts, followed by group discussions facilitated by experts. The attendees engaged in collaborative reflection and discussion on predetermined questions. Discussions were systematically recorded by University of Arizona students, and qualitative analysis was conducted. A detailed thematic analysis was performed using an inductive approach, supported by MAXQDA software to manage and organize data. Two independent researchers coded the transcripts; discrepancies in coding were resolved through consensus, ensuring a rigorous synthesis of the findings.Results: The workshop hosted 27 experts at the University of Arizona, 21 (78%) of whom were from public health-related fields. Of these 27 experts, 8 (30%) were from the field of resilience. In addition, participants from governmental agencies, American Indian groups, weather services, and a mobile health organization attended. Qualitative analysis identified major themes, including the potential of RI tools, threats to resilience (eg, health care access, infrastructure, and climate change), challenges with RI tools (eg, usability, funding, and real-time response), and standards for RI tools (eg, technological, logistical, and sociological). The attendees emphasized the importance of equitable access, community engagement, and iterative development in RI projects.Conclusions: The RI workshop emphasized the necessity for accessible, user-friendly tools bridging technical knowledge and community needs. The workshop's conclusions provide a road map for future public health resilience, highlighting the need for scalable, culturally sensitive, community-driven interventions. Future directions include focused discussions to yield concrete outputs such as implementation guidelines and tool designs, reshaping public health strategies in the face of emerging threats.
• Arora, M., Comrie, A. C., & Ernst, K. E. (2023). Assessing climate and health curriculum in graduate public health education in the United States. Frontiers in Public Health, 11(Issue). doi:10.3389/fpubh.2023.1124379
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  Climate change has been identified as both a challenge and an opportunity for public health. The onus to prepare the next generation of public health practitioners lies heavily on schools and programs of public health. This article (i) assesses the status of climate change and health curricula in accredited schools of public health in the United States and (ii) proposes strategies to better train professionals so they are more informed and prepared to mitigate, manage, and respond to the health impacts of climate change. Course offerings and syllabi listed in online course catalogs from 90 nationally accredited schools of public health were evaluated with the purpose of identifying the extent of climate change education in graduate programs. Only 44 public health institutions were found to offer a climate change related course at the graduate level of education. Of the 103 courses identified, approximately 50% (n = 46) are focused on this climate change and health. These courses cover a wide array of topics with an emphasis on conveying fundamental concepts. In-depth assessment revealed a need for integrating learning opportunities that build practical skills useful in a hands-on public health practice environment. This assessment indicates the limited availability of climate-health course offerings available to graduate students in accredited schools. The findings are used to propose an educational framework to integrate climate change into public health curricula. The proposed framework, while rooted in existing directives, adopts a tiered approach that can be readily applied by institutions training the next generation of public health leaders.
• Mayer, B., Helm, S., Heinz, E., Barnett, M., & Arora, M. (2023). Doubt in store: vaccine hesitancy among grocery workers during the COVID-19 pandemic. Journal of Behavioral Medicine, 46(Issue 1-2). doi:10.1007/s10865-021-00276-0
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  The objective of this study was to assess the influence of workplace safety conditions alongside the World Health Organization’s model of the “3 Cs”, on grocery store workers’ vaccine hesitancy concerning COVID-19. Data for this study come from the Arizona Frontline Workers Survey, a longitudin web-based survey of 770 grocery store workers in the state of Arizona (US) collected in July 2020 and January 2021. We utilized ordinary least squares and multinomial logistic regression analyses to assess predictors of hesitancy at our Wave 2. Thirty-nine percent of our sample reported being unlikely to get vaccinated against COVID-19. Two aspects of the “3 Cs” model, confidence and convenience, were correlated with lower levels of vaccine hesitancy while the perceptions of being protected by one’s employer increased hesitancy. Our findings underscore the importance of workplace conditions for vaccine hesitancy and the need to include vaccine messaging in employers’ safety practices.
• Armstrong, A., Arora, M., Hoffmann, S., McClelland, J. D., Villa-Zapata, L., Owusu-Dommey, A., Austhof, E., Schaefer, K., Boyd, K., & Pogreba-Brown, K. (2022). Complications Associated with Foodborne Listeriosis: A Scoping Review. Foodborne Pathogens and Disease. doi:10.1089/fpd.2022.0012
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  Listeria monocytogenes is a relatively rare but highly pathogenic bacterium that can cause foodborne infections. In the United States there are ∼1600 cases per year, 94% of which result in hospitalizations and 20% in deaths. Per-case burden is high because the disease also causes serious complications, including sepsis, encephalitis, meningitis, miscarriage, and stillbirth. The disease burden of L. monocytogenes is underestimated because some of these acute complications can also result in long-term outcomes. In this article, we conducted a scoping review of L. monocytogenes complications and longer term outcomes from articles published between 2000 and 2018. Search terms were developed for four major databases (PubMed, Scopus, Web of Science, and Embase) as well as gray literature and hand searches of review articles. We follow standard scoping review methodology and assessment. Out of 10,618 unique articles originally identified, 115 articles were included, representing 49 unique outcomes. The majority of studies were cohort designs (n = 67) and conducted in the United States or Europe (n = 98). Four major outcome groupings were death, neurological disorders, sepsis, and congenital infection. This study identifies substantial research on the common acute complications of L. monocytogenes and few long-term consequences of L. monocytogenes. We identify the need for additional studies to determine the longer term impacts of these acute complications.
• Mayer, B. M., Helm, S. V., Heinz, E. M., Barnett, M. A., & Arora, M. (2022). Doubt in Store: Vaccine Hesitancy among Grocery Workers During the COVID-19 Pandemic. Journal of Behavioral Medicine, 12. doi:10.1007/s10865-021-00276-0
• Mayer, B., Helm, S., Barnett, M., & Arora, M. (2022). Essential but Ill-Prepared: How the COVID-19 Pandemic Affects the Mental Health of the Grocery Store Workforce.. Public health reports (Washington, D.C. : 1974), 137(1), 120-127. doi:10.1177/00333549211045817
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  Frontline essential workers face elevated risks of exposure to COVID-19 because of the interactive nature of their jobs, which require high levels of interaction with the general public and coworkers. The impact of these elevated risks on the mental health of essential workers, especially outside the health care sector, is not well studied. To address this knowledge gap, we examined correlations between perceptions of workplace risks and mental health distress among grocery store workers in Arizona..We collected the first statewide sample of essential workers outside the health care sector focused on mental health and well-being. A total of 3344 grocery store workers in Arizona completed an online survey in July 2020. We used multiple regression models to identify demographic and work-based correlates of mental health distress..Levels of mental health distress among respondents were high: 557 of 3169 (17.6%) reported severe levels and 482 of 3168 (15.2%) reported moderate levels. Perceptions of workplace safety were strongly correlated with significantly reduced levels of mental health distress (ß = -1.44; SE = 0.20) and reduced perceived stress (ß = -0.97; SE = 0.16). Financially disadvantaged workers and employees aged
• Mayer, B., Helm, S., Barnett, M., & Arora, M. (2022). The impact of workplace safety and customer misbehavior on supermarket workers' stress and psychological distress during the COVID-19 pandemic. International Journal of Workplace Health Management, 15(3). doi:10.1108/IJWHM-03-2021-0074
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  Purpose: Essential frontline workers in the retail sector face increased exposure risks to coronavirus disease 2019 (COVID-19) due to frequent interactions with the general public. Often these interactions are fraught with controversies over public safety protocols. The purpose of this study is to examine the impacts of frontline workers' perceptions of workplace safety and customer misbehaviors on their stress and psychological distress to inform managing workplace health and safety during public health crises. Design/methodology/approach: The authors conducted an online survey of 3,344 supermarket workers in the state of Arizona (US) during the state's first COVID-19 pandemic wave in July 2020. Measures included mental health distress, and perceptions of workplace safety and customer behaviors. The authors utilized a mixed-methods approach combining multiple regression analyses with qualitative analyses of open-ended comments. Findings: Workers reported high rates of stress and psychological distress. Increases in mental health morbidity were correlated with perceptions of being unsafe in the workplace and concerns about negative customer encounters. Qualitative analyses reveal frustration with management's efforts to reduce risks intertwined with feelings of being unsafe and vulnerable to threatening customer encounters. Practical implications: The findings highlight the need to provide and enforce clear safety guidelines, including how to manage potential hostile customer interactions, to promote positive health workplace management during a pandemic. Originality/value: This study is among the first to assess the COVID-19 pandemic's impact on the mental health of non-health care frontline essential workers and presents novel insights regarding perceived customer misbehavior and need for management support and guidance in a public health crisis.
• Arora, M., Sami, I., Austof, E., Iroz-Elardo, N., & Keith, L. (2021). Extreme Heat at Outdoor COVID-19 Vaccination Site. Journal of Climate Change and Health, 4(2021), 100043. doi:doi.org/10.1016/j.joclim.2021.100043
• Arora, M., Sami, Z., Austof, E., Iroz-Elardo, N., & Keith, L. (2021). Extreme heat at outdoor COVID-19 vaccination sites. The Journal of Climate Change and Health, 4, 100043. doi:https://doi.org/10.1016/j.joclim.2021.100043
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  Extreme heat is an increasing climate risk due to climate change and the urban heat island (UHI) effect and can jeopardize points of dispensing (PODs) for COVID-19 vaccination distribution and broader public health emergency preparedness (PHEP) response operations. These PODs were often located on large parking lot sites with high heat severity and did not take heat mitigation or management strategies into account for unacclimated workers and volunteers. To investigate the personal heat exposure of workers, volunteers, and clients at three PODs in Tucson, Arizona, we collected ambient air temperatures, wet bulb globe temperatures (WBGT), surface temperatures, and thermal images. We also made qualitative observations and compared data against daily meteorological records. Ambient air temperatures at all three PODs exceeded the meteorological recorded high. WBGT on average were 8°F (4.4 °C) higher in full sun locations than shaded locations such as tents. Evaporative cooling decreased ambient air temperatures by 2°F (1.2 °C) when placed one per tent, but decreased ambient air temperatures by 7°F (3.9 °C) when placed en masse in a larger tent. Vehicle surface temperatures exceeded recommended safe limits of 140°F (60 °C) at all three sites, with a maximum temperature recorded at 170.9°F (77.2 °C). Public health professionals should consider heat resilience, including heat mitigation and management measures, in POD and PHEP response operations to reduce exposure. This includes considering the UHI effect in the siting of PODs, applying heat mitigation strategies in the design of PODs such as the adaptive use of solar panels for shading, and improving heat safety guidance for workers and volunteers.
• Arora, M., Sami, Z., Austof, E., Iroz-Elardo, N., & Keith, L. (2021). Response to correspondence on "Extreme heat at outdoor COVID-19 vaccination sites". The Journal of Climate Change and Health, 4, 100073.
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  A central tenant in minimizing personal heat exposure is that context matters. In our article reporting on personal heat exposure in outdoor COVID-19 vaccination sites in Arizona, USA during spring 2021, we emphasized that heat mitigation strategies are highly specific to the underlying climatological and site design contexts. The Mungmunpuntipantip and Wiwanitkit letter illustrates the importance of context quite well. The authors highlight a valid concern of unintended consequences of COVID-19 transmission through changing humidity levels through heat mitigation strategies such as evaporative cooling.
• Helm, S. V., Arora, M., Barnett, M. A., & Mayer, B. M. (2021). Grocery workers suffer the mental health effects of customer hostility and lack of safety in their workplace. The Conversation.
• Keith, L., Iroz-Elardo, N., Austof, E., Sami, I., & Arora, M. (2021). Extreme heat at outdoor COVID-19 vaccination sites. Journal of Climate Change and Health, 4(Issue). doi:10.1016/j.joclim.2021.100043
  More info

  Extreme heat is an increasing climate risk due to climate change and the urban heat island (UHI) effect and can jeopardize points of dispensing (PODs) for COVID-19 vaccination distribution and broader public health emergency preparedness (PHEP) response operations. These PODs were often located on large parking lot sites with high heat severity and did not take heat mitigation or management strategies into account for unacclimated workers and volunteers. To investigate the personal heat exposure of workers, volunteers, and clients at three PODs in Tucson, Arizona, we collected ambient air temperatures, wet bulb globe temperatures (WBGT), surface temperatures, and thermal images. We also made qualitative observations and compared data against daily meteorological records. Ambient air temperatures at all three PODs exceeded the meteorological recorded high. WBGT on average were 8°F (4.4 °C) higher in full sun locations than shaded locations such as tents. Evaporative cooling decreased ambient air temperatures by 2°F (1.2 °C) when placed one per tent, but decreased ambient air temperatures by 7°F (3.9 °C) when placed en masse in a larger tent. Vehicle surface temperatures exceeded recommended safe limits of 140°F (60 °C) at all three sites, with a maximum temperature recorded at 170.9°F (77.2 °C). Public health professionals should consider heat resilience, including heat mitigation and management measures, in POD and PHEP response operations to reduce exposure. This includes considering the UHI effect in the siting of PODs, applying heat mitigation strategies in the design of PODs such as the adaptive use of solar panels for shading, and improving heat safety guidance for workers and volunteers.
• Keith, L., Iroz-Elardo, N., Austof, E., Sami, I., & Arora, M. (2021). Response to correspondence on “Extreme heat at outdoor COVID-19 vaccination sites”. Journal of Climate Change and Health, 4(Issue). doi:10.1016/j.joclim.2021.100073
• Arora, M., Burgess, J. L., Granillo, B., & Zepeda, T. K. (2018). Experiential Adult Learning: A Pathway to Enhancing Medical Countermeasures Capabilities.. American journal of public health, 108(S5), S378-S380. doi:10.2105/ajph.2018.304703
• Vilaly, A. E., Arora, M., Butterworth, M. K., Vilaly, M. A., Vilaly, A. E., Jarnagin, W., Comrie, A. C., & Arora, M. (2013). Climate, environment and disease: The case of Rift Valley fever. Progress in Physical Geography, 37(2), 259-269. doi:10.1177/0309133313478315
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  Rift Valley fever is a disease of animals and humans found throughout much of Africa, and recently in the Arabian Peninsula. It is spread via mosquito vectors and direct contact with infected tissu...
• Arora, M., Ernst, K. C., & Munga, S. (2012). Ownership and disuse of bed nets in Kenyan children under five years of age. Malaria Reports, 2(1), 1. doi:10.4081/malaria.2012.e1
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  Recent campaigns to increase the percentage of households owning a bed net have been very successful yet there remains a subset of the population who do not sleep under bed nets. We used data from the 2008 Kenya Demographic and Health Survey (KDHS) to compare children under the age of five years of age who slept under any bed net to children sleeping without a bed net who resided in households with: i) no bed net; ii) all bed nets used (intra-household access); and iii) at least one unused bed net. Ownership, intra-household access, and non-use of available bed nets were all associated with the child’s age and the mother’s relationship to the head of the household. Intra-household access was strongly associated with provincial residence, where the child was born and frequency of reading newspapers. Furthermore, disuse of available nets for children was associated with marital status, bed net use of the head of the household, and residing in rural communities at higher elevations. Improving bed net/long-lasting insecticide treated nets (LLIN) use in Kenya requires a multi-faceted approach that addresses the complexity of the behavioral, social and economic drivers of non-use.

Proceedings Publications

• Ngaybe, M. G., Sierra, L. A., McNair, A., Gonzalez, M., Arora, M., Ernst, K., Noriega-Atala, E., & Iyengar, M. S. (2025). Resilience Informatics in Public Health: Qualitative Analysis of Conference Proceedings. In JMIR, 9.
  More info

  Background: In recent years, public health has confronted 2 formidable challenges: the devastating COVID-19 pandemic and the enduring threat of climate change. The convergence of these crises underscores the urgent need for resilient solutions. Resilience informatics (RI), an emerging discipline at the intersection of informatics and public health, leverages real-time data integration from health systems, environmental monitoring, and technological tools to develop adaptive responses to multifaceted crises. It offers promising avenues for mitigating and adapting to these challenges by proactively identifying vulnerabilities and fostering adaptive capacity in public health systems. Addressing critical questions regarding target audiences, privacy concerns, and scalability is paramount to fostering resilience in the face of evolving health threats. Objective: The University of Arizona held a workshop, titled Resilience Informatics in Public Health, in November 2023 to serve as a pivotal forum for advancing these discussions and catalyzing collaborative efforts within the field. This paper aims to present a qualitative thematic analysis of the findings from this workshop. Methods: A purposive sampling strategy was used to invite 40 experts by email from diverse fields, including public health, medicine, weather services, informatics, environmental science, and resilience, to participate in the workshop. The event featured presentations from key experts, followed by group discussions facilitated by experts. The attendees engaged in collaborative reflection and discussion on predetermined questions. Discussions were systematically recorded by University of Arizona students, and qualitative analysis was conducted. A detailed thematic analysis was performed using an inductive approach, supported by MAXQDA software to manage and organize data. Two independent researchers coded the transcripts; discrepancies in coding were resolved through consensus, ensuring a rigorous synthesis of the findings. Results: The workshop hosted 27 experts at the University of Arizona, 21 (78%) of whom were from public health-related fields. Of these 27 experts, 8 (30%) were from the field of resilience. In addition, participants from governmental agencies, American Indian groups, weather services, and a mobile health organization attended. Qualitative analysis identified major themes, including the potential of RI tools, threats to resilience (eg, health care access, infrastructure, and climate change), challenges with RI tools (eg, usability, funding, and real-time response), and standards for RI tools (eg, technological, logistical, and sociological). The attendees emphasized the importance of equitable access, community engagement, and iterative development in RI projects. Conclusions: The RI workshop emphasized the necessity for accessible, user-friendly tools bridging technical knowledge and community needs. The workshop's conclusions provide a road map for future public health resilience, highlighting the need for scalable, culturally sensitive, community-driven interventions. Future directions include focused discussions to yield concrete outputs such as implementation guidelines and tool designs, reshaping public health strategies in the face of emerging threats.
• Iyengar, M., Merchant, N., Ernst, K., Rains, S., Arora, M., Ngaybe, M., & Gonzalez, M. (2024). Resilience Informatics for Public Health. In JMIR.
  More info

  Resilience research is attracting increasing attention as stressors such as pandemics and climate change impact normal life worldwide. Informatics tools can play an important role in enhancing resilience of people, communities, and organizations. We present Resilience Informatics as a sub-discipline of resilience research and propose a conceptual framework for Resilience Informatics to aid in the development and effective deployment of informatics systems for resilience.
• Roy, M., Keith, L., Arora, M., Luna, F., & Robinson, J. (2024, Feb). Coproducing Opportunities to Advance Heat Resilience in Southern Arizona. In Southern Arizona Heat Planning Summit, 8.

Presentations

• Arora, M., Roy, M., Robinson, J., Keith, L., Luna, F., & Mithu, I. (2025, January). J4.5 - Enhancing Heat Resilience in Southern Arizona through Codesign and Academic Public Health Partnerships. 105th AMS Annual Meeting. New Orleans, LA.
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  Extreme heat is a global concern that necessitates cross-sectoral collaboration and solutions to mitigate impacts on human health and wellbeing. The U.S. Southwest is at the forefront of extreme heat events that are increasing in frequency, duration, and intensity. Heat-related deaths in Arizona alone have climbed from approximately 150 deaths in 2012 to 990 deaths in 2023, a six-fold increase in a little over a decade. Recognizing the threat to Arizonans health and wellbeing, Arizona Governor, Katie Hobbs, declared an extreme heat emergency in 2023 and issued an Executive Order to develop a statewide heat preparedness plan.Led by the City of Tucson, Pima County Health Department, and the University of Arizona, partners from across Southern Arizona mobilized to convene the Southern Arizona Heat Planning Summit which brought together over 100 representatives from grassroots, non-profit, local and tribal government, private sector, labor unions, utilities, and academic organizations. The Summit engaged local and regional experts to a) understand current practices, b) identify opportunities to improve heat resilience; c) develop strategies to enhance heat response, coordination, and mitigation efforts; and d) coordinate input for ongoing state and local heat planning initiatives.The Summit acknowledged the lived experiences of the community and sought to develop a shared vision for building heat resilience. Key heat management recommendations identified at this summit included: improving outreach and education on heat relief efforts and services (e.g., utility assistance programs); improving data collection, early warning systems and risk communication during heat waves; implementing mandatory employee training on the risks of heat exposure and protection; and establishing plans and protocols to ensure cooling center operations are accessible to community members who are at increased risk and vulnerability. Outcomes of the Summit included the development of the City of Tucson’s Heat Action Roadmap and the Pima County Health Department’s 3-year Heat Plan. The convening also fostered new partnerships and bolstered collaboration across local organizations for cooling center operations and improved communication and education to individuals with increased risk and vulnerabilities. This session will:Describe the recommendations and outcomes of the Southern Arizona Heat Planning Summit.Highlight the collaborative approach adopted for the co-design of heat planning and response efforts.Introduce effective strategies and characteristics to enable effective multi-sectoral, academic-practice partnerships.
• Rath, L., Arora, M., & Rooney, B. C. (2025, April).

  Heat Waves, Wildfires, and Floods—Oh My! How to Become a Wizard of CascadingClimate Threats

  . Preparedness Summit. San Antonio, TX: National Association of City and Council Health Officials.
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  Climate change poses significant risks to human health and wellbeing through an increase in duration, frequency, and intensity of disasters from extreme heat to storms and wildfires. However, these disasters are being felt by communities and individuals unequally; local impacts to this global phenomenon are being mediated by social determinants of health that influence both risk and resilience.  Public health emergency preparedness (PHEP) programs and local health departments are on the front lines of the response and are now faced with not just managing and responding to climate threats but also engaging in mitigation and adaptation strategies. This session will present findings from a content analysis of over 15 county level hazard mitigation and emergency response plans to understand commonalities and differing approaches to integrating climate-informed practices into preparedness and response activities. While all plans discuss and address climate driven hazards, including floods, extreme heat, and wildfires, there is a need for better alignment of preparedness plans and actions with other county and state level climate action commitments. This session will present the integrative approach that Pima County Health Department has taken to the extreme heat response by engaging with cross-sectoral partners in planning, mitigation, response, and recovery. The session will close out with an engaging breakout group conversation to allow participants to identify a) barriers and facilitators to integrating climate change into hazard planning and response; b) approaches to equity-centered climate preparedness and resilience; and c) approaches to plan for climate-driven cascading or compounding disasters.  
• Rooney, B. C., & Arora, M. (2025, February). Beyond the Urban Heat Island: Rural Arizona’s Hidden Heat Crisis. 2025 Arizona Rural Health Policy Forum. Phoenix, AZ: Arizona Center for Rural Health.
• Arora, M. (2024, October). Libraries at the frontlines: Addressing health disparities and serving as hubs of resilience. 2024 APHA Annual Meeting. New Orleans, LA.
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  Rural public libraries adapted their service models to continue providing services to communities during the COVID-19 pandemic. They expanded existing programs and services to meet the needs and challenges and continue to serve patrons with a wide array of issues ranging from misinformation to health resource navigation. This session describes the role libraries play to advance health equity across rural communities in Arizona and highlights a Library Champions Program, co-developed by UArizona Center for Rural Health and the Arizona Library Association.
• Arora, M., & Barnett, C. L. (2024, October). Unexpected vulnerabilities of schools to extreme weather and impacts on children.. 2024 APHA Annual Meeting. Minneapolis, MN.
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  Understanding that children and not just little adults and schools are not just little offices, this presentation will provide an overview of the unexpected and as yet unaddressed climate impacts on schools and on school children. Children in low income, rural remote and justice communities often suffered the worst impacts and the communities have the least ability to keep schools resilient and open or to recover. Coordinated federal interagency priorities and actions for children are critically needed.
• Arora, M., & Lewis, L. (2024, September).

  Need books, a blood pressure cuff, yoga class, garden seeds? There’s a (library) card for that!

  . College-wide Seminar. Tucson, AZ: MEZCOPH.
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  I was invited to do the college-wide seminar on a novel project and partnership that engages rural and small libraries across the state to address heatlh disparities among communities impacted by COVID. 
• Arora, M., & Weinburke, M. (2024, October). Addressing Climate Change in Rural Communities. 2024 APHA Annual Meeting. New Orleans, LA.
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  Recognizing climate change as a critical public health issue, the Intersectional Council's topical group on Climate Change & Health aims to foster intersectional collaboration for action on climate change and health within APHA membership. With this purpose in mind, the overall theme of our annual roundtable session will be “How can we as APHA members communicate about emerging climate issues to drive action?
• Arora, M., Schweers, L., & Lewis, L. (2024, June). Libraries at the frontlines: Addressing health disparities and serving as hubs of resilience. 2024 Arizona Rural Health Conference. Flagstaff, AZ.
• Arora, M. (2022). Mobilizing Partnerships to Advancing Health Equity and Addressing Disparities (AHEAD) in Arizona. Presenter. . Arizona Center for Rural Health and Arizona State Office of Rural Health Webinar Series.
• Arora, M. (2022, November). Academic‐LHD Partnerships: Lessons Learned & Recommendations for Enhancing Preparedness Post COVID.. APHA 2022 Annual Meeting and Expo.
• Arora, M. (2023, January). Joint Panel Discussion JPD8- Panel on Climate, Environment, Health, and Early Warning.. 103rd Annual American Meteorological Society Meeting.
• Arora, M. (2023, October). Collaborations to Address Extreme Heat Risk & Build Health Equity in Arizona Communities. ADHS Extreme Heat Planning Summit. Phoenix, AZ.
  More info

  THis activity captures my presentation at the ADHS Extreme Heat Planning Summit in 2023; the deliberations of the summit along with the input from our City of Tucson and Pima County Heat Summits were submitted to the Governor's office for inclusion into the state's first ever Extreme Hat Preparedness Plan.Appendix B of the report provides a brief summary of the summit and includes the speakers list.
• Arora, M. (2023, October). Extreme Heat Impacts in Rural Arizona. 2023 Arizona Heat Planning Summit. Phoenix, AZ: Arizona Department of Health Services.
• Arora, M., Lewis, L., & Schweers, L. (2023, September). Arizona Librarians Fostering Resilient Rural Communitie. Arizona Health Equity Conference. Phoenix, AZ.
• Arora, M., Lewis, L., & Shweers, L. (2023, June). Arizona Librarians Fostering Resilient Rural Communities: Lessons Learned & Best Practices. 49th Annual Arizona Rural Health Conference. Flagstaff, AZ.
• Koch, B. D., & Arora, M. (2023, February). Workforce Capacity: Scaling up for the Next Fight in Arizona. Arizona Public Health Association Spring Meeting 2023Arizona Public Health Association.
• Arora, M. (2022). Exploring Partnership Opportunities between the UArizona Center for Rural Health and Libraries. . Arizona Library Association Annual Conference 2022.
• Arora, M. (2022). Strategies & Perspectives: Integrating Climate Change Into Graduate Public Health Courses. Presenter.. APHA 2022 Annual Meeting and Expo..
• Arora, M. (2021, October). Supporting an educational system that addresses climate change, health and equity. APHA 2021 Conference. Virtual: APHA Center for Climate, Health & Equity.
  More info

  I was invited to be on this panel to discuss findings from a national evaluation of CEPH accredited institutions that I completed in 2019. The presentation highlighted the facets influencing public health education on climate change and established the need for building formal and informal support mechanisms. The presentation also highlighted pilot projects and data making the case for climate, health and equity education at all levels.
• Arora, M., Mayer, B. M., Helm, S. V., & Barnett, M. A. (2021). Mental Health Impacts of COVID-19 on Grocery Store Workers in Arizona: Results from Online Surveys. American Public Health Association Annual Meeting.
• Mayer, B. M., Helm, S. V., Barnett, M. A., & Arora, M. (2021, August). Essential but Ill-Prepared: Mental Health Effects among Grocery Store Workers during COVID-19’s First Wave in Arizona. American Sociological Association Annual Conference. Virtual.

Poster Presentations

• Arora, M., Beamer, P., Ingram, M., & Mithu, I. (2025, 01/2025). Assessing Heat Action Planning in Arizona Through Hierarchy of Controls and Socio-ecological Model Lens [Conference presentation].. 105th AMS Annual Meeting. New Orleans, LA, United States.
• Arora, M., Saha, R., & Robinson, J. (2025, 01/2025). Adapting to Extreme Heat: A Structured Toolkit for Establishing Safe and Effective
  Cooling Centers. 105th AMS Annual Meeting. New Orleans, LA.
  More info

  Extreme heat events pose significant health risks particularly to vulnerable populations such asthe elderly, children, and individuals with pre-existing medical conditions. Cooling centers serveas an essential public health intervention which provides safe, air-conditioned environments toprevent heat-related illnesses and also offer refuge for individuals at risk. Pima County HealthDepartment operates a robust heat relief response that includes over 30 cooling centers supportedby community partners such as libraries and community centers. Recognizing the wide array ofcooling center practices, services, and facilities, the PCHD and University of Arizona researcherscollaborated to identify standard operating procedures and best practices for cooling centeroperations. A preliminary literature and web search on cooling center guidelines revealed limitedprotocols and standardized operational guidelines for community facilities. Our content analysisof publicly available heat action plans, government websites, and literature reviews identifiedlimited information relating to cooling center operations including guidelines on topics such asinfection prevention and addressing needs of individuals with access and functional needs(AFN).To address these gaps, a structured toolkit was developed to provide cooling center partners withbest practices and recommendations for establishing effective cooling centers that meet healthand safety standards for vulnerable populations. The toolkit covers essential aspects of coolingcenter management and provides checklists and templates to guide community partners inorganizing their facility to provide heat relief. Topics include the definition and importance ofcooling centers, facility preparation, health and safety protocols, staff training, strategies forAccess and Functional Needs (AFN) communities, creating engaging environments, policies forpets, and management frameworks.Key aspects of the toolkit include:● A detailed facility evaluation checklist addressing accessibility, resources, and safety.● Guidelines for monitoring heat-related illnesses and maintaining sanitation standards.● Comprehensive staff training protocols to ensure preparedness.● Strategies for creating inclusive and engaging environments.● Clear policies for managing pets within cooling centers.● An effective management and evaluation framework for continuous improvement.By implementing these guidelines organizations can create safe, accessible, and comfortablecooling centers during extreme heat events. Continuous evaluation and feedback mechanismscan help ensure that these centers maintain high standards and deliver effective services. Thistoolkit is a valuable resource for public health officials, community organizations, andpolicymakers seeking to strengthen heat relief strategies, particularly in regions like PimaCounty and Arizona where extreme heat is a persistent threat to the community.
• Schweers, L., Lewis, L., Rooney, B. C., Arora, M., & Kajal, F. (2025).

  Arizona Libraries at the Front Lines: Addressing Health Disparities and Serving as Hubs of Resilience during the COVID-19 Pandemic

  . University of Arizona Public Health Research Forum. Tucson, AZ.
• Arora, M., Halili, L., SantaMaria, B., Sibart, J., Shanks, A., Crwley, C. J., Padilla, A. R., Cameron, E., & Derksen, D. J. (2023, May). Collaborative Community Engagement to Address Substance Use and Opioid Use Disorders in Rural Arizona . National Rural Health Association Health Equity Conference. San Diego, CA: Alyssa R. Padilla5, Elena Cameron1.
• Arora, M., & Koch, B. D. (2022).

  Lessons learned as we emerge from the pandemic.

  . APHA 2022.

Others

• Arora, M., & Robinson, J. (2024, October). 2024 Interim Heat Season Report. Government/Website. https://content.civicplus.com/api/assets/0581a931-ab5c-4211-8ade-f70c17b5fa66
  More info

  This is the interm Pima County Heat Season Report that presents the entire range of heat response activities undertaken by County partners. I ran the post heat season hotwash or debrief for the health department and the preliminary findings of our work were included in this report that was submitted to the Pima County Board of Supervisors.
• Arora, M., Luna, F., & Robinson, J. (2024, September). City of Tucson Heat Action Roadmap. https://assets.tucsonaz.gov/share/gis-docs/caap/COT_Heat_Action_Roadmap_FINAL_G.pdf
  More info

  I am a member of the City of Tucson and Pima County Health Department's Joint Heat Action Team (J-HAT). This team was convened at the 2024 Southern AZ Heat Summit in February 2024 with the purpose of developing the city's first ever heat action roadmap. Once this deliverable was completed, the group continued to collaborate to implement hreat risk mitigation strategies to prevent morbidity and mortality. As a member of this group, I provided expertise and technical assistance to local government, health department, and partners and helped structure this roadmap.
• Rooney, B. C., Peters, J. S., Derksen, D. J., Koch, B. D., & Arora, M. (2024, April 23). Arizona Public Health System Capacity: COVID-19 Action Item Summary. Arizona Center for Rural Health. https://crh.arizona.edu/sites/default/files/2024-04/240422AZPH%20System%20Capacity%20Action%20Summary.pdf
• Arora, M., Peters, J. S., Rooney, B. C., & Koch, B. D. (2023, August). Public Health System Capacity in Arizona: Learning from the COVID-19 Pandemic Response. https://crh.arizona.edu/public-health-system-capacity-arizona-learning-covid-19-pandemic-response
• Arora, M., Rooney, B. C., & Koch, B. D. (2023, September). Arizona Public Health Workforce: Recruitment and Retention. https://crh.arizona.edu/arizona-public-health-workforce-recruitment-and-retention
• Koch, B. D., Arora, M., Moore, M., Peters, J. S., Rooney, B. C., Rooney, B. C., Arora, M., Koch, B. D., & Peters, J. S. (2023, August). Public Health System Capacity in Arizona: Learning from the COVID-19 Pandemic Response. Arizona Center for Rural Health. https://crh.arizona.edu/public-health-system-capacity-arizona-learning-covid-19-pandemic-response
• Koch, B. D., Rooney, B. C., & Arora, M. (2023, September). Arizona Public Health Workforce: Recruitment and Retention. Arizona Center for Rural Health. https://crh.arizona.edu/arizona-public-health-workforce-recruitment-and-retention
• Arora, M., Becker, J. A., Scmeltz, M., & Schneider, R. (2021, March). Issue Paper for CEPH inclusion of Climate into Workforce Training. Online Webpage.
  More info

  Subject matter experts and APHA International Health Section members from three universities collaborated on this Issue Brief to highlight the need for integrating climate change into public health curriculum. This brief was signed by 158 professionals from across the US as an indication of support for this issue. This brief spurred the issue of future workforce education and training on climate change among other national communities of practice (e.g., Columbia Consortium, Physicians for Health) and our workgroup continues to advocate on this topic through outreach and education.
• Austhof, E., Sami, Z., Iroz-Elardo, N., & Keith, L. (2021, April). Extreme Heat at Outdoor Vaccination Sites: UArizona POD Report. The University of Arizona.
  More info

  Exposure to extreme heat causes more than 3,000 heat-related illness emergency room visits every year in Arizona, and has caused over 2,000 deaths in the past 10 years combined (AZDHS, 2019). Given the Tucson region’s hot summer temperatures and the current COVID-19 vaccination schedule requiring mass vaccination sites through at least May 2021, the Pima County Office of Emergency Management requested assistance in better understanding heat risk at the outdoor vaccination sites.We measured ambient temperature and wet-bulb globe temperature (WBGT) at the UArizona POD site on March 31, 2021 from 12:00-5:00 PM. NOAA reported an average daily temperature of 69°F (range of 49-88°F) with an average wind speed of 6.4 MPH, and average humidity of 13%.
• Keith, L., Iroz-Elardo, N., Sami, Z., & Austhof, E. (2021, April). Extreme Heat at Outdoor Vaccination Sites: Tucson Medical Center (TMC) Report. The University of Arizona.
  More info

  Exposure to extreme heat causes more than 3,000 heat-related illness emergency room visits every year in Arizona, and has caused over 2,000 deaths in the past ten years combined (AZDHS, 2019). Given the Tucson region’s hot summer temperatures and the current COVID-19 vaccination schedule requiring mass vaccination sites through at least May 2021, the Pima County Office of Emergency Management requested assistance in better understanding heat risk at the outdoor vaccination sites. We measured ambient temperature and wet-bulb globe temperature (WBGT) at the Tucson Medical Center (TMC) vaccination site on April 2, 2021 from 12:00-5:00 PM. NOAA reported an average daily temperature of 76°F (range of 62-89°F) with an average wind speed of 6.2 MPH and average humidity of 15%.