A National Agenda for Public Health Systems Research on Emergency Preparedness

A National Agenda for Public Health Systems Research on Emergency Preparedness

Joie Acosta
Christopher Nelson
Ellen Burke Beckjord
Shoshana R. Shelton
Erin Murphy
Kristin L. Leuschner
Jeffrey Wasserman
Copyright Date: 2009
Published by: RAND Corporation
Pages: 126
  • Cite this Item
  • Book Info
    A National Agenda for Public Health Systems Research on Emergency Preparedness
    Book Description:

    The Office of the Assistant Secretary for Preparedness and Response asked RAND to facilitate development of a public health systems research agenda for emergency preparedness, identify short- and long-term research priorities, and provide a basis for coordinating funders and researchers inside and outside the federal government. To identify research priorities, RAND staff conducted an extensive literature review and convened a panel of experts.

    eISBN: 978-0-8330-4908-7
    Subjects: Health Sciences, Sociology, Political Science

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iv)
  3. Table of Contents
    (pp. v-vi)
  4. Figures
    (pp. vii-viii)
  5. Tables
    (pp. ix-x)
  6. Summary
    (pp. xi-xiv)
  7. Acknowledgments
    (pp. xv-xvi)
  8. Abbreviations
    (pp. xvii-xviii)
  9. CHAPTER ONE Introduction
    (pp. 1-2)

    The lack of frequent opportunities to observe and learn from real-world responses to large-scale public health emergencies has hindered the development of an evidence base for public health emergency preparedness (PHEP).¹ As a result, efforts to develop performance measures and standards, best practices, program guidance, training, and other tools have proceeded without a strong empirical and analytical basis.

    To identify strategies to address the gap in evidence, the Pandemic and All-Hazards Preparedness Act of 2006 (PAHPA) (Pub. L. 109–417, § 101 et seq.) requires the Secretary of Health and Human Services to formulate a broad public health systems research...

  10. CHAPTER TWO Approach
    (pp. 3-6)

    RAND, in collaboration with ASPR, identified and convened an expert panel to guide the development of a research agenda and to identifyshort- andlong-termpriorities.¹ To prepare for the meeting, RAND staff reviewed existing literature on public health systems and emergency preparedness. Prior to the meeting, panelists received a background paper, which included the panel’s objectives and tasks as well as initial thoughts on how those tasks might be addressed. The paper was developed from the literature review, a review of relevant statutes and policies, and discussions with key stakeholders inside and outside government and across professional disciplines involved...

  11. CHAPTER THREE Research Priorities Related to Planning and Other Pre-Incident Activities
    (pp. 7-12)

    The priorities presented in this chapter involve planning and other pre-incident activities, including engaging diverse groups, organizations, and communities; anticipating likely population behavior during disasters; and reducing population and health system vulnerabilities.

    Advanced planning is critical in delineating key roles and responsibilities, establishing trigger points and decisionmaking processes, ensuring that response partners approach responses with common assumptions, and establishing processes and procedures. Planning for multijurisdictional, multiagency responses can be difficult, given the need to coordinate among health departments, between public health and other first responders (e.g., emergency management), and among public, private, and nonprofit actors and to harmonize the work...

  12. CHAPTER FOUR Research Priorities Related to Key Response Capabilities
    (pp. 13-20)

    The research priorities described in this chapter involve many of the core elements required for responses to public health emergencies, including epidemiology, public health laboratory networks, crisis and emergency risk communication, countermeasure delivery, providing health care to large populations during and after disasters, caring for special needs and displaced populations, and activities needed during the recovery phase.

    While epidemiology is a well-developed field, additional research is needed to ensure early detection of public health risks and to support ongoing situational awareness and decisionmaking during public health emergencies. Timely detection triggers response operations, such as disease investigation and implementation of control...

  13. CHAPTER FIVE Research Priorities Related to Infrastructure, Resources, and Legal Frameworks
    (pp. 21-24)

    This set of priorities includes elements of preparedness needed to support the full range of planning and response activities, including information technology and infrastructure, workforce and training, and legal framework research.

    New technology will have a future impact on the public health system and how the system prepares for and responds to emergency events. Panelists identified the need to understand what the most relevant technologies are, how those technologies will likely affect the public health system, and how public health agencies will respond given the impacts of technology on the system.

    For example, cyberinfrastructure is one type of technology that...

  14. CHAPTER SIX Research Priorities Related to Accountability and Quality Improvement
    (pp. 25-28)

    This final set of priorities relates to systems for defining, measuring, and improving the quality of public health preparedness and for holding the public health system accountable for the use of public funds.

    A pervasive and cross-cutting theme in the panel discussion was the need for performance standards, measures, and quality improvement tools that can help those responsible for public health preparedness assess, evaluate, and improve preparedness at all levels of government and across all participating organizations.

    Standards provide an answer to the question, “How good is good enough?” Yet, the development of standards has been limited by the absence...

  15. CHAPTER SEVEN Conclusion
    (pp. 29-30)

    This report described the results of an expert panel process to define a comprehensive public health systems research agenda for emergency preparedness. Based on a review of published literature, consultation with key experts, and an expert panel meeting, the agenda includes 20 priority areas, nine of which were identified by the panelists as top short-term priorities. Many of the priority areas describe steps needed to build a more robust research infrastructure. PHEP efforts need to synthesize relevant research and leverage practical and applied knowledge (i.e., knowledge and research not found in peer-reviewed publications). As noted in the agenda, measures and...


    • APPENDIX A Expert Panel
      (pp. 31-32)
    • APPENDIX B Developing the Research Agenda
      (pp. 33-38)
    • APPENDIX C Literature Review
      (pp. 39-72)
    • APPENDIX D Peer-Reviewed Literature
      (pp. 73-84)
    • APPENDIX E Summaries of Statutes, Policies, and Other Governmental or Organizational Reports Reviewed
      (pp. 85-92)
    • APPENDIX F Data Abstraction Forms
      (pp. 93-98)
  17. References
    (pp. 99-108)