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Special Focus

How Can We Strengthen the Evidence Base in Public Health Preparedness?

Christopher D. Nelson, PhD, Ellen Burke Beckjord, PhD, MPH, David J. Dausey, PhD, Edward Chan, PhD, Debra Lotstein, MD, MPH and Nicole Lurie, MD, MSPH

Address correspondence and reprint requests to Dr Christopher D. Nelson, RAND Corporation, 4570 Fifth Ave, Room 4216, Pittsburgh, PA 15213 (e-mail: cnelson{at}rand.org).

The lack of frequent real-world opportunities to study preparedness for large-scale public health emergencies has hindered the development of an evidence base to support best practices, performance measures, standards, and other tools needed to assess and improve the nation’s multibillion dollar investment in public health preparedness. In this article, we argue that initial funding priorities for public health systems research on preparedness should focus on using engineering-style methods to identify core preparedness processes, developing novel data sources and measures based on smaller-scale proxy events, and developing performance improvement approaches to support the translation of research into practice within the wide variety of public health systems found in the nation.

Key Words: public health • preparedness • evidence base • best practices • performance measures • engineering methods