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bioterrorism, disaster planning, emergency preparedness, outbreak control, public health



  1. Jones, Maggie MPH
  2. O'Carroll, Patrick MD, MPH
  3. Thompson, Jack MSW
  4. D'Ambrosio, Luann MEd


Objective: To provide regional, state, and local public health officials a conceptual framework and checklist for assessing regional public health emergency preparedness, specifically in regard to cross-border public health preparedness needs.


Methods: The project had four phases that are as follows: defining the scope, conducting a literature review, soliciting expert opinion, and creating the assessment framework and checklist. A conceptual framework was developed to define the scope of the project on the basis of the kinds of resources likely to be shared across borders in a public health response (eg, data, supplies, staff), in support of the public health functions likely to be important in a health emergency (eg, epidemiology, laboratory). A literature review was then conducted to identify key articles and tools addressing regional preparedness. Key informant interviews (n = 23) were conducted with public health and emergency management professionals in the Pacific Northwest to identify a set of systems, agreements, and protocols that should be systematically considered in assessing regional public health preparedness. Using the literature review and themes from interviews, a checklist was developed.


Results: A checklist was developed for use by public health leaders, which recommends 24 specific agreements, protocols, systems, and management structures that should be considered to foster cross-border public health preparedness.


Conclusions: Regional public health preparedness represents not only the sum of state-level preparedness of the states in a region but also the capacity of those states to collaborate across state and international borders during a public health emergency. This checklist provides a tool to systematically consider cross-border preparedness issues.