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Evidence-Based Practice for Public Health Emergency Preparedness and Response

National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Board on Health Sciences Policy; Committee on Evidence-Based Practices for Public Health Emergency Preparedness and Response ; Editors: Autumn Downey , Lisa Brown , and Ned Calonge .

When communities face complex public health emergencies, state local, tribal, and territorial public health agencies must make difficult decisions regarding how to effectively respond. The public health emergency preparedness and response (PHEPR) system, with its multifaceted mission to prevent, protect against, quickly respond to, and recover from public health emergencies, is inherently complex and encompasses policies, organizations, and programs. Since the events of September 11, 2001, the United States has invested billions of dollars and immeasurable amounts of human capital to develop and enhance public health emergency preparedness and infrastructure to respond to a wide range of public health threats, including infectious diseases, natural disasters, and chemical, biological, radiological, and nuclear events. Despite the investments in research and the growing body of empirical literature on a range of preparedness and response capabilities and functions, there has been no national-level, comprehensive review and grading of evidence for public health emergency preparedness and response practices comparable to those utilized in medicine and other public health fields. Evidence-Based Practice for Public Health Emergency Preparedness and Response reviews the state of the evidence on PHEPR practices and the improvements necessary to move the field forward and to strengthen the PHEPR system. This publication evaluates PHEPR evidence to understand the balance of benefits and harms of PHEPR practices, with a focus on four main areas of PHEPR: engagement with and training of community-based partners to improve the outcomes of at-risk populations after public health emergencies; activation of a public health emergency operations center; communication of public health alerts and guidance to technical audiences during a public health emergency; and implementation of quarantine to reduce the spread of contagious illness.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON EVIDENCE-BASED PRACTICES FOR PUBLIC HEALTH EMERGENCY PREPAREDNESS AND RESPONSE
• Reviewers
• Preface
• Acronyms and Abbreviations
• Abstract
• Summary
  • ABOUT THIS REPORT
  • IMPROVING AND EXPANDING THE EVIDENCE BASE FOR PHEPR
  • DEVELOPING AN EVIDENCE-BASED PROCESS TO INFORM PHEPR DECISION MAKING
  • BRIDGING THE GAP BETWEEN PHEPR RESEARCH AND PRACTICE
  • CONCLUDING REMARKS
  • STUDY CHARGE
  • CONCEPTUALIZING THE COMPLEX PHEPR SYSTEM
  • UNDERLYING REASONS FOR THE CURRENT STATE OF THE PHEPR EVIDENCE BASE
  • THE IMPORTANCE OF EVIDENCE-BASED PRACTICE AND GUIDELINES
  • ABOUT THIS REPORT
  • REFERENCES
  • CHARACTERIZING THE RESEARCH ON PHEPR: A MAP OF THE EVIDENCE
  • A LOOK BACK AT PHEPR RESEARCH PROGRAMS
  • LIMITATIONS OF PHEPR RESEARCH PROGRAMS
  • CONCLUDING REMARKS
  • REFERENCES
  • EVOLVING PHILOSOPHIES FOR EVALUATING EVIDENCE TO INFORM EVIDENCE-BASED PRACTICE: IMPLICATIONS FOR PHEPR
  • HOW DO DIFFERENT FIELDS EVALUATE EVIDENCE?: A REVIEW OF EXISTING FRAMEWORKS
  • APPLYING A METHODOLOGY TO REVIEW, SYNTHESIZE, AND ASSESS THE COE FOR PHEPR PRACTICES
  • LIMITATIONS, LESSONS LEARNED, AND RECOMMENDATIONS FOR THE FUTURE
  • REFERENCES
  • DESCRIPTION OF THE PRACTICE
  • OVERVIEW OF THE KEY REVIEW QUESTIONS AND ANALYTIC FRAMEWORK
  • OVERVIEW OF THE EVIDENCE SUPPORTING THE PRACTICE RECOMMENDATION
  • CONSIDERATIONS FOR IMPLEMENTATION
  • PRACTICE RECOMMENDATION, JUSTIFICATION, AND IMPLEMENTATION GUIDANCE
  • EVIDENCE GAPS AND FUTURE RESEARCH PRIORITIES
  • REFERENCES
  • DESCRIPTION OF THE PRACTICE
  • OVERVIEW OF THE KEY REVIEW QUESTIONS AND ANALYTIC FRAMEWORK
  • OVERVIEW OF THE EVIDENCE SUPPORTING THE PRACTICE RECOMMENDATION
  • CONSIDERATIONS FOR IMPLEMENTATION
  • PRACTICE RECOMMENDATION, JUSTIFICATION, AND IMPLEMENTATION GUIDANCE
  • EVIDENCE GAPS AND FUTURE RESEARCH PRIORITIES
  • REFERENCES
  • DESCRIPTION OF THE PRACTICE
  • OVERVIEW OF THE KEY REVIEW QUESTIONS AND ANALYTIC FRAMEWORK
  • OVERVIEW OF THE EVIDENCE SUPPORTING THE PRACTICE RECOMMENDATION
  • CONSIDERATIONS FOR IMPLEMENTATION
  • PRACTICE RECOMMENDATION, JUSTIFICATION, AND IMPLEMENTATION GUIDANCE
  • EVIDENCE GAPS AND FUTURE RESEARCH PRIORITIES
  • REFERENCES
  • DESCRIPTION OF THE PRACTICE
  • OVERVIEW OF THE KEY REVIEW QUESTIONS AND ANALYTIC FRAMEWORK
  • OVERVIEW OF THE EVIDENCE SUPPORTING THE PRACTICE RECOMMENDATION
  • CONSIDERATIONS FOR IMPLEMENTATION
  • PRACTICE RECOMMENDATION, JUSTIFICATION, AND IMPLEMENTATION GUIDANCE
  • EVIDENCE GAPS AND FUTURE RESEARCH PRIORITIES
  • REFERENCES
  • A NATIONAL PHEPR SCIENCE FRAMEWORK
  • SUPPORTING METHODOLOGICAL IMPROVEMENTS FOR PHEPR RESEARCH
  • IMPROVING SYSTEMS TO GENERATE HIGH-QUALITY EXPERIENTIAL EVIDENCE FOR PHEPR
  • WORKFORCE CAPACITY DEVELOPMENT FOR RESEARCHERS AND PRACTITIONERS IN PHEPR
  • TRANSLATION, DISSEMINATION, AND IMPLEMENTATION OF PHEPR RESEARCH TO PRACTICE
  • ANNEX 8-1. GENRES OF RESEARCH TO INFORM PUBLIC HEALTH EMERGENCY PREPAREDNESS AND RESPONSE PRACTICES
  • REFERENCES

  This activity was supported by a contract between the National Academy of Sciences and the Centers for Disease Control and Prevention (Contract #200-2011-38807, Task Order 60). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

  Suggested citation:

  National Academies of Sciences, Engineering, and Medicine. Evidence-based practice for public health emergency preparedness and response. Washington, DC: The National Academies Press. https://doi.org/10.17226/25650.

  Library of Congress Control Number: 2020943124

  Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

  Printed in the United States of America