portunities inherent in integrating public health into a broader field. In order to address the challenges and maximize the opportunities, the committee recommends that all federal entities concerned with bioterrorism preparedness (e.g., CDC, HRSA, ODP) more actively coordinate guidance and funding activities. Federal agencies should also work together to develop mechanisms that facilitate coordination and collaboration among their grantees at the state and local levels. Such mechanisms may include, but are not limited to, regular meetings to familiarize CDC and ODP program staff with each other’s program priorities and activities, a database for informing ODP and other partners of exercises planned by CDC grantees, etc. Federal coordination efforts should also include the clarification of primary responsibility and authority in bioterrorism events, to ensure that CDC can fulfill its unique role as the nation’s public health agency.

THE EVIDENCE BASE FROM DISASTER RESEARCH AND PRACTICE

Nature of the Evidence

Although quantitative evidence (with randomized controlled trials as the gold standard) is extremely important in public health and medicine, this level of evidence may be difficult or impossible to obtain in research pertaining to public health disasters. While endeavoring to conduct quantitative, empirical research whenever possible, public health professionals also value other types of knowledge that contribute to decision-making and research methodologies that provide alternate routes to usable evidence. For example, the Task Force on Community Preventive Services, which is a major contributor to evidence-based public health, evaluates population-based health interventions through systematic and rigorous reviews that are not restricted to empirical and quantitative evidence (Briss et al., 2004). Methodologies for research used in public health are drawn from the social sciences, statistics, and epidemiology rather than solely from the biologic sciences.

Disaster research is in a position somewhat similar to public health research; there is some disconnectedness between academic research and practice (i.e., bringing research to bear on practice, and practice to inform and be validated by research), researchers come from diverse disciplines, there are challenges in translating research to practice, and it has been difficult to develop and secure funding for a comprehensive research agenda (Tierney, 1993; Quarantelli, 1994; Peters et al., 2001). Being aware of these similarities may help public health better understand and interpret disaster research and practice and their potential contributions to public health preparedness.



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