National Public Health Strategy for Terrorism Preparedness and Response Joan P. Cioffi, Ph.D. Senior Service Fellow Public Health Practice Program Office Centers for Disease Control and Prevention U.S. Department of Health and Human Services Atlanta, GA Joan P. Cioffi, Ph.D. Senior Service Fellow Public Health Practice Program Office Centers for Disease Control and Prevention U.S. Department of Health and Human Services Atlanta, GA

CDC: National Public Health Strategy for Terrorism Preparedness and Response + Strategic Imperative: “ a competent and sustainable workforce ” + Implementation: ! State and local grant program ! CDC-directed education/training ! Partnerships + Strategic Imperative: “ a competent and sustainable workforce ” + Implementation: ! State and local grant program ! CDC-directed education/training ! Partnerships

State and Local Grantee Education and Training + Grantees include: 50 states, D.C., NYC, LA, Chicago and 8 territories + Education/training part of all 7 focus areas + 52% grantees completed needs assessments in FY FY 2004 – most grantees planned distinct training interventions to address needs ( Range: ) + Next steps ! Disseminate best practices ! Use performance indicators; exercises/drills to refine training plans + Grantees include: 50 states, D.C., NYC, LA, Chicago and 8 territories + Education/training part of all 7 focus areas + 52% grantees completed needs assessments in FY FY 2004 – most grantees planned distinct training interventions to address needs ( Range: ) + Next steps ! Disseminate best practices ! Use performance indicators; exercises/drills to refine training plans

Leveraging Partnerships + Centers for Public Health Preparedness ! 23 academic centers (Schools of Public Health) ! 13 specialty centers ( School of Medicine, Nursing, Veterinary Medicine, Law) + Clinician Outreach ! Association of American Medical Colleges (AAMC) and 8 specialty societies + Centers for Public Health Preparedness ! 23 academic centers (Schools of Public Health) ! 13 specialty centers ( School of Medicine, Nursing, Veterinary Medicine, Law) + Clinician Outreach ! Association of American Medical Colleges (AAMC) and 8 specialty societies

CDC Terrorism Preparedness and Emergency Response Need for coordination of all CDC programs with roles in the science and/or service of terrorism preparedness and emergency response; all have education activities NCEH NCID NCIPC NIP PHPPO NIOSH EPO ATSDR OC OTPER OC CDC Director’s Office of Communication ATSDR Agency for Toxic Substances & Disease Registry NIOSH National Center for Occupational Safety & Health NCIPC National Center for Injury Prevention & Control NCID National Center for Infectious Diseases NCEH National Center for Environmental Health EPO Epidemiology Program Office NIP National Immunization Program PHPPO Public Health Program Practice Office

CDC Information Development and Dissemination Critical Health Information Communication Professional Education Identification, development, and dissemination of critical information to support terrorism preparedness and emergency response activities at CDC requires planning and close coordination across the agency and collaboration with a broad range of partners Public Media Other stakeholders Public health professionals Clinicians Others

CDC Terrorism Preparedness and Emergency Response Information and Education Considerations “Just in case”: Information that all frontline PH professionals and clinicians will need to recognize illness caused by terrorist agents  Delivery: Ongoing rollout; didactic, interactive, Web-based formats; distance learning “Just in time”: Information that can be immediately accessed by PH professionals and clinicians when presented with suspect or known persons affected by terrorism events  Delivery Real-time; continuous updates; quick communication “Just in case”: Information that all frontline PH professionals and clinicians will need to recognize illness caused by terrorist agents  Delivery: Ongoing rollout; didactic, interactive, Web-based formats; distance learning “Just in time”: Information that can be immediately accessed by PH professionals and clinicians when presented with suspect or known persons affected by terrorism events  Delivery Real-time; continuous updates; quick communication

Resources Lynn Steele, Senior Advisor for Education and Training, OTPER/CDC ! Lynn Steele, Senior Advisor for Education and Training, OTPER/CDC !

Education and Training Includes All Hazards Public Health Preparedness Biological Terrorism Chemical Terrorism ! Choking agents (phosgene/ chlorine) ! Blood agents (cyanides) ! Blister agents (mustard gas) ! Nerve agents (sarin, soman, tabun, etc.) Radiation Terrorism ! Dirty bombs ! Food/water contamination ! Power plants Biological Terrorism Chemical Terrorism ! Choking agents (phosgene/ chlorine) ! Blood agents (cyanides) ! Blister agents (mustard gas) ! Nerve agents (sarin, soman, tabun, etc.) Radiation Terrorism ! Dirty bombs ! Food/water contamination ! Power plants

In the event of a terrorist act or emergency, CDC needs to provide just-in-time information immediately in at least the following 5 areas Just-in-time Information  Ready and available Guidance for first responders Immediate clinical guidance, medical management Public health response Clinical and reference laboratory protocols Basic information for the public Identifying Information Needs and Gaps

Refining a Terrorism Preparedness Education Strategy Questions to Consider:  What have we learned from the needs assessments?  How can we minimize redundancy of materials? Can we consolidate/standardize?  What actions can be taken to ensure consistent, accurate information? Quality education?  What is the impact of education? How do we know that learning has occurred? What evaluation programs are/should be in place?  Where are the content gaps in training and education materials? In audiences reached?  Can we better coordinate resources for development and delivery of training ?

Hospitals DoD & VA Vital Records Environmental (BioWatch) Pharmacy Data Veterinary Laboratory Cargo/ Imports Immigration International Schools Employers Law Enforcement Intersection of Information/ Analysis ACTION POINT Media Clinicians Public First Responders Quarantine Stations Border States Desired State of Connectivity