Recent international and national events such as the SARS outbreak in 2002–2003, the rising incidence of West Nile Virus, and the increasing threat of a pandemic influenza outbreak have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. The effective coordination of all agencies at metropolitan, regional, provincial, and federal levels is essential to the management of public health emergencies. The level of inter-organizational coordination and preparedness of public health and emergency preparedness organizations throughout Alberta was investigated. An online organizational questionnaire provided a census of organizations involved in public health preparedness, and information on the structure of inter-organizational relations in Alberta and the state of public health preparedness from the perspective of organizational members. The primary goal was to use the information provided by individual agencies to help improve how policymakers and public health and emergency management officials plan and organize for public health threats and emergencies. Major findings are as follows: i) organizational characteristics including organizational training opportunities, size, and jurisdiction are associated with different dimensions of organizational-level preparedness in Alberta, ii) perceived organizational connectivity serves as a proxy measure of formal ties objectively reported by organizations with respect to pandemic influenza preparedness, iii) higher jurisdictional organizations display greater degrees of interconnectedness on average, and iv) organizational connectivity moderates the association of perceived public health preparedness with an organization’s objective level of preparedness, independent of jurisdictional level. The true test of public health preparedness is in how the system responds to an actual crisis. Since public health emergencies are rare, there is an absence of province-wide data in this regard; however, this work has measured organizational-level perceptions of public health preparedness as a proxy for actual preparedness. It is critical that organizations have a written emergency response plan which is tested in practice through exercises or in a real situation to observe jurisdictional and organizational ability to execute an appropriate response and assess communication and resource flow among organizations. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2009-04-17 15:58:33.093

Previous findings have demonstrated that the preparedness and infrastructure of the public health system is inadequately developed for a biological and/or chemical terrorism attack.(1-4) Chen et al. reported that those primary care providers that would have to respond to such an attack do not feel prepared to diagnose and manage such an event.(5)This research was an observational study using e-mail/web based survey to assess the levels of preparedness (PL) and willingness to respond (WTR) to a bioterrorism attack, and identify factors that predict PL and WTR of Florida community healthcare providers. The conceptual framework and questionnaire was designed based on empirical studies and the use of an expert panel to assess the providers administrative and clinical competencies, WTR, and PL. The questionnaire was pilot tested in 30 subjects. Reliability was high (Cronbachs alpha =.82). The emailed invitaiton letters were sent to 22,800 healthcare providers in Florida. The questionniare was posted for 7 days on the website during December, 2004.There were 2,279 respondents of 9,124 who received the e-mails. Response rate was 28%, with 86% completed questionnaires. The subjects included physicians (n=604), nurses (n=1,152), and pharmacists (n=486). The results demonstrated that only 32% of the Florida providers were competent and willing to respond to a bioterrorism attack. 82.7% of providers were willing to respond in their local community and 53.6% within the State. The subjects were more competent in administrative skills than clinical knowledge (62.8% vs. 45%) The most competent areas were the initiation of the treatment and recognition of their clinical and administrative roles. The least competent areas were identifying the cases and communicate risk to the others.

The presence of naturally occurring and man-made public health threats necessitate the design and implementation of mitigation strategies, such that adequate response is provided in a timely manner. Since multiple variables, such as geographic properties, resource constraints, and government mandated time-frames must be accounted for, computational methods provide the necessary tools to develop contingency response plans while respecting underlying data and assumptions. A typical response scenario involves the placement of points of dispensing (PODs) in the affected geographic region to supply vaccines or medications to the general public. Computational tools aid in the analysis of such response plans, as well as in the strategic placement of PODs, such that feasible response scenarios can be developed. Due to the sensitivity of bio-emergency response plans, geographic information, such as POD locations, must be kept confidential. The generation of synthetic geographic regions allows for the development of emergency response plans on non-sensitive data, as well as for the study of the effects of single geographic parameters. Further, synthetic representations of geographic regions allow for results to be published and evaluated by the scientific community. This dissertation presents methodology for the analysis of bio-emergency response plans, methods for plan optimization, as well as methodology for the generation of synthetic geographic regions.