Graduation Year


Document Type




Degree Granting Department

Public Health

Major Professor

Raymond D. Harbison, Ph.D.

Committee Member

Jay Wolfson, Dr.Ph., J.D.

Committee Member

M. Rony Francois, M.D. Ph.D.

Committee Member

Wayne Westhoff, Ph.D.


Core competencies, Emergency preparedness planning, Public health preparedness, Terrorism, Strategic national stockpile


Previous findings have demonstrated that the preparedness and infrastructure of the public health system are 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 (Cronbach’s 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. About 55% of the subjects had previous bioterrorism training and 31.5% had emergency drills. Gender, race, previous training and drills, preceived threats of bioterrorism attack, and preceived benefits of training and drills and “feeling” prepared were the predictors of overall preparedness.

The findings suggest that only one-third of Florida community healthcare providers were prepared for a bioterrorism attack. To effectively plan for a bioterrorism attack it is important to target the interventions to improve clinical knowledge in every healthcare profession.