Thematic Areas

A Literature Review of Public Health Systems Research (PHSR) in Public Health Emergency Preparedness (PHEP)

US Pandemic Flu Model

Background: To conduct a systematic literature review in order to identify and characterize the PHSR literature produced in the United States in the past ten years in the field of public health emergency preparedness.

Methods: Articles were searched in Medline, Embase as well as in the gray literature. Two independent reviewers classified the articles according to study design and Institute of Medicine (IOM) PHEP research goal areas.

Results: From January 1, 1997 through May 31, 2008, 547 articles that met the inclusion criteria were published. We were able to classify 314 (57%) articles into at least one of the four IOM emergency preparedness research goal areas.

IOM Emergency Preparedness Research Goal Area Number of Articles Percentage of Total
Area 1: Usefulness of training 61 11%
Area 2: Communications in preparedness and response 39 7%
Area 3: Sustainable preparedness and response systems 193 35%
Area 4: Criteria and metrics to measure effectiveness and efficiency 39 7%
More than one category 21 4%

The majority of the articles (81%), including commentaries and reviews and case studies, were based on qualitative analysis. Commentary and review articles were the most common study type (62%).

Conclusions: Since 2001, the PHSR literature on PHEP issues has grown at about 33% per year. However, most studies lack of a rigorous design raising questions about the validity of the results.

This project was conducted by researchers from Harvard School of Public Health - Center for Public Health Preparedness (Elena Savoia, Sarah Massin-Short), Georgetown University - Department of Health Systems Administration (Mike Stoto, Melissa Higdon), and Harvard School of Public Health - Department of Biostatistics (Mike Stoto, Lisa Sahagian, Angiemae Rodday).

For more information please see our article in the American Journal of Preventive Medicine:

Savoia, Elena, Sarah B. Massin-Short, Angie Mae Rodday, Lisa A. Aaron, Melissa A. Higdon, and Michael A. Stoto. 2009. A Literature Review of Public Health Systems Research in Emergency Preparedness. American Journal of Preventive Medicine 37(2): 150-156.

For this literature review, we identified 547 studies which met our inclusion criteria. A complete list of these studies, along with the classifications, is available below.

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