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Abstract

The Cities Readiness Initiative (CRI) was created in 2004 to help the nation's largest metropolitan areas develop the ability to provide life-saving medications in the event of a large-scale biological terrorist attack or naturally occurring disease outbreak. In 2007, the Centers for Disease Control and Prevention asked RAND to provide an initial evaluation of the impact of the Cities Readiness Initiative on awardees' readiness and capability to conduct mass countermeasure dispensing above and beyond what would be the case without the program. The subsequent study drew on available empirical evidence, including data from the Technical Assistance Review, a CDC-administered assessment of jurisdictions' capabilities in 12 core functional areas associated with countermeasure distribution and dispensing, as well as qualitative data collected through discussions with personnel involved with countermeasure dispensing in nine metropolitan areas (both CRI awardees and non-CRI jurisdictions). The evaluation showed that, overall, CRI awardees had benefited from the program's preparedness guidance and scenario focus and that the program had strengthened or encouraged the development of partnerships with other stakeholders. The program also encouraged a variety of changes to awardees' training plans and had spillover effects on non-CRI sites. However, this evaluation did not address questions of how the documented benefits compare to the program costs.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Evaluation Approach

  • Chapter Three

    Evidence of CRI's Impact in Technical Assessment Review Program Assessment Data

  • Chapter Four

    CRI's Impact on Resources Available for Countermeasure Dispensing

  • Chapter Five

    CRI's Impact on Planning

  • Chapter Six

    CRI's Impact on Partnerships

  • Chapter Seven

    CRI's Impact on Dispensing Strategies

  • Chapter Eight

    CRI's Impact on Operational Capabilities: Exercises and Real Events

  • Chapter Nine

    Key Findings and Policy Implications

  • Appendix A

    Tables of CRI Planning Metropolitan Statistical Areas

  • Appendix B

    Components of the Cities Readiness Initiative

  • Appendix C

    Details of the Site-Visit Methodology

  • Appendix D

    Site-Visit Discussion Guide

  • Appendix E

    Current Local Technical Assistance Review Tool

The research in this report was prepared for the U.S. Centers for Disease Control and Prevention and conducted by RAND Health.

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