Research Publications

Patterns of Institutional Trust During COVID-19

To explore patterns of institutional trust among adults in the United States Gulf Coast region, we utilized data from the Survey of Trauma, Resilience, and Opportunity among Neighborhoods in the Gulf.

Alyson B. Harding, Samer Atshan, Vanessa Parks, Bonnie Ghosh-Dastidar, Pamela N. Waldron-Moore, Lynsay Ayer

Feasibility and Acceptability of a Compassion-Focused Program to Support Staff, Improve Workflows and Enhance the Clinic Environment in South African Primary Health Clinics with Low ART Retention

We used a positive deviance (PD) approach to develop a program called Connect designed to increase retention in HIV care by improving the staff and patient experience in South Africa.

Allison J. Ober, Donald Harry Skinner, Laura M. Bogart, Leletu Busakwe, Hassan Mahomed, Debbie Ling, Virginia Zweigenthal

The 988 Lifeline’s Integration Into the Broader Crisis Care Continuum

The objective of this paper is to understand how 988 Lifeline centers are connected to the broader crisis care continuum, including 911, mobile crisis response, and community-based services.

Stephanie Brooks Holliday, Samantha Matthews, Rachel Slover, James Liu, Joshua Breslau, Jonathan Purtle, Vikram Kilambi, Megan S. Schuler, Rajeev Ramchand, Beth Ann Griffin, Jonathan H. Cantor, Ryan K. McBain

Realising the 100 Days Mission: Accelerating Defence and Health Capabilities for Medical Countermeasures Readiness

This paper examines how the defence and health sectors can collaborate to advance the 100 Days Mission, drawing on capability mapping, stakeholder interviews, and a scenario-based exercise to identify priority joint capabilities.

Daniela Rodriguez-Rincon, James Ward, Sarah Parkinson, John P. Tarangelo, Oluwatosin Akande, Henry H. Willis, Cindy Friedman, Claire J. Standley, Zoe Adler, Andrew M. Hebbeler, Elizabeth Cameron, Sana Zakaria

Personal Protective Equipment Prioritization and Demand: Using Occupational Characteristics to Understand Risk and Benefits

This report presents an occupation-based framework to estimate vital workforce size and personal protective equipment demand during a pandemic. An interactive dashboard supports scenario-based planning at the national, state, and regional levels.

Aaron Strong, Henry H. Willis, Casey Aveggio, Cheryl K. Montemayor

Upgrading Slums as Pathway to Climate Resiliency: Evaluating Urban Infrastructure Impact on Health During Heatwaves

This study provides empirical evidence that slum upgrading programs are associated with meaningful climate adaptation benefits as an unintended consequence.

Diogo Prosdocimi, Kelly Klima, Maria DeYoreo

Respirator Surge Manufacturing: Options to Ensure U.S. Small and Medium-Sized Enterprises Can Surge the Manufacturing of Respiratory Personal Protective Equipment

Small and medium-sized enterprises stepped up production of personal protective equipment in response to the coronavirus disease 2019 pandemic and could do so again if the conditions exist for them to remain viable, competitive, and surge ready.

Saskia Popescu, Rushil Bakhshi, Derek Roberts, John P. Tarangelo, Henry H. Willis, Rebecca Moritz, Nikhil Kalathil, David Glickstein, Amy Nabel

AI and the Future of Emergency Management: Market Supply and Adoption Pathways

In this report, the authors present the results of a landscape assessment of artificial intelligence–enabled products that are available to support the work of emergency management across the United States.

Jessica Jensen, Jessie Riposo, Leah Dion, Glen L. Woodbury

Principles for Communicating the Risks of Mirror Life

This paper presents principles for communicating to the public and specific audiences about the risks of mirror life—a hypothetical life form, such as a mirror bacterium, that could pose catastrophic danger to humans, animals, and plants.

Andrew M. Parker, Forrest W. Crawford, Gerald L. Epstein, Sella Nevo, David Glickstein, Matthew L. Nicotra, Henry H. Willis

Living with Wet Basements: Experiences, Barriers, and Solutions in Pittsburgh, Pennsylvania

This report presents findings from a study conducted in Pittsburgh to document the prevalence of and experiences with basement wetness, the barriers that residents face in addressing it, and options available to solve the problem.

Linnea Warren May, Pierrce Holmes, Robin L. Beckman, Jemima E. Ohwobete, Daniel J. Bain, Sarah-Jane Haig, Adaeze Ibeanu, La'Vette Wagner, Michelle Hunter, Alyssa Lyon, Walter Lewis, Tamara Dubowitz

Differences in Rural and Urban Home Healthcare Agency Responses to the COVID-19 Pandemic

With COVID-19 impacting urban and rural communities differently, we examined how home healthcare agencies experienced and responded to the pandemic by rurality.

Denise D. Quigley, Ashley M. Chastain, Uduwanage Perera, Monika Pogorzelska-Maziarz, Patricia Stone, Jingjing Shang

Determinants of COVID-19 Vaccine Hesitancy Across 186 Countries: A Multifaceted Analysis Using Structural Equation Modeling

This research examined the prevalence of COVID-19 vaccine hesitancy and its influencing factors.

Le Van Truong, Thanh Van Nguyen, Vu Thi Thu Trang, Thi Thu Thao Le, Chern Choong Thum, Dang Hai Nguyen, Yen Jun Wong, Nityanand Jain, Minh Nguyen Le Thi Binh, Dao Huynh Anh, Sammer M. Marzouk, Cameron John Sabet, Fatima Ezzahraa El Idrissi, Le Thi Phuong Thuy, Khoa Le Anh Huynh, Abdelrahman M. Makram, Hiep-Hung Pham, Elvira Lesmana, Daniel Martin Simadibrata, Ahmed Mohamed Abbas, Muhammad Anas Kudsi, Nguyen Anh Minh, Nguyen Thanh Ngoc, Nguyen Huy Binh, Nguyen Truong Nam, Ibrahim Abdelrhim Ali, Jaiprakash Suresh Gurav, Nguyen Hoang Minh Tri, Pham Trung Tin, Abdulmajid Makki, Momen Albakkar, Mustafa Hamed Naji, Jaafer Ammar Jouini, Aditya Anand, Amal Abdulaziz Abdulwali Raweh Al-Moughales, Pham Ba Tuyen, Abhishek Kashyap, Malaz Hamed Nasr Mohamed, Hisham Alhosni, Barah Badreldin Ali MohamedAhmed, Subramaniam Ramanarayanan, Clara Menna, Ahmed Ramzi, Moumen Arnaout, Jesline Merly James, Manh van Pham, Fathia Babiker Mokhtar, Ebenezer Mani, Usha Kumari, S. Shabana Fathima, Derren David Christian Homenta Rampengan, Hung Pham Thi Cam, Ali Mohamed Abdelgawwad Mansour Elhadidy, Debra Ukamaka Okeh, Cindy Thiovany Soetomo, Pooja Latti, Priya Babu, Abdelatte Khaled Ghanam, Mohammed Ahmed Osman, Ni Putu Menganti Harum Putrinata, Gis George, Zahraa Adnan Khalaf Alhumrani, Patrick Amanning Kwaah, Mohab Alsaid Saad, Abdulelah Dawod Ibrahim, Mahmoud Ahmed Said Mohamed, Xuyen Thi Dinh, Jonathan Salim, Jennifer Bouey, Nguyen Tien Huy

Willingness-to-Pay for HIV Pre-Exposure Prophylaxis Among Men Who Have Sex with Men in the United States

An online survey of 612 GBMSM in New England found cost was the primary barrier to PrEP uptake. Each $10 monthly increase reduced willingness to pay by 6 points, supporting elimination of cost-sharing for PrEP.

Zachary Predmore, Jessica Richard, Rahel Dawit, Julia Raifman, Lorraine T. Dean, Philip A. Chan

How Does and Should Tort Liability Affect High-Consequence Life Sciences Research?

In this report, the authors explain the effect of tort liability on safety incentives for life sciences researchers and research institutions.

James M. Anderson, Gerald L. Epstein, Katie Dammer, Elika Somani, Lloyd Dixon, Bethany Saunders-Medina

Home sensor technology in social care reform: Moving from potential to practice at scale in tech-enabled care

This brief examines how home sensors can support proactive adult social care. It highlights their potential to improve independence and hospital admissions, while addressing limited evidence on implementation, impact, sustainability and scale.

Effect of Plain Cigarette Packaging on Point-of-Sale Purchasing Behavior Among Young Adults Who Smoke

This study provides new experimental evidence that fully plain packaging reduces cigarette purchasing, whereas partial plain packaging, a proposed compromise, does not.

Steven C. Martino, Michael S. Dunbar, Claude Messan Setodji, Desmond Jenson, Maggie Hieber, William G. Shadel

Agricultural Security Considerations for the U.S. Corn Belt: Reviewing Key Threats and Mitigation Strategies for Bioresiliency

The authors examine key threat categories to the agricultural industries of the U.S. Corn Belt and identify proactive and integrated approaches to safeguarding U.S. crop production against emerging biological, environmental, and societal risks.

Tyler Hoard, Adeline E. Williams, David Luckey

Infinite Potential—Insights from the Business and Civil Society Scenario: After-Action Report from a Sequence of Day After Artificial General Intelligence Exercises

This report describes a series of exercises run with the Business and Civil Society scenario on the Infinite Potential platform. Players took on roles as business and civil society leaders and tackled challenges arising from artificial intelligence.

Richard S. Girven, Beba Cibralic, Gregory Smith

Making Bricks from Straw: Resources and Productivity in Health Care

This paper examines the role of financial constraints in health facilities in developing countries.

Edward N. Okeke

Infinite Potential—Insights from the Viral Uplift Scenario: After-Action Report from a Sequence of Day After Artificial General Intelligence Exercises

In this after-action report, the authors describe a series of exercises centered on the misuse of artificial intelligence models to generate novel biological threats and intended to elicit policy options that could help reduce the risks and impact.

Anton Shenk, Matt Chessen, Barbara Del Castello, Gregory Smith, Richard S. Girven

A Framework for Evaluating Implementation, Impact, and Cost-Effectiveness of Wastewater and Environmental Surveillance

This conceptual analysis addresses a program evaluation guidance gap by presenting a modular, evidence-based logic model grounded in wastewater and environmental surveillance evaluations from 2016-2025 across diverse contexts and program types.

Henry H. Willis, Adeline E. Williams, Saskia Popescu, Derek Roberts, Eva Coringrato, Laura J. Faherty, Pedro Nascimento de Lima, Sana Zakaria

Toward a Grand Strategy for AI Resilience

In this paper, the authors argue that the increasing adoption of artificial intelligence is likely to change society in significant and potentially threatening ways and that a policy strategy centered on resilience is the best path forward.

Asad Ramzanali, Ganesh Sitaraman

Decision Support for Selecting Projected Intensity-Duration-Frequency Curve Change Factors: A Guide for Stormwater Professionals

This document provides guidance for stormwater professionals on how to select change factors from the Projected Intensity‑Duration‑Frequency Curve Data Tool for the Chesapeake Bay Watershed and Virginia via a structured, risk-based decision process.

Krista Romita Grocholski, Michelle E. Miro, Sarah Fendrich

Consensus building research to identify the 'ideal' policy framework for early cancer care

Using expert consensus methods, we developed an evidence-based framework for early cancer care emphasising integrated policy, system strengthening, workforce capacity, data infrastructure, and ongoing evaluation for equitable, sustainable outcomes.

Fifi Olumogba, Callum Gunn, Manon Richard-Sheridan, Daniela Moye Holz

Cohort Profile: Design and Respondent Characteristics for the Longitudinal Survey of Trauma, Resilience and Opportunity Among Neighbourhoods in the Gulf (STRONG) Cohort

As a longitudinal disaster cohort, STRONG provides a unique opportunity to examine disaster impacts.

Alyson B. Harding, Andrew M. Parker, Vanessa Parks, Rachana Seelam, Samer Atshan, Allison Dormanesh, Kirsten Becker, Bonnie Ghosh-Dastidar, Rajeev Ramchand, Melissa L. Finucane, Tim Slack, Pamela N. Waldron-Moore, Lynsay Ayer

Improving Diffusion of Clinical Care Innovations in Public Health Emergencies: 5 Things Emergency Department and Health System Leaders Can Do

This document describes strategies to strengthen the process of sharing and applying emerging knowledge on patient care before and during public health emergencies, focusing on strategies that emergency department and health system leaders can use.

Claire E. O'Hanlon, Carl T. Berdahl, Jessica L. Sousa, Mallika Bhandarkar, Shira H. Fischer, Peter Mendel

Improving Diffusion of Clinical Care Innovations in Public Health Emergencies: 6 Things Frontline Emergency Department Clinicians Can Do

This document describes strategies to strengthen the process of sharing and applying emerging knowledge on patient care before and during public health emergencies, focusing on strategies that frontline emergency department clinicians can use.

Claire E. O'Hanlon, Carl T. Berdahl, Jessica L. Sousa, Mallika Bhandarkar, Shira H. Fischer, Peter Mendel

Improving Diffusion of Clinical Care Innovations in Public Health Emergencies: 5 Things Influential Emergency Department Clinicians on Digital Media Can Do

This document lists strategies to strengthen the process of sharing and applying emerging knowledge on patient care before and during public health emergencies, focusing on strategies for emergency department clinicians with digital media platforms.

Claire E. O'Hanlon, Carl T. Berdahl, Jessica L. Sousa, Mallika Bhandarkar, Shira H. Fischer, Peter Mendel

Improving Diffusion of Clinical Care Innovations in Public Health Emergencies: 7 Things Leaders of Professional Societies Can Do

This document describes strategies to strengthen the process of sharing and applying emerging knowledge on patient care before and during public health emergencies, focusing on strategies that leaders of professional societies can use.

Claire E. O'Hanlon, Carl T. Berdahl, Jessica L. Sousa, Mallika Bhandarkar, Shira H. Fischer, Peter Mendel

Improving Diffusion of Clinical Care Innovations in Public Health Emergencies: 6 Things Journal and Preprint Editors Can Do

This document describes strategies to strengthen the process of sharing and applying emerging knowledge on patient care before and during public health emergencies, focusing on strategies that journal and preprint editors can use.

Claire E. O'Hanlon, Carl T. Berdahl, Jessica L. Sousa, Mallika Bhandarkar, Shira H. Fischer, Peter Mendel

Improving Diffusion of Clinical Care Innovations in Public Health Emergencies: 4 Things State and Local Public Health Officials Can Do

This document describes strategies to strengthen the process of sharing and applying emerging knowledge on patient care before and during public health emergencies, focusing on strategies that state and local public health officials can use.

Claire E. O'Hanlon, Carl T. Berdahl, Jessica L. Sousa, Mallika Bhandarkar, Shira H. Fischer, Peter Mendel

'We Just Want to See People Like Us': Lessons Learned on Engaging Youth Advisory Groups for Public Health Awareness Efforts

This study evaluates a statewide youth and young adult council established as part of a public health initiative addressing adverse childhood experiences.

Gabriela Alvarado, Stacey Yi, Alejandro Roa Contreras, Sarah Ismail, Anda Kuo, Setareh Harsamizadeh Tehrani, Gabriela Escobar, Nicole K. Eberhart

Equitable Water Management: A Practical Guide for Utilities

This guidebook was developed in response to growing recognition within the water sector that water services are not equitably distributed.

Linnea Warren May, Alexandra Ntazinda, Michelle E. Miro, Lena Easton-Calabria, Krista Romita Grocholski

Medicare Ground Ambulance Data Collection System (GADCS) Report Appendix: Year 1 – Year 4 Cohort Analysis Data Reported Through May 15, 2025

This appendix updates the response rates, summary statistics, and econometric analyses described in the previous report with data from all cohorts of the GADCS reported as of May 15, 2025 (including Year 1 through Year 4 cohorts).

Christine Buttorff, Daniel J. Crespin, Sara E. Heins, Petra W. Rasmussen, Rose Kerber, Jonathan H. Cantor, Hannah James, Jennifer Gildner, Sarah Dalton, Kelsey Marx

Poisoning Prevention, Treatment, and Detection as Public Health Investments: Assessing the Economic and Societal Value of the U.S. Poison Center Network

The authors assessed the economic and societal value of the U.S. Poison Center Network by identifying and monetizing returns for every dollar spent by Poison Centers to help prevent, treat, and manage poisonings and exposures.

David Metz, Elizabeth Marsolais, Anthony Yu, Elena Younossi, Benjamin M. Miller, Chandra Garber

Scaling Pandemic Preparedness and Response Cost Estimates for Disease Transmission Modes

In this paper, the authors aim to understand what the world needs to spend annually to prepare for and respond to emerging respiratory pandemic diseases resulting from different modes of transmission: respiratory, insect-vectored, and fluid-borne.

Aaron Strong, Matt Sharkey, Saskia Popescu, Henry H. Willis, Anita Chandra

Preparedness of Public Health Laboratories for Respiratory Infectious Diseases: EU/EEA Country Perspectives on Lessons Learned from the COVID-19 Pandemic

The purpose of this study was to provide evidence on how to help public health laboratories be better prepared and more resilient to future public health challenges related to respiratory infectious diseases.

Sarah Parkinson, Saoirse Moriarty, Katarina Pisani, Fifi Olumogba, Katie Sykes, Daniela Moye Holz, Daniela Rodriguez-Rincon

A Practical Guide to Vulnerability Assessments for Stormwater Agencies: Approaches, Applications, and Best Practices

This guide offers a systematic approach for conducting vulnerability assessments to help stormwater agencies prioritize investments, foster resilience, and improve compliance and adaptation planning for stormwater infrastructure.

Michelle E. Miro, Krista Romita Grocholski, Nihar Chhatiawala, David Wood, Michele Berry

Developing a Research Agenda to Improve Rural Health Access and Quality in West Virginia

This report presents West Virginia's strengths and challenges in rural health access and quality and describes a preliminary research agenda to guide evidence-based improvements in access and care delivery across the state.

Julia Rollison, Zara Fatima Abdurahaman, Lisa H. Jaycox, Viviana Mercado

Ethical Criteria for Self-Identifying Societal Risk Associated with Dangerous Gain-of-Function Research

We suggest a layered review process for the assessment of societal consequences to inform implementation of the 5 May 2025 executive order "Improving the safety and security of biological research."

Mary Patricia Delarosa, Matt Sharkey, Kristjan Hollo

First convening of the UK Microbial Forensics Consortium 2024: Workshop summary

Workshop findings from the UK Microbial Forensics Consortium highlight gaps in roles, data sharing, forensic capability and communication, offering recommendations to strengthen the UK's ability to investigate and attribute biological threats.

Sana Zakaria, Teodora Chis, Rebecca Lucas, Toby Webster, Sarah Winder, Ondrej Palicka

Strategies to Improve Detection of Novel Pandemic Pathogens: Cost Versus Detection Performance for Promising Pathogen-Agnostic Detection Workflows

To inform decisions that enable the next generation of biosurveillance systems to rapidly detect outbreaks of novel pathogens, the authors evaluated the cost and detection performance of three promising pathogen-agnostic detection strategies.

Alex Demarsh, Pedro Nascimento de Lima, Cassidy Nelson, Javier Rojas Aguilera, Nathan Duarte, Sella Nevo, Henry H. Willis

Toward Comprehensive Benchmarking of the Biological Knowledge of Frontier Large Language Models

The authors evaluate the most-capable artificial intelligence (AI) models (as of May 2025) against eight knowledge benchmarks to determine the degree to which frontier AI models pose a risk of helping bad actors create biological or chemical weapons.

Sunishchal Dev, Charles Teague, Grant Ellison, Kyle Brady, Jeffrey Lee, Sarah L. Gebauer, Henry Alexander Bradley, Dawid Maciorowski, Bria Persaud, Jordan Despanie, Barbara Del Castello, Alyssa Worland, Michael Miller, Adrian Salas, Dave Nguyen, James Liu, Jason Johnson, Andrew Sloan, Will Stonehouse, Travis Merrill, Thomas Goode, Greg McKelvey, Jr., Ella Guest

U.S. Adults’ Perceptions of Six Possible Global Threats and Hazards

This report presents U.S. adults’ perceptions of risks of six possible global catastrophes: harms from artificial intelligence, asteroids and comets hitting Earth, severe changes to Earth’s climate, nuclear war, severe pandemics, and supervolcanoes.

Robert Bozick, Andrew M. Parker, Henry H. Willis

Early Success for California’s “Live Beyond” Adverse Childhood Experiences Public Awareness Campaign

Adverse childhood experiences (ACEs) are traumatic events that occur before age 18. This brief describes evaluation of a California campaign to address ACEs called Live Beyond and summarizes a report of findings on campaign development and outcomes.

Graham DiGuiseppi, Dana Schultz, Rebecca L. Collins, Elizabeth Roth, Nicole K. Eberhart, David M. Adamson

Evaluation of “Live Beyond”: A Public Awareness Campaign to Address Adverse Childhood Experiences and Toxic Stress in California

Adverse childhood experiences are potentially traumatic events that occur before the age of 18. Authors evaluated a campaign called Live Beyond and report their findings on campaign outcomes for California youth and caregivers.

Graham DiGuiseppi, Dana Schultz, Rebecca L. Collins, Elizabeth Roth, Nicole K. Eberhart

Empowering Patients to Make Goal-Aligned Decisions in Unhealthy Information Environments

Clinicians taking a prevention-focused, environmental approach can help ensure patients make diagnostic and treatment decisions that better align with their health goals.

Laura J. Faherty, David A. Scales

Trends in Focus 2025

Prepared for the 2025 RAND Europe Foresight Forum, this inaugural ‘Trends in Focus’ report highlights nine important yet often overlooked trends organised into three thematic clusters that are shaping the United Kingdom and Europe more broadly.

Erik Silfversten, Artur Honich, Zsofia Wolford, Fook Nederveen

Barriers to Public Health Trust-Building Using Social Media: A Qualitative Analysis

This study identifies modifiable factors that could be intervened upon to strengthen the public health workforce's social media communication and highlights existing efforts to address barriers.

Lia Pak, Joie D. Acosta, Laura J. Faherty

Evaluating Safety and Security in Biological Research: A Proposed Tool to Assess Dual-Use Research of Concern and Pathogens with Enhanced Pandemic Potential

The authors provide the foundations for a decisionmaking tool to assess dual-use research of concern and pathogens with enhanced pandemic potential without hampering U.S. biotechnology innovation.

Adeline E. Williams, John P. Tarangelo, Barbara Del Castello, Rebecca Moritz, Saskia Popescu, Matt Sharkey

Fire and Our Future: Results from RAND Workshop on Envisioning Interactions with the Built Environment, Utilities, and Health Systems in 2075

Researchers from RAND and outside partners brought together big-picture, future-focused thinkers and influencers to understand the broad future of wildland fire and how seemingly disparate parts of society might interact with it.

Jay Balagna, Aaron Clark-Ginsberg, Chandra Garber, Val Kostelnik, Elizabeth Cavasso, Jane Darnell, Maggie Hieber, Katie Lighthall, Viviana Mercado

Evaluation of the BOLD Public Health Center of Excellence on Dementia Caregiving

This report presents an evaluation of the University of Minnesota’s BOLD Public Health Center of Excellence on Dementia Caregiving, which supports public health agencies in implementing dementia caregiving initiatives.

Julia Rollison, Sara G. McCleskey, Melissa Davoust, Mekdes Shiferaw, Armenda Bialas