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Thomas TN, Leander-Griffith M, Harp V, Cioffi JP. MMWR Morb. Mortal. Wkly. Rep. 2015; 64(35): 965-971.


Learning Office, Office of Public Health Preparedness and Response, CDC.


(Copyright © 2015, (in public domain), Publisher U.S. Centers for Disease Control and Prevention)






In response to concern about strengthening the nation's ability to protect its population and way of life (i.e., security) and ability to adapt and recover from emergencies (i.e., resilience), the President of the United States issued Presidential Policy Directive 8: National Preparedness (PPD-8) (1). Signed on March 30, 2011, PPD-8 is a directive for the U.S. Department of Homeland Security to coordinate a comprehensive campaign across government, private and nonprofit sectors, and individuals to build and sustain national preparedness. Despite efforts by the Federal Emergency Management Agency (FEMA) and other organizations to educate U.S. residents on becoming prepared, growth in specific preparedness behaviors, including actions taken in advance of a disaster to be better prepared to respond to and recover, has been limited (2). In 2012, only 52% of U.S. residents surveyed by FEMA reported having supplies for a disaster (2), a decline from 57% who reported having such supplies in 2009 (3). It is believed that knowledge influences behavior, and that attitudes and beliefs, which are correlated with knowledge, might also influence behavior (4). To determine the association between knowledge and beliefs and household preparedness, CDC analyzed baseline data from Ready CDC, a personal disaster preparedness intervention piloted among Atlanta- and Morgantown-based CDC staff members during 2013–2015. Compared with persons with basic preparedness knowledge, persons with advanced knowledge were more likely to have assembled an emergency kit (44% versus 17%), developed a written household disaster plan (9% versus 4%), and received county emergency alert notifications (63% versus 41%). Similarly, differences in household preparedness behaviors were correlated with beliefs about preparedness. Persons identified as having strong beliefs in the effectiveness of disaster preparedness engaged in preparedness behaviors at levels 7%–30% higher than those with weaker preparedness beliefs. Understanding the influences of knowledge and beliefs on household disaster preparedness might provide an opportunity to inform messages promoting household preparedness.

In 2013, CDC partnered with the American Red Cross and state and local Georgia emergency management agencies to develop and pilot Ready CDC among CDC staff members living in metropolitan Atlanta. Co-branded with FEMA's Ready campaign, the program consisted of a pre-assessment of household preparedness behaviors, a 1-hour in-person workshop with local experts, a workshop evaluation, receipt of three behavioral reinforcement messages, and a post-assessment evaluation 3 months after the workshop. Eleven Ready CDC recruitment campaigns were held from September 2013 through June 2015. All participants provided informed consent and completed a pre-assessment survey before enrollment. Approval of data collection activities was granted by CDC's institutional review board (Protocol #6472). This analysis includes data from the pre-assessment only....

1. US Department of Homeland Security. Presidential Policy Directive (PPD-8): national preparedness. Available at

2. Federal Emergency Management Agency. Personal preparedness in America: findings from the 2012 FEMA National Survey. Available at

3. Federal Emergency Management Agency. Personal preparedness in America: findings from the 2009 Citizen Corps National Survey. Available at

4. Fabrigar L, Petty R, Smith S, et al. Understanding knowledge effects on attitude-behavior consistency: the role of relevance, complexity, and amount of knowledge. J Pers Soc Psychol 2006;90:556–77.

5. Glanz K, Rimer B, Viswanath K. Health behavior and health education: theory, research, and practice. 4th ed. San Francisco, CA: Josey-Bass; 2008.
Federal Emergency Management Agency. Emergency supply list. Available at

6. Basolo V, Steinberg L, Burby R, et al. The effects of confidence in government and information on perceived and actual preparedness for disasters. Environ Behav 2009;41:338–64.

7. Paek HJ, Hilyard K, Freimuth V, et al. Theory-based approaches to understanding public emergency preparedness: implications for effective health and risk communication. J Health Commun 2010;15:428–44.

8. Becker J, Paton D, Johnston D, et al. Salient beliefs about earthquake hazards and household preparedness. Risk Anal 2013;33:1710–27.

Language: en


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