title: Impact of tabletop exercises on participants' knowledge of and confidence in legal authorities for infectious disease emergencies.
abstract: OBJECTIVE
  Legal preparedness is a critical component of comprehensive public health preparedness for public health emergencies. The scope of this study was to assess the usefulness of combining didactic sessions with a tabletop exercise as educational tools in legal preparedness, to assess the impact of the exercise on the participants' level of confidence about the legal preparedness of a public health system, and to identify legal issue areas in need of further improvement.
  
  
  METHODS
  The exercise scenario and the pre- and postexercise evaluation were designed to assess knowledge gained and level of confidence in declaration of emergencies, isolation and quarantine, restrictions (including curfew) on the movement of people, closure of public places, and mass prophylaxis, and to identify legal preparedness areas most in need of further improvement at the system level. Fisher exact test and paired t test were performed to compare pre- and postexercise results.
  
  
  RESULTS
  Our analysis shows that a combination of didactic teaching and experiential learning through a tabletop exercise regarding legal preparedness for infectious disease emergencies can be effective in both imparting perceived knowledge to participants and gathering information about sufficiency of authorities and existence of gaps.
  
  
  CONCLUSIONS
  The exercise provided a valuable forum to judge the adequacy of legal authorities, policies, and procedures for dealing with pandemic influenza at the state and local levels in Massachusetts. In general, participants were more confident about the availability and sufficiency of legal authorities than they were about policies and procedures for implementing them. Participants were also more likely to report the need for improvement in authorities, policies, and procedures in the private sector and at the local level than at the state level.
authors.affiliation: Division of Public Health Practice, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA. esavoia@hsph.harvard.edu
authors.forename: Elena
authors.initials: E
authors.lastname: Savoia
authors.forename: Paul D
authors.initials: PD
authors.lastname: Biddinger
authors.forename: Priscilla
authors.initials: P
authors.lastname: Fox
authors.forename: Donna E
authors.initials: DE
authors.lastname: Levin
authors.forename: Lisa
authors.initials: L
authors.lastname: Stone
authors.forename: Michael A
authors.initials: MA
authors.lastname: Stoto
mesh_terms: D003141:Communicable Diseases; D004189:Disaster Planning / Q000379:methods*; D004630:Emergencies; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D007251:Influenza, Human / Q000517:prevention & control*; D035846:Law Enforcement; D008404:Massachusetts; D015980:Public Health Practice / Q000331:legislation & jurisprudence; D012926:Social Control, Formal; D011795:Surveys and Questionnaires