30 IDENTIFYING THE GAPS BETWEEN BIODEFENSE RESEARCHERS, PUBLIC HEALTH, AND RURAL CLINICAL PRACTICE.

Objective It is essential for health care professionals to be prepared in the event of a bioterrorist attack or other public health emergency. Despite this, many physicians and public health officials still feel unprepared for a bioterrorist event. We sought to determine how well biodefense and emerging infectious disease research information was being disseminated to rural health care providers, first responders, and public health officials. Methods In June-July, 2005 we conducted semi-structured, audio-taped interviews using the key informant technique. Interviewees were selected from a federally funded research institution and a rural community in Washington State. Population Ten interview subjects included researchers, community physicians, other health care providers, first responders, and public health officials. Outcomes Measured Perceived level of biodefense preparedness; quality and quantity of information disseminated regarding biodefense and emerging infectious diseases; communication between clinicians and public health officials; and importance of basic research in biodefense and emerging infectious diseases. Results Based on interviewee responses, we found that there is inadequate information dissemination regarding biodefense and emerging infectious disease research and an overall lack of preparedness for a bioterrorist event exists among rural clinicians and first responders. In addition, a significant communication gap exists between public health and clinical practice regarding policies for bioterrorism and emerging infectious disease. However, we were surprised to find that there was a great deal of support and understanding for the research enterprise in bioterrorism. Conclusions Biodefense preparedness and availability of information about emerging infectious diseases continue to be a problem. Further research is needed to develop methods for adequate information dissemination. In addition, the relationship of public health officials and clinicians in rural communities needs to be improved.