Author ORCID Identifier

0000-0002-1166-0595

Date of Award

Summer 7-24-2024

Degree Type

Dissertation

Degree Name

Doctor of Public Health (DrPH)

Department

Public Health

First Advisor

Dr. Harry J Heiman, MD MPH

Second Advisor

Dr. Kimberley Freire, PhD

Third Advisor

Dr. Fuyuen Yip, PhD

Fourth Advisor

Dr. Amy Schnall, DrPH

Fifth Advisor

Brandy Maddox, MPH

Abstract

OBJECTIVE: Despite the potential high impact and devastation of a radiation emergency, preparedness and response efforts for radiation incidents continue to be a low priority and ever-growing gap in the United States and globally. Exercises, a method of improving preparedness capabilities, have been found to be lacking in engagement and the facilitation of coordination and collaboration among different response partners across the government. The Centers for Disease Control and Prevention (CDC) has developed a serious game to support preparedness for radiation emergency response that addresses these gaps and aligns with current exercise frameworks called This is a TEST, a Training and Exercise Simulation Tool (TEST).

METHODS: To determine if TEST meets its design objectives and fills gaps in available exercise materials, we evaluated participant feedback through anonymous surveys (N = 228) and focus groups following jurisdictional implementation of TEST as exercises across 11 host sites. We conducted descriptive analysis of survey data and sentiment analysis on focus group feedback. Spearman’s rank correlation was used to determine correlation between survey responses. Research questions were answered by combining intercorrelated survey questions into representative measures following appropriate Cronbach alpha. One way ANOVA and t-tests were performed to determine significant differences between subgroups.

RESULTS: Most respondents felt that TEST provided an engaging (96.5%) and 97.4% satisfying experience. Regardless of board game enjoyment, respondents (94.7%) felt they had a greater understanding of radiation operations. Major planning gaps identified by respondents included lack of adequate resources and staffing.

CONCLUSIONS: Overall, the findings from this evaluation showed that TEST was successful in meeting its design objectives. The serious game format of TEST was found to be acceptable to different response organizations and unique in the value it brought to the radiation preparedness exercise cycle. These data show that serious games, such as TEST, increase engagement during exercises and provide an environment for response agencies to learn about each other’s roles and how best to coordinate and plan together before an emergency. TEST was impactful in bridging communication gaps and driving urgency to work together to update radiation response plans, overall providing opportunities to improve jurisdictional response capacity.

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