Document Type

Capstone Experience

Graduation Date


Degree Name

Master of Public Health



First Committee Member

Dr. Sharon Medcalf, PhD

Second Committee Member

Dr. Nicole Kolm-Valdivia, PhD

Third Committee Member

Mr. Keith Hansen, MBA


Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack, and identify factors that predict preparedness and willingness among Nebraska Emergency Medical Service providers, who are key to resilience in the face of an attack. The survey was available for one month in 2021 during which 190 EMS providers responded to the survey. The subjects included Registered Nurses, doctors, EMTs, and paramedics. Only 10% of the respondents are both willing and able to effectively function in a bioterror environment. Policy changes and increased focus on training and drills related to bioterrorism are needed to ensure a prepared EMS system which is crucial to a resilient state.