The Tabletop Exercise Model: An Integrative Socio-Ethical Framework for Inclusive and Participatory Planning of Biosecurity and Pandemic Preparedness

This inquiry explores the critical need for inclusive biosecurity planning and emergency response efforts that prioritize vulnerable populations, including minorities, seniors, rural residents, and low-income communities. Using the hypothetical scenario of Untounga 7, a zoonotic pathogen causing widespread illness, the inquiry underscores systemic inequities in healthcare access, health literacy, and public health trust that exacerbate outcomes for these groups during crises. This inquiry advances a novel equity-centered Tabletop Exercise (TTX) theoretical model for biosecurity and pandemic preparedness that extends beyond the conventional use of scenario-based exercises as planning tools. The model conceptualizes TTXs as an integrative socio-ethical framework that operationalizes trust repair, communication infrastructures, framing processes, and intersectional vulnerability within a single, structured simulation architecture. Unlike existing theories that primarily explain communication, trust, or inequity in isolation, the proposed TTX model uniquely synthesizes these theoretical domains into a procedural, time-phased, and role-differentiated system capable of generating actionable insights before and during public health crises. The model’s advantages include its experiential grounding, ethical reflexivity, and capacity to surface hidden structural inequities through participatory simulation. Its limitations include dependence on facilitation quality, representational fidelity, and contextual transferability. By explicitly articulating goals, phases, and participant roles, this theoretical framework demonstrates how equity can be systematically embedded into biosecurity planning, offering a replicable and evaluative alternative to static or purely discursive theoretical approaches.