Thus as still over one of every four employees from a large urban tertiary care hospital indicated they would not report for work even if required – at a time they would be most needed in their respective work roles. Of all attitudes and beliefs, the attitude statements most strongly associated with high WTR was willingness to work extra hours if required. Those able and willing to work extra hours were 20 times more likely to be willing to respond during this event, after controlling for demographic factors. These results may be interpreted in view of the strong association identified between lower ‘if asked’ WTR and having dependents at home – either elderly, children or even pets. Single parents with children had the lowest estimated likelihood to respond to this event. One reasonable explanation may be that some of the hesitance to report to duty among those unable to work long hours is associated with the need to continuously take care of dependents during such an event. Indeed, 88% of those unwilling to work extra hours had a family member or a pet dependent solely on them. Witte’s EPPM offers a framework for examining the interplay and influence of perceptions of “threat” and “efficacy” on adaptive or maladaptive behavior in the face of risk. It has shown its utility in previous work assessing WTR in pandemic influenza and other catastrophic event scenarios. Our study is the first to analyze hospital employees’ perceived threat, efficacy, and WTR during a RDD event through the lens of the EPPM. This model potentially allows us to see how hospital workers’ individual degrees of perceived threat and perceived efficacy influence their willingness to respond to this type of event. In accordance with EPPM theory, our survey results show that those who have a perception of high threat and high efficacy – i.e., those who fit a “concerned and confident” profile in the EPPM framework—had a high rate of declared self-reported willingness to respond to a dirty bomb event, which was about seven times higher than those fitting a “low threat/low efficacy” profile. In contrast with the classic EPPM theory, perception of threat had little impact on willingness to respond among hospital workers in our study. This could either imply that the perception of threat in motivating response behavior in hospital employees is not as important as the perception of one’s efficacy in response, or that our threat assessment questions assessed the ‘analytic’ aspect of RDD risk perception, and could not assess the ‘affective’ effect of the additional dread associated with this event, which is the effect that may impact WTR more significantly. One other potential explanation is that the level of dread from such a scenario is such that only minor variability exists between individuals, in a level that bears little impact on decision making. Our survey indicates that hospital employees are receptive to more training in response to a ONX-0914 960374-59-8 radiation disaster. In fact, 87% of respondents agreed that the hospital should provide pre-event preparation and training for dirty bomb emergencies.