DESCRIPTION (provided by applicant): The purpose of this pre-post intervention assessment proposal is to develop, implement, and evaluate novel computerized simulation training programs for the reduction of infectious disease risk in registered nurses. Healthcare workers, including nurses, are at risk for a wide range of occupational health hazards, including the risk from infectious diseases such as blood borne pathogens and tuberculosis. In order to reduce morbidity and mortality associated with occupationally acquired infections, a number of risk management strategies have been developed. While, safety training programs are acknowledged as an important part of an overall risk management strategy, there are however, a number of challenges and banters to effective health and safety training, especially in the healthcare work setting. To address this problem, a multidisciplinary team of researchers has partnered with two large medical centers and a professional nurses' association in order to evaluate an innovative approach to safety training for nurses. Simulation exercises, which are based on embedded testing theories arid shown to be an effective safety training method in other occupational settings, will be developed using a participatory action research format. The exercises, targeting blood born pathogens and tuberculosis, will be formatted into a computerized interactive web-based program and administered to 5000 volunteer registered nurses who will be recruited with assistance from our partner collaborators. Participants will receive CEU credits as an incentive for participation. The exercises will be evaluated by multiple measurements using a risk behavior theory driven questionnaire. Exercises and questionnaires will be completed on-line at the study's website Baseline measures of employee knowledge, perceptions, attitudes, behavioral intentions, current safety practices, and recent past history of exposures will be collected from participants, and followed by three month and six month follow-up questionnaires. Analyses will be directed towards change in pre-post risk behavior determinants, as well as nurses' satisfaction with simulation exercises and with computer-based training formats. The results of this study may have important implications for effective health and safety training for nurses.