This thesis recommends ways to support decision makers who must operate within the multi-stakeholder complex situation of response and recovery from a major foot-and-mouth disease outbreak. This is important because poor decision making and uncoordinated response and recovery execution to a foot-and-mouth disease outbreak may lead to increases in the size and scope of the outbreak with associated increased economic costs. The United States can strengthen its preparedness posture and can improve its ability to support effective decision making in responding to and recovering from a foot-and-mouth disease outbreak in the following three ways. Maintain Regional Multi-Stakeholder Partnerships Strengthen Data and Information Support to Decision Makers Understand the Complexity of the Situation and Approach Decision Making Accordingly The first sets up an ongoing, regional, multi-stakeholder enabling structure that can be used to build trust by convening collaborative people from the multiple stakeholder groups. The second supports the provision of credible and rapid information upon which to make decisions. The third provides decision makers with a sense making framework for understanding and working in complex situations with multiple stakeholders.