The National Institute of Standards and Technology (NIST) Technical Investigation of the 2011 Joplin, MO tornado identified that no widely accepted standards exist for emergency communications in tornado events and more specifically, policies involving the use of outdoor siren systems to alert the public in advance of tornadoes. As a result, siren usage, testing, education and training, and all-clear procedures vary widely across the U.S.; leading to distrust and confusion among community residents surrounding emergency communications.This study is designed to develop evidence-based guidance for communities on the creation and provision of public alerts, including both alerts provided by outdoor siren (warning) systems and "short messages" sent by social media or other short message service (SMS) platforms. It is the hope that this guidance can eventually be used as a basis for standardization, through codes and standards, of the procedures and policies for outdoor siren systems and social media used by communities across the United States. Standardization of emergency communication policies and procedures could occur at multiple levels, including among multiple jurisdictions, state-wide, regionally, or even nationally.This document focuses on outdoor siren systems, specifically presenting a review of technology, usage and public response. First, an overview is provided on the current status of siren systems in the United States, i.e., the current siren technology available to communities and the ways in which this technology is used in communities across the United States. Second, a review of the literature is presented on the ways in which people respond to alerting signals (including siren systems) and the current limitations of siren systems in light of these findings. This document concludes with a discussion on the key findings and recommendations from the literature on the ways in which to improve current outdoor siren systems, based on the methods by which people receive and process alerts. Following this work, a review will be performed and published on "short messages", which will also be used, along with the work published here, to develop the overall evidence-based guidance for communities on the creation and provision of public alerts.