Enhancing a Willingness to Respond to Disasters and Public Health Emergencies Among Health Care Workers, Using mHealth Intervention: A Multidisciplinary Approach.

Health care workers (HCWs) are increasingly faced with the continuous threat of confronting acute disasters, extreme weather-related events, and protracted public health emergencies. One of the major factors that determines emergency-department-based HCWs' willingness to respond during public health emergencies and disasters is self-efficacy. Despite increased public awareness of the threat of disasters and heightened possibility of future public health emergencies, the emphasis on preparing the health care workforce for such disasters is inadequate in low-and-middle-income countries (LMICs). Interventions for boosting self-efficacy and response willingness in public health emergencies and disasters have yet to be implemented or examined among emergency HCWs in LMICs. Mobile health (mHealth) technology seems to be a promising platform for such interventions, especially in a resource-constrained setting. This paper introduces an mHealth-focused project that demonstrates a model of multi-institutional and multidisciplinary collaboration for research and training to enhance disaster response willingness among emergency department workers in Pakistan.

The Role of Self-Efficacy and Risk Perception in the Willingness to Respond to Weather Disasters Among Emergency Medicine Health Care Workers in Pakistan.

OBJECTIVE: Optimizing health care workers' (HCWs) willingness to respond (WTR) is critical in low-and-middle-income countries (LMICs) for proper health system functioning during extreme weather events. Pakistan frequently experiences weather-related disasters, but limited evidence is available to examine HCW willingness. Our study examined the association between WTR and behavioral factors among emergency department HCWs. METHODS: A cross-sectional survey was conducted from August to September 2022 among HCWs from 2 hospitals in Karachi, Pakistan. Non-probability purposive sampling was used to recruit participants. A survey tool was informed by Witte's Extended Parallel Process Model (EPPM). Multivariate logistic regression analyses were performed to examine the association between WTR and attitudes/beliefs as well as EPPM profiles. RESULTS: Twenty-nine percent of HCWs indicated a low WTR. HCWs using public transportation had a higher WTR. Perceived knowledge and skills, self-efficacy, and perceived impact of one's response showed positive associations with WTR if required. Perception that one's colleagues would report to work positively predicted WTR if asked. Consistent with the EPPM, HCWs with high efficacy and perceived threat were willing to respond to weather disasters. CONCLUSIONS: Our findings highlight the need of strengthening WTR by promoting self-efficacy and enhancing accurate risk perception as a response motivator, among emergency department HCWs in Pakistan.

Perceived Disaster Preparedness and Willingness to Respond among Emergency Nurses in South Korea: A Cross-Sectional Study.

INTRODUCTION: Emergency nurses serve a vital role in disaster situations. Understanding their disaster preparedness and willingness to respond to a disaster is important in maintaining appropriate disaster management. The purpose of this study was to explore emergency nurses' disaster preparedness and willingness to respond based on demographic and disaster-related characteristics, and their willingness to respond based on specific disaster situations. METHODS: In this descriptive, cross-sectional study, the Disaster Preparedness Questionnaire for Nurses and willingness to report to duty by type of event were used to collect data from 158 nurses working in four regional emergency medical centers from 1 December 2019 to 30 April 2020 in the early stages of the COVID-19 pandemic. RESULTS: Emergency nurses with personal disaster experience as a victim or witness (t = 3.65, p < 0.001), professional disaster experience (i.e., working as a nurse) (t = 3.58, p < 0.001), who were current members of Korean Disaster Medical Assistance Teams (t = 6.26, p < 0.001), and who received disaster-related training within a year (t = 5.84, p < 0.001) showed a high level of perceived disaster preparedness. Emergency nurses who have professional disaster experience (i.e., working as a nurse) (t = 2.42, p = 0.017), are on a current disaster team (t = 2.39, p = 0.018), and have received disaster training (t = 2.73, p = 0.007) showed a high level of willingness to respond. Our study showed a high willingness to respond to natural disasters and low willingness to respond to technological disasters. DISCUSSION: To promote the engagement of emergency nurses in disaster response, disaster education programs should be expanded. Enhancing the safety of disaster response environments through supplementing medical personnel, distributing available resources, and providing sufficient compensation for emergency nurses is also essential.

Motivators of Continued Participation in Public Health Emergency Response Among Federal Public Health Workers: A Qualitative Study.

The purpose of this study was to identify factors that motivate public health workers to deploy to the field during an emergency event. We conducted 25 semistructured interviews with employees at the US Centers for Disease Control and Prevention, all of whom had deployed to the field for the 2014-2016 Ebola, 2016-2017 Zika, and 2017 hurricane responses. We used a grounded theory approach in our analysis of the data. Themes that emerged from the interviews related to responder autonomy, competence, and relatedness, which are consistent with self-determination theory. Motivating factors included having clarity about the response role, desire to be challenged, ability to apply existing skills in the field (or apply new skills learned during deployment to their home office), desire to be helpful, and feeling rewarded by working with affected populations, communities, and other response staff. These preliminary findings suggest that introjected and identified motivating factors may form the foundation of willingness among public health workers to assist during an emergency event. Understanding what motivates staff at public health agencies to participate in emergency deployment can inform the development of recruitment strategies, strengthen effectiveness of response activities, and improve overall agency preparedness.

Factors Influencing Health Care Workers' Willingness to Respond to Duty during Infectious Disease Outbreaks and Bioterrorist Events: An Integrative Review.

BACKGROUND: Infectious disease emergencies are increasingly becoming part of the health care delivery landscape, having implications to not only individuals and the public, but also on those expected to respond to these emergencies. Health care workers (HCWs) are perhaps the most important asset in an infectious disease emergency, yet these individuals have their own barriers and facilitators to them being willing or able to respond. AIM: The purpose of this review was to identify factors affecting HCW willingness to respond (WTR) to duty during infectious disease outbreaks and/or bioterrorist events. METHODS: An integrative literature review methodology was utilized to conduct a structured search of the literature including CINAHL, Medline, Embase, and PubMed databases using key terms and phrases. PRISMA guidelines were used to report the search outcomes and all eligible literature was screened with those included in the final review collated and appraised using a quality assessment tool. RESULTS: A total of 149 papers were identified from the database search. Forty papers were relevant following screening, which highlighted facilitators of WTR to include: availability of personal protective equipment (PPE)/vaccine, level of training, professional ethics, family and personal safety, and worker support systems. A number of barriers were reported to prevent WTR for HCWs, such as: concern and perceived risk, interpersonal factors, job-level factors, and outbreak characteristics. CONCLUSIONS: By comprehensively identifying the facilitators and barriers to HCWs' WTR during infectious disease outbreaks and/or bioterrorist events, strategies can be identified and implemented to improve WTR and thus improve HCW and public safety.

Willingness to Respond to Radiological Disasters Among First Responders in St. Louis, Missouri.

During radiological disasters, firefighters and emergency medical services personnel are expected to report to work and engage in response activities; however, prior research exploring willingness to respond to radiological disasters among first responders has considered only radiological terrorism scenarios and not nonterrorism radiological scenarios. The goal of this study was to compare willingness to respond to terrorism and nonterrorism radiological disaster scenarios among first responders in St. Louis, Missouri, and to explore determinants of willingness to respond. Firefighters and emergency medical services personnel were surveyed about their willingness to respond to a dirty bomb detonation (terrorism) and a radioactive landfill fire (nonterrorism). McNemar's tests were used to assess differences in individual willingness to respond between the 2 scenarios and differences if requested versus required to respond. Chi-square tests were used to identify significant individual predictors of willingness to respond. Multivariate logistic regressions were used to determine final models of willingness to respond for both scenarios. Willingness to respond was lower for the dirty bomb scenario than the landfill scenario if requested (68.4% vs 73.0%; P < .05). For both scenarios, willingness to respond was lower if requested versus required to respond (dirty bomb: 68.4% vs 85.2%, P < .001; landfill: 73.0% vs 87.3%, P < .001). Normative beliefs, perceived susceptibility, self-efficacy, and perceived barriers were significant predictors of willingness to respond in the final models. Willingness to respond among first responders differed significantly between terrorism and nonterrorism radiological disasters and if requested versus required to respond. Willingness to respond may be increased through interventions targeting significant attitudinal and belief predictors and by establishing organizational policies that define expectations of employee response during disasters.

Willingness of Firefighting Program Students to Work in Disasters-Turkey.

Introduction Firefighting is an important profession during disasters. Firefighters are on duty for many vital functions, including fire extinguishing, search and rescue work, and evacuation of disaster victims to a safe zone. In case of a disaster situation, it is vital to have willing personnel to work in disasters. In the literature, type of disaster, individual demographic factors, family factors, and workplace factors have been identified as factors that influence health care personnel's willingness to work during a disaster. However, little is known about firefighters and firefighter candidates' willingness to work in a disaster. Hypothesis/Problem This study was aimed to identify the willingness of civil defense and firefighting program students to work in different disasters after graduation and the factors associated with their willingness. METHODS: The universe of this descriptive, epidemiological study was 1,116 students of civil defense and firefighting programs in Turkey. They were from 11 different universities. In the research study, a sample was not chosen as it was aimed at reaching the whole universe. A standardized survey form of 58 questions, prepared by researchers, was used to gather data. RESULTS: The rate of participation was 65.5%. Of the students, 82.8% said that after graduation they would like to work in disasters, whereas 16.2% were indecisive. The students were less willing to work in nuclear accidents (42.4%) and epidemic disasters (32.1%). In chi-square analysis, "willingness of students to work in disasters after graduation" (dependent variable) and the independent variables: "university of student," "exercising regularly," "having a hobby related to disaster," "having been educated about disaster," and "being satisfied from the received education" were found statistically significant. When students' willingness to work in disasters after graduation (ref=unwilling) was analyzed with multi-variate analysis, only "university of students" and "having a hobby related to disasters" were found statistically significant. CONCLUSION: Overall, 16.2% of the students stated that they were indecisive to work in disasters in the future, and 1.0% of them stated that they did not want to work in disasters. Moreover, willingness of students to work in nuclear accident and contagious disease disasters has been found to be lower compared to other disaster types. Kaya E , Altintas H . Willingness of firefighting program students to work in disasters-Turkey. Prehosp Disaster Med. 2018;33(1):13-22.