Individual emergency-preparedness efforts: A social justice perspective.

BACKGROUND: Since 2010, the United States has experienced 228 disasters, affecting over 86 million people. Because of population shifts, the growing number of people living with chronic conditions or disabilities, and the growing number of older citizens living independently, access and service gaps often exist for those without money or other transferable resources. There is a lack of evidence regarding individual community members' capacity to prepare for emergencies. RESEARCH OBJECTIVE: The purpose of this study is to highlight participant experiences in becoming better prepared for emergencies and provide insight from a social justice perspective. RESEARCH DESIGN: This is a descriptive qualitative study, staying very close to the data as an end product rather than a beginning for interpretation. PARTICIPANTS AND RESEARCH CONTEXT: A total of 13 low-income, uninsured, or under-insured attendees at a medical outreach clinic were interviewed. ETHICAL CONSIDERATIONS: Institutional Review Board approval was obtained from the University of Texas at Tyler. FINDINGS: Four themes emerged from the interview data: (a) evaluation of the emergency-preparedness education, (b) making emergency plans, (c) challenges in preparing for emergencies, and (d) facilitators of emergency preparedness. DISCUSSION: Identifying the potential challenges to individual emergency preparedness among vulnerable populations is the first step in overcoming them. The capacity to comply with such measures, especially the ability of those with limited incomes and other vulnerable populations, must be considered. CONCLUSION: Synchronized, well-ordered assistance will close gaps in recovery and enhance efficiency in pre- and post-event aid. Theoretically, doing so will promote engaged and resilient members of society who are better able to withstand adverse events. The importance of the relationship between individual preparedness levels and the resiliency of nations supports the social justice imperative to address the needs of vulnerable populations in the mitigation and planning phase of the emergency management cycle.

The Relationship Between Perceptions of Emergency Preparedness, Disaster Experience, Health-Care Provider Education, and Emergency Preparedness Levels.

Objective The purpose of this study was to assess the self-reported level of individual emergency preparedness, the dependent variable, of people who attended a community health-related fair. The study's independent variables included demographic characteristics, perceptions of preparedness, previous disaster experience, and the presence of a medical condition and were used to examine the variability in self-reported emergency preparedness levels. Methods Data came from attendees at two community health-related fairs. Multivariate analysis on 188 participants was performed. A model predicting preparedness levels with demographic variables was constructed; successive models were built adding perceptions of preparedness, personal experiences with disasters, and presence of a medical condition. Results Preparedness levels varied little across sociodemographic dimensions explaining virtually no variance in overall preparedness. Subsequent models adding perceptions of preparedness and personal experiences significantly increased the explained variance to 40%. Of participants who reported a medical condition, the model including discussions about emergency preparedness with health-care providers explained 67% of the variance in overall preparedness levels. Conclusion The strong, positive relationship between the health-care provider and preparedness levels indicates a pathway for effecting change in preparedness levels and ultimately community health after an emergency. The inclusion of such education at community events should be considered. Research agendas should include providing evidence for the contents of disaster supply kits.

Health-Care and Supportive Services in General Population Disaster Shelters.

OBJECTIVES: The Communication (C), Maintaining Health (M), Independence (I), Services, Support and Self-Determination (S), and Transportation (T) is a framework (C-MIST) for identifying functional needs in an emergency response. A C-MIST documentation tool provides shelter staff with a list of potential client needs and actions to address them. This retrospective review describes the needs and actions indicated on completed C-MIST documentation tools (ie, records) within domestic general population shelters following Hurricane Florence in 2018. METHODS: A convenience sample of 1209 records completed by shelter disaster health services personnel was provided by the American Red Cross. The records correspond to client stays in 19 shelters between September and October 2018. Data abstracted from hardcopy forms were de-identified and recorded in a database. Summary statistics were computed. RESULTS: High incidence needs included medical supplies for everyday care (including medications) not related to mobility (15.4%), medically or culturally needed diets (12.2%), durable medical equipment (9.7%), mental health care (8.8%), and transportation (8.4%). High incidence actions included replacement medication (9.3%), refer to Disaster Mental Health Services (6.4%), provide assistive mobility equipment (5.1%), provide diabetes management supplies (5.0%), provide alternative food and beverages (4.1%), and provide transportation (3.9%). CONCLUSIONS: The process for identifying health and functional support needs in shelters should be standardized through the use of the C-MIST framework.

Household Emergency Preparedness Instrument Development: A Delphi Study.

OBJECTIVE: The main objective of this research was to generate a consensus on the conceptual definition of household emergency preparedness from experts representing multiple disciplines and countries, in order to facilitate the development of an all-hazards, comprehensive, valid, and reliable instrument. METHODS: Questions were generated via 3 methods: literature search, using existing instruments, and expert panels using the Delphi technique. RESULTS: Panelists (n = 154) representing 36 countries came to a consensus that household emergency preparedness is defined as the completion of several preparedness actions and assembling a kit that can be transported in an evacuation. The new 51-question instrument demonstrates face, content, and criterion validity and internal consistency reliability (α = 0.96). The instrument assesses whether specific preparedness actions have been taken, and the presence or absence of essential supplies that could enable households to safely endure conditions that disasters would likely present (loss of power, water limitations, and/or lack of access to additional supplies for a few days). CONCLUSION: A valid and reliable instrument provides researchers with a replicable approach to assessment of preparedness levels, which is necessary to plan mitigation strategies, enhance health promotion, prevent injuries, and increase resilience for individuals and communities. The instrument can provide evidence to support interventions addressing health needs of community members following a disaster.

Validation and Revision of the Household Emergency Preparedness Instrument (HEPI) by a Pilot Study in the City University of New York.

OBJECTIVE: The aim of this study was to pilot test the Household Emergency Preparedness Instrument (HEPI) with a diverse sample, allowing for assessment of reliability and validity of the instrument. The HEPI is an international, all-hazards questionnaire created to measure disaster preparedness of households, which results in data that can be used to enhance health promotion/disease prevention for individuals and promote resilience for communities. METHODS: A cross-sectional study of faculty, staff, and students (N = 284) was completed to perform factor analysis to establish the HEPI's construct validity and compare preparedness across groups. RESULTS: The factor analysis revealed 2 dimensions of general preparedness, explaining 35% of the sample variance (Cronbach's α = 0.89): preparedness actions and planning (α = 0.86) and disaster supplies and resources (α = 0.80). This factor analysis resulted in the revision of the subscaling of HEPI questions. Consistent with previous studies, faculty/staff, older age, higher income, and those with previous disaster experience were more prepared. The mean score was 15.28 out of 40 points. CONCLUSIONS: The HEPI is easy to administer and explains an acceptable amount of variance. The reliability was strong in this assessment, particularly for a pilot test. Construct, criterion, face, and content validity support the adequacy of the HEPI to capture essentials of household emergency preparedness.

Stories after disaster survival: Preparing, heeding warnings, and self-reliance.

OBJECTIVE: The purpose of the study was to examine the content of stories told by people personally impacted by disasters. DESIGN: Semistructured, qualitative interviews. SETTING: Northwest part of a mid-south state. PARTICIPANTS: Fourteen disaster survivors who were recruited through their attendance at an emergency preparedness-related fair. MAIN OUTCOME MEASURES: Interview schedule based on previous research using the family resilience framework. RESULTS: Three themes emerged: prior emergency preparation, heeding warnings of impending disaster, and rural self-reliance. CONCLUSIONS: Participants had made prior emergency preparedness plans, but their personal experiences led to them adjusting their plans, or making more relevant plans for future disasters. Participants expressed the importance of sharing their experiences with family and community members, expressing hope that others would learn, vicariously rather than first-hand, from their experiences.