Disaster preparedness for children and families: a critical review

Parental Influence on Child Mental Health Post-Hurricane Harvey

Purpose

Many children who face natural disasters experience significant mental health consequences. Parents play a prominent role in the likelihood of child mental health outcomes after a weather-related disaster. This study aimed to examine the relationship between parent risk factors and children's psychological well-being post Hurricane Harvey.

Methods

Parents (n = 140) completed a survey that measured hurricane exposure, parental depression and anxiety, parenting behaviors, and assistance given and received during or after Hurricane Harvey. Additionally, parents were asked to complete questionnaires assessing one of their children's post-disaster psychosocial functioning and distress.

Results

Results indicated that heightened parent anxiety was significantly associated with an increased risk for emotional symptoms, conduct problems, and hyperactivity-inattention symptoms in children. Additionally, inconsistency in parental discipline was significantly associated with an increased risk of child conduct problems. Further, higher numbers of assistance types received by parents-a proxy indicator of resource loss-was associated with higher child emotional distress scores.

Conclusions

Broader systems-level interventions that address parents' physical and emotional needs may help mitigate maladaptive reactions in children and facilitate greater post-disaster psychosocial adjustment.

Understanding Mothers' Worries about the Effects of Disaster Evacuation on Their Children: A Cross-Sectional Study

In Japan, there is an imminent threat of major earthquakes and floods. Children's health is increasingly at risk from climate-change-related disasters. The purpose of this study was to identify factors related to mothers' worries about the effects of evacuation on their children. Participants were mothers whose children attended a childcare center in one municipality in Ishikawa, Japan. A cross-sectional design was used. A questionnaire was developed based on previous studies, and it was used to conduct a survey. A total of 1298 individuals who provided valid data were included in the analysis. The following factors were related to mothers' worries about the effects of evacuation on their children: not having prepared a grab bag as a disaster risk reduction strategy, having no neighbors to help them in case of disaster, having children aged <3 years, and having children with allergies. The mothers of children <3 years old with allergies who are unprepared and have no social support are likely to worry about evacuating their children. Policymakers must be aware that the mothers of children aged <3 years and the mothers of children with allergies experience substantial concerns about the effects of evacuation on their children.

Insights on the COVID-19 pandemic: Youth engagement through Photovoice

Youth engagement in disaster risk reduction is a growing area of research, practice and policy. The COVID-19 pandemic highlighted the need for improved opportunities for youth to participate and have their voices heard. Our Photovoice study explores experiences, perceptions, and insights of youth regarding the COVID-19 pandemic, while providing an opportunity for youth to participate in disaster risk reduction and contribute to resilient communities. We conducted nine focus groups from February 2019 to August 2020 with four teenaged youth; we analyzed the data using reflexive thematic analysis and hosted two virtual Photovoice exhibitions. Our results explore youth experiences of public health measures, impacts of the pandemic, pandemic magnification of social inequities, and the power of youth to create change. We provide six calls to action, focusing on a holistic, upstream, all-of-society approach for stakeholders to collaborate with youth in creating change on complex social justice issues to support COVID-19 recovery.

O’Sullivan T. "It's Like Youth are Talking Into a Microphone That is not Plugged in": Engaging Youth in Disaster Risk Reduction Through Photovoice

Over the last decade, youth have been acknowledged as agents of change in the fight against climate change, and more recently in disaster risk reduction. However, there is a need for improved opportunities for youth to participate and have their voices heard in both contexts. Our Photovoice study explores youth perceptions of the capability of youth to participate in disaster risk reduction and climate change action. We conducted six focus groups from February 2019 to June 2019 with four teenaged youth participants in Ottawa, Canada, hosting two virtual Photovoice exhibitions in 2021. Our results highlight 11 themes across a variety of topics including youth as assets, youth-adult partnerships, political action on consumerism, social media, education, accessibility, and art as knowledge translation. We provide four calls to action, centering youth participation and leadership across all of them, to guide stakeholders in how to improve disaster risk reduction and climate change initiatives by meaningfully including youth as stakeholders.

Facing flood disaster: A cluster randomized trial assessing communities' knowledge, skills and preparedness utilizing a health model intervention

Floods occur when a body of water overflows and submerges normally dry terrain. Tropical cyclones or tsunamis cause flooding. Health and safety are jeopardized during a flood. As a result, proactive flood mitigation measures are required. This study aimed to increase flood disaster preparedness among Selangor communities in Malaysia by implementing a Health Belief Model-Based Intervention (HEBI). Selangor's six districts were involved in a single-blinded cluster randomized controlled trial Community-wide implementation of a Health Belief Model-Based Intervention (HEBI). A self-administered questionnaire was used. The intervention group received a HEBI module, while the control group received a health talk on non-communicable disease. The baseline variables were compared. Immediate and six-month post-intervention impacts on outcome indicators were assessed. 284 responses with a 100% response rate. At the baseline, there were no significant differences in ethnicity, monthly household income, or past disaster experience between groups (p>0.05). There were significant differences between-group for intervention on knowledge, skills, preparedness (p<0.001), Perceived Benefit Score (p = 0.02), Perceived Barrier Score (p = 0.03), and Cues to Action (p = 0.04). GEE analysis showed receiving the HEBI module had effectively improved knowledge, skills, preparedness, Perceived Benefit Score, Perceived Barrier Score, and Cues to Action in the intervention group after controlling the covariate. Finally, community flood preparedness ensured that every crisis decision had the least impact on humans. The HEBI module improved community flood preparedness by increasing knowledge, skill, preparedness, perceived benefit, perceived barrier, and action cues. As a result, the community should be aware of this module. Clinical trial registration: The trial registry name is Thai Clinical Trials Registry, trial number TCTR20200202002.

A qualitative study of developers' discussions of their problems and joys during the early COVID-19 months

Many software developers started to work from home on a short notice during the early periods of COVID-19. A number of previous papers have studied the wellbeing and productivity of software developers during COVID-19. The studies mainly use surveys based on predefined questionnaires. In this paper, we investigate the problems and joys that software developers experienced during the early months of COVID-19 by analyzing their discussions in online forum devRant, where discussions can be open and not bound by predefined survey questionnaires. The devRant platform is designed for developers to share their joys and frustrations of life. We manually analyze 825 devRant posts between January and April 12, 2020 that developers created to discuss their situation during COVID-19. WHO declared COVID-19 as pandemic on March 11, 2020. As such, our data offers us insights in the early months of COVID-19. We manually label each post along two dimensions: the topics of the discussion and the expressed sentiment polarity (positive, negative, neutral). We observed 19 topics that we group into six categories: Workplace & Professional aspects, Personal & Family well-being, Technical Aspects, Lockdown preparedness, Financial concerns, and Societal and Educational concerns. Around 49% of the discussions are negative and 26% are positive. We find evidence of developers' struggles with lack of documentation to work remotely and with their loneliness while working from home. We find stories of their job loss with little or no savings to fallback to. The analysis of developer discussions in the early months of a pandemic will help various stakeholders (e.g., software companies) make important decision early to alleviate developer problems if such a pandemic or similar emergency situation occurs in near future. Software engineering research can make further efforts to develop automated tools for remote work (e.g., automated documentation).

Coping with COVID: pandemic narratives for Australian children

The experience of the COVID-19 pandemic can be recognised as traumatic for the way in which its sudden and unexpected onset disrupted a sense of ordinary life for so many around the world. Adults, and far less so children, were unable to prepare for the danger of the rapidly spreading disease. As such, both were left vulnerable to the experience of trauma and anxiety that surrounds the threat of COVID. Whereas adults, however, have access to a range of resources and strategies for mental health protection, children of various ages need targeted resources to enable them to understand, prepare for, and come to terms with a trauma situation. A great deal of research exists around the value of children developing their own narratives as a means of coming to terms with trauma, such that storytelling is identified as a primary coping device. Similarly, literature exists that compares parental narratives of trauma with those of their children. Moreover, the use of the fairy tale as a cautionary tale has long been examined. What has not been established is the way in which contemporary multimedia narratives – such as television programmes, animations, and digital stories – can be used to develop coping strategies in children and to mitigate anxiety in young people experiencing global or collective trauma. This article examines a selection of such narratives produced for Australian children during the COVID-19 pandemic. Through a cross-disciplinary framework, this work considers how these resources can help (or hinder) mental health recovery in young children under the age of five, as well as strategies for best practice in the future development of trauma-informed resources for this age group.

Factors Associated With Individual Emergency Preparedness Behaviors: A Cross-Sectional Survey Among the Public in Three Chinese Provinces

Introduction: This study aimed to identify factors associated with individual emergency preparedness behaviors which play an important role in effective emergency response.

Methods: Data were drawn from a cross-sectional survey conducted in China's Heilongjiang, Guangdong and Sichuan provinces in 2017. Questionnaires were administered through face-to-face interviews, and 2,506 were valid for data analyses. A structural equation model was established to test the direct and indirect effects of the relevant factors on individual emergency preparedness behaviors.

Results: Low levels of emergency preparedness were found: 28% of respondents reported being fully/partly prepared. The attitudes of the respondents toward emergency preparedness had the strongest association with emergency preparedness behaviors, with a total effect of 0.483. This was followed by self-efficacy (0.305) and training/exercise (0.295). Risk perception had the weakest effect (0.045) on emergency preparedness behaviors.

Discussion: Improving attitudes of the public as well as their ability to prepare for emergency events is important for effective emergency management.

Earthquake preparedness of households and its predictors based on health belief model

Background

Earthquakes are one of the most destructive natural disasters in which many people are injured, disabled, or died. Iran has only 1 % of the world’s population, but the percentage of its earthquake-related deaths is absolutely higher. Therefore, this study aimed to determine the level of earthquake preparedness of households and its predictors using the Health Belief Model (HBM).

Methods

This observational descriptive and analytical study was conducted on 933 households in Hamadan province, located in the west of Iran, in 2019. Multi-stage cluster random sampling was used for selecting the participants. The inclusion criteria were being at least 18 years old and being able to answer the questions. A questionnaire was used for data collection including earthquake preparedness, awareness of earthquake response, predictors of earthquake preparedness based on the HBM, and demographic information. Analysis of variance, independent t-test, and a linear regression model was used.

Results

The mean age of participants was 38.24 ± 12.85 years. The average score of earthquake preparedness was low (approximately 30%). There was a significant relationship between earthquake preparedness and gender (P < 0.001), homeownership (P < 0.001), marriage status (P < 0.001), education (P < 0.001), and previous earthquake experience (P < 0.001). Regarding the HBM constructs, perceived benefits (P < 0.001), cues to action (P < 0.001), and self-efficacy (P < 0.001) were significant predictors of earthquake preparedness.

Conclusions

Earthquake preparedness was insufficient. Besides, perceived benefits, cues to action, and self-efficacy were predictors of earthquake preparedness. These predictors can be taken into account, for designing and implementing related future interventions.

Disaster Preparedness among Service Dog Puppy- Raisers (Human Subject Sample)

Simple Summary

Before service animals are matched with clients, they undergo training programs for increasing the dogs’ ability to navigate public spaces. Increasingly, service dog training programs recruit young adults from universities and college campuses. Little is known, however, how these students prepare for disasters and the ways in which they create plans to keep service dogs in training safe during hazard events. We collected data from service dog puppy raisers in a hurricane-prone region of the United States to understand their concepts and actions of disaster preparedness. People who were raising a service puppy for the first time were more likely to consider evacuating from Hurricane Irma in 2017 than people who had participated in the program before. Additionally, over half of the respondents did not have a disaster preparedness kit. Finally, many respondents in this study indicated that their service dog in training provides a sense of safety and security.

Abstract

Little is known about the ways in which puppy raisers engage in disaster preparedness for their puppies (or “guide dogs in training”). The aim of this research is to understand disaster preparedness among service dog puppy raisers. A web-based survey was distributed to people raising puppies in a service dog training program (n = 53 complete survey responses). Questions in the survey included items about disaster preparedness and plans for canine safety in hazards events. Out of those who said they had an evacuation plan for their puppy in training, 59% stated they would put the dog in their vehicles for evacuating to safety in the event of a hurricane or other disaster. The odds of first-time puppy raisers who considered evacuation for Hurricane Irma in 2017 was 15.3 times the odds of repeat raisers. Over half the raisers reported that they did not have a disaster kit. Additionally, 82% of respondents indicated that having a service puppy in training makes them feel safer. These results can be used as a foundation for service dog organizations in disaster preparedness among their puppy raiser volunteers and in designing recruitment messages for new volunteers.

Factors affecting home-based disaster preparedness among school-aged children's parents: A cross-sectional study

This study aimed to identify the factors affecting home-based disaster preparedness among Korean parents of school-aged children, based on an ecological model. A descriptive study was conducted involving 233 parents with school-aged children, using an online survey questionnaire. Parents' home-based disaster preparedness scores were classified into four groups: not prepared (36.5%), minimally prepared (38.2%), better prepared (17.6%), and most prepared (7.7%). Home-based disaster preparedness predictors corresponded to occupation and disaster-related knowledge in Model I, parents who had received disaster education in Model II, and age and participation in disaster education for parents and children together in Model III. The findings indicate that home-based disaster preparedness in Korea is inadequate. Therefore, it is necessary to develop and provide disaster-related education programs that consider each population group's needs and disaster preparedness level. Additionally, it is important to form networks for sharing the latest disaster-related information both inside and outside the family to maintain and manage disaster preparedness at home.

Pandemic programming: How COVID-19 affects software developers and how their organizations can help

CONTEXT

As a novel coronavirus swept the world in early 2020, thousands of software developers began working from home. Many did so on short notice, under difficult and stressful conditions.

OBJECTIVE

This study investigates the effects of the pandemic on developers' wellbeing and productivity.

METHOD

A questionnaire survey was created mainly from existing, validated scales and translated into 12 languages. The data was analyzed using non-parametric inferential statistics and structural equation modeling.

RESULTS

The questionnaire received 2225 usable responses from 53 countries. Factor analysis supported the validity of the scales and the structural model achieved a good fit (CFI = 0.961, RMSEA = 0.051, SRMR = 0.067). Confirmatory results include: (1) the pandemic has had a negative effect on developers' wellbeing and productivity; (2) productivity and wellbeing are closely related; (3) disaster preparedness, fear related to the pandemic and home office ergonomics all affect wellbeing or productivity. Exploratory analysis suggests that: (1) women, parents and people with disabilities may be disproportionately affected; (2) different people need different kinds of support.

CONCLUSIONS

To improve employee productivity, software companies should focus on maximizing employee wellbeing and improving the ergonomics of employees' home offices. Women, parents and disabled persons may require extra support.

The Dark Side of the (Preparedness) Moon: Why Promoting Public Preparedness Remains Challenging

Despite best intentions and considerable effort, promoting households' preparedness to emergencies remains insufficiently low globally. It seems that, in some cases, particularly those in which populations are frequently exposed to any given threat, a more complex sociopsychological framework emerges – one in which classical motivators, such as threat perception cues, are no longer capable of turning salient belief into action. Recent studies suggest that this phenomenon, called victimization, has considerable implications on the efficacy of risk communication efforts and could jeopardize the success in promoting public readiness. Circumventing the psychological barriers caused by this phenomenon requires innovative approaches, such as using external incentives. The model and its implications are discussed (Disaster Med Public Health Prep. 2019;13:593-595)

Tsunami evacuation simulation using geographic information systems for homecare recipients depending on electric devices

Tsunamis cause direct damage to property and destroy infrastructure. In addition, power outages can lead to death, especially for patients who rely on medical equipment requiring a power supply. Recently, Nankai Trough Earthquakes have been predicted, and much effort has been put into developing countermeasures in Japan. Kochi City on Shikoku Island is expected to suffer in the event of a large tsunami. The present study identifies individuals living in Kochi who need evacuation assistance and depend on electrical medical devices, simulates evacuation behavior and inundation during a tsunami using a geographic information system (GIS), and considers the usefulness of such a GIS. We asked caregivers, including visiting nurses, to introduce us to homecare recipients who rely on a ventilator, an endotracheal suction device, or other medical devices requiring electric power. We received introductions to 52 homecare recipients. Using a GIS, we plotted the area of predicted inundation and the locations of homecare recipients, nursing stations, and welfare evacuation shelters. We predicted evacuation routes, and then analyzed the time difference between the time required for evacuation and tsunami arrival at a welfare evacuation shelter. To measure the effects of the main parameters, we conducted both one-way and multi-way sensitivity analysis. In the event of a tsunami, eight of the homecare recipients living in the forecasted inundation areas in Kochi may face delayed evacuation. Among homecare recipients facing a high possibility of escape delay, 95.2% lived more than 1,800 m from the nearest welfare evacuation shelter. We found that individual evacuation behavior can be simulated by specifying the residence of a homecare recipient and the evacuation route using a GIS.

Pediatric Trauma Care in Low Resource Settings: Challenges, Opportunities, and Solutions

Trauma constitutes a significant cause of death and disability globally. The vast majority -about 95%, of the 5.8 million deaths each year, occur in low-and-middle-income countries (LMICs) 3-6. This includes almost 1 million children. The resource-adapted introduction of trauma care protocols, regionalized care and the growth specialized centers for trauma care within each LMIC are key to improved outcomes and the lowering of trauma-related morbidity and mortality globally. Resource limitations in LMICs make it necessary to develop injury prevention strategies and optimize the use of locally available resources when injury prevention measures fail. This will lead to the achievement of the best possible outcomes for critically ill and injured children. A commitment by the governments in LMICs working alone or in collaboration with international non-governmental organizations (NGOs) to provide adequate healthcare to their citizens is also crucial to improved survival after major trauma. The increase in global conflicts also has significantly deleterious effects on children, and governments and international organizations like the United Nations have a significant role to play in reducing these. This review details the evaluation and management of traumatic injuries in pediatric patients and gives some recommendations for improvements to trauma care in LMICs.

Emergency Management and Preparedness Training for Youth (EMPTY): The Results of the First Swedish Pilot Study

OBJECTIVE

To examine the impact of a simulation training in raising a group of young students' personal and situational awareness in disasters and emergencies.

METHODS

In total, 25 young students participated in two simulation scenarios representing two actual events, fire, and shooting, using a combination of two validated simulation training (Emergency Management and Preparedness Training for Youth [EMPTY]). The changes in their knowledge and awareness were evaluated by using questionnaires and the whole simulation was evaluated by three independent observers and a reference group.

RESULTS

New concepts of emergency management, for example, evacuation, and barricading, could be trained in a safe environment. There was a significant increase in students' personal and situational awareness and their active engagement in the management of emergencies.

CONCLUSION

EMPTY could raise the youth basic knowledge and ability to understand the concept of preparedness by being mentally prepared, available for collaboration, gaining a higher confidence, understanding the physical and psychological consequences of a major incident and the importance of their own safety. (Disaster Med Public Health Preparedness. 2018;12:685-688).

Communicating with children and adolescents about the risk of natural disasters

A vast number of people annually are affected by natural disasters. Children are at risk of losing their lives and suffer mentally or physically after such events. The fostering of resilience and preparedness ahead of disasters can reduce untoward effects of disastrous events. Risk communication and disaster education are considered important aspects of disaster preparedness, but little is known about whether such strategies influence children's behaviour when natural disasters occur or how they cope in the aftermath. This paper presents and discusses various strategies that promote preparedness activities to save lives. To a minor extent, it also includes strategies that can promote coping in the aftermath. Strategies such as informational campaigns, educational activities, psychoeducation and parental guidance are addressed. The literature to date indicates that schools are a suitable arena for risk communication, and that adolescents themselves should be involved and engaged in the communication strategies. However, the relationship between knowledge of preparedness strategies and the resulting preparedness actions is largely unknown. It is unknown whether changes in awareness and attitudes have resulted in actual behaviour change. It is advocated that preparedness activities and parental involvement should supplement information-based strategies.

Self-efficacy and barriers to disaster evacuation in Hong Kong

OBJECTIVES

To investigate specific challenges to Hong Kong's capacity for effective disaster response, we assessed perceived barriers to evacuation and citizens' self-efficacy.

METHODS

Global positioning system software was used to determine random sampling locations across Hong Kong, weighted by population density. The resulting sample of 1023 participants (46.5% female, mean age 40.74 years) were invited to complete questionnaires on emergency preparedness, barriers to evacuation and self-efficacy. Latent profile analysis and multinomial logistic regression were used to identify self-efficacy profiles and predictors of profile membership.

RESULTS

Only 11% of the sample reported feeling prepared to respond to a disaster. If asked to evacuate in an emergency, 41.9% of the sample cited significant issues that would preclude them from doing so. Self-efficacy was negatively associated with barriers to disaster response so that participants reporting higher levels of self-efficacy cited fewer perceived barriers to evacuation.

CONCLUSIONS

Hong Kong has established effective strategies for emergency response, but concerns regarding evacuation and mobilisation remain. The findings indicate that improving self-efficacy for disaster response has potential to increase evacuation readiness.

Public Disaster Communication and Child and Family Disaster Mental Health: a Review of Theoretical Frameworks and Empirical Evidence

Children have been identified as particularly vulnerable to psychological and behavioral difficulties following disaster. Public child and family disaster communication is one public health tool that can be utilized to promote coping/resilience and ameliorate maladaptive child reactions following an event. We conducted a review of the public disaster communication literature and identified three main functions of child and family disaster communication: fostering preparedness, providing psychoeducation, and conducting outreach. Our review also indicates that schools are a promising system for child and family disaster communication. We complete our review with three conclusions. First, theoretically, there appears to be a great opportunity for public disaster communication focused on child disaster reactions. Second, empirical research assessing the effects of public child and family disaster communication is essentially nonexistent. Third, despite the lack of empirical evidence in this area, there is opportunity for public child and family disaster communication efforts that address new domains.

Approaches to the Assessment of Children in the Context of Disasters

Children exposed to disasters are a vulnerable population, making the assessment of children post-disaster an important issue. Utilizing a Multiple Gating Stepped Care framework, we highlight recent literature related to post-disaster assessment and intervention for children. In particular, we focus on screening, clinical evaluation, and feedback-informed service delivery. Screening allows large populations of children to be assessed at a relatively low cost. Children identified by screening as being at risk may then be assessed through more in-depth clinical evaluations, in order to assess clinical symptoms, strengths, and stressors, and to make determinations about appropriate interventions. Continued assessment during therapy provides important feedback for the delivery of appropriate care. New formats for assessment, as well as issues related to identifying sources for assessment, are discussed. Recommendations for future directions are provided.

Child Disaster Mental Health Services: a Review of the System of Care, Assessment Approaches, and Evidence Base for Intervention

Several decades of research have informed our knowledge of children's reactions to disasters and the factors that influence their reactions. This article describes the system of care for child disaster mental health services using population risk to determine needed services and a stepped care approach built on assessment and monitoring to advance children to appropriate services. To assess the evidence base for disaster interventions, recent reviews of numerous child disaster mental health interventions are summarized.