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Griffin JS, Hipper TJ, Chernak E, Berhane Z, Davis RK, Popek L, Kurapati P, Kim J, Turchi RM. A Virtual Home Preparedness Intervention Centered on Children and Youth With Special Health Care Needs. Acad Pediatr 2024:S1876-2859(24)00167-0. [PMID: 38866363 DOI: 10.1016/j.acap.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/30/2024] [Accepted: 06/01/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE Children and youth with special health care needs (CYSHCN) require additional considerations for staying safe in emergencies. Our team of clinicians and preparedness professionals developed and tested a virtual home preparedness intervention (VHPI) in families with CYSHCN receiving care in a statewide medical home network. METHODS The VHPI comprised 1) a pre/post interview covering fire safety, emergency evacuation, sheltering in place, and informing emergency responders of the child/youth's care needs; 2) a resource packet containing emergency planning templates and information on local supports; and 3) individualized referrals coordinated through the medical home/community partners. Eligible CYSHCN had medical technology reliance, physical/mobility needs, communication/intellectual challenges, and/or vision/hearing loss. Preparedness was measured as pre/post affirmed rates of 19 items from the interview and as mean composite scores of these items; associations were evaluated using generalized estimating equations-based regression for repeated measures. RESULTS The pre and post-VHPI interviews were completed by 170 and 148 participants, respectively. Significant individual-item gains included having a current Emergency Information Form for the child/youth (31% [pre] to 47% [post] affirmed) and assembling an evacuation kit (50% to 68%). The mean preparedness score was 13.33/19 items affirmed at baseline and increased to 14.96 post-VHPI (P < .01). In the adjusted regression model, the post-intervention preparedness score remained significantly higher than pre-VHPI, with mean increases of 1.22 preparedness steps affirmed for homeowners and 1.85 for renters. CONCLUSIONS Preparedness scores improved post-VHPI in families with CYSHCN. Future work should address incorporating the VHPI into care visits in the medical home.
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Affiliation(s)
- Jennifer S Griffin
- Department of Community Health and Prevention (JS Griffin, RK Davis, P Kurapati, J Kim, and RM Turchi), Drexel University Dornsife School of Public Health, Philadelphia, Pa.
| | - Thomas J Hipper
- Center for Public Health Readiness and Communication (TJ Hipper, E Chernak, and L Popek), Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, Pa
| | - Esther Chernak
- Center for Public Health Readiness and Communication (TJ Hipper, E Chernak, and L Popek), Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, Pa; Department of Medicine, Drexel University College of Medicine (E Chernak), Philadelphia, Pa
| | - Zekarias Berhane
- Department of Epidemiology and Biostatistics (Z Berhane), Drexel University Dornsife School of Public Health, Philadelphia, Pa
| | - Renee K Davis
- Department of Community Health and Prevention (JS Griffin, RK Davis, P Kurapati, J Kim, and RM Turchi), Drexel University Dornsife School of Public Health, Philadelphia, Pa
| | - Leah Popek
- Center for Public Health Readiness and Communication (TJ Hipper, E Chernak, and L Popek), Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, Pa
| | - Priyatham Kurapati
- Department of Community Health and Prevention (JS Griffin, RK Davis, P Kurapati, J Kim, and RM Turchi), Drexel University Dornsife School of Public Health, Philadelphia, Pa
| | - John Kim
- Department of Community Health and Prevention (JS Griffin, RK Davis, P Kurapati, J Kim, and RM Turchi), Drexel University Dornsife School of Public Health, Philadelphia, Pa
| | - Renee M Turchi
- Department of Community Health and Prevention (JS Griffin, RK Davis, P Kurapati, J Kim, and RM Turchi), Drexel University Dornsife School of Public Health, Philadelphia, Pa; Department of Pediatrics, St. Christopher's Hospital for Children (RM Turchi), Philadelphia, Pa; Department of Pediatrics, Drexel University College of Medicine (RM Turchi), Philadelphia, Pa
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Mosgrove M, Greenky D, Iannucci G, Philipsborn R, Bohling A, Steigerwald S, Herron B, Jergel A, Murray B. Assessment of Disaster Preparedness at the Household Level in a Pediatric Cardiology Clinic Population. Pediatr Cardiol 2024; 45:840-846. [PMID: 38431885 DOI: 10.1007/s00246-024-03445-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/06/2024] [Indexed: 03/05/2024]
Abstract
Natural and human-provoked disasters pose serious health risks to children, particularly children and youth with special healthcare needs, including many cardiology patients. The American Academy of Pediatrics (AAP) provides preparedness recommendations for families, but little is known about recommendation adherence. Caregivers of children seen in a pediatric cardiology clinic network were recruited to complete an electronic survey. Participants self-reported child medical history and their household's implementation of AAP recommended disaster preparedness items. Families received a link to AAP resources and a child ID card. Data were analyzed using descriptive statistics with Fisher's exact and Wilcoxon rank sum tests. 320 caregivers participated in the study, of whom 124 (38.8%) indicated that their child has a diagnosed cardiac condition, and 150 (46.9%) indicated that their child had special healthcare needs. The average preparedness item completion rate was 70.7% for household preparedness, 40.1% for reunification preparedness, and 26.3% for community preparedness. Households of children with medical needs had similar rates of preparedness compared to overall rates. Of all respondents, 27.8% previously received disaster preparedness resources, 67.7% would like resources on discussing disaster preparedness, and 93.0% intend to talk with their household about disaster preparedness after completing the survey. These results demonstrate a gap between AAP recommendations and household-level disaster preparedness, including patients with cardiac conditions and those with special healthcare needs. Families expressed that they were interested in getting resources for disaster preparedness. Pediatric cardiologists may consider asking about disaster preparedness and providing disaster preparedness resources tailored to the needs of their patients.
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Affiliation(s)
- Matthew Mosgrove
- Emory University School of Medicine, Atlanta, GA, USA.
- School of Medicine Department of Pediatrics, Emory University, Atlanta, GA, USA.
- Children's Medical Center, University of Texas Southwestern, 1935 Medical District Dr, Dallas, TX, 75235, USA.
| | - David Greenky
- Emory University School of Medicine, Atlanta, GA, USA
- School of Medicine Department of Pediatrics, Emory University, Atlanta, GA, USA
- School of Medicine Department of Emergency Medicine, Emory University, Atlanta, GA, USA
- Department of Emergency Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Glen Iannucci
- Emory University School of Medicine, Atlanta, GA, USA
- School of Medicine Department of Pediatrics, Emory University, Atlanta, GA, USA
- Children's Healthcare of Atlanta Cardiology, Atlanta, GA, USA
| | - Rebecca Philipsborn
- Emory University School of Medicine, Atlanta, GA, USA
- School of Medicine Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - Amy Bohling
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Andrew Jergel
- Emory University School of Medicine, Atlanta, GA, USA
- School of Medicine Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - Brittany Murray
- Emory University School of Medicine, Atlanta, GA, USA
- School of Medicine Department of Pediatrics, Emory University, Atlanta, GA, USA
- School of Medicine Department of Emergency Medicine, Emory University, Atlanta, GA, USA
- Department of Emergency Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
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Lindsay S, Hsu S. Emergency and disaster preparedness among children and youth with disabilities and chronic conditions, their caregivers and service providers: a scoping review. Disabil Rehabil 2024; 46:1239-1255. [PMID: 38554389 DOI: 10.1080/09638288.2023.2185294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 02/23/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE People with disabilities, especially children and youth, are often not considered in emergency and disaster preparedness planning, which leaves them vulnerable and at a higher risk of the negative effects of natural and human caused disasters. The purpose of this study was to understand the extent of emergency and disaster preparedness and factors influencing preparedness among children and youth with disabilities and chronic conditions, their caregivers and service providers. METHODS Our scoping review involved searching six international databases that identified 1146 studies of which 27 met our inclusion criteria. RESULTS The studies in this review involved 2613 participants (i.e., children, parents, educators and clinicians) across nine countries over a 20-year period. Our results highlighted the following trends: (1) the extent of emergency preparedness; (2) factors affecting emergency preparedness; and (3) interventions to enhance preparedness. CONCLUSIONS Our findings underscore the critical need for more attention to emergency preparedness for children and youth with disabilities, their families and service providers and their inclusion in planning.
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Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Shaelynn Hsu
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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Smith N, Donaldson M, Mitton C, Lee E. Communication in disasters to support families with children with medical complexity and special healthcare needs: a rapid scoping review. Front Public Health 2024; 12:1229738. [PMID: 38544735 PMCID: PMC10967951 DOI: 10.3389/fpubh.2024.1229738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 02/13/2024] [Indexed: 04/24/2024] Open
Abstract
Disasters can disrupt normal healthcare processes, with serious effects on children who depend upon regular access to the health care system. Children with medical complexity (CMC) are especially at risk. These children have chronic medical conditions, and may depend on medical technology, like feeding tubes. Without clear, evidence-based processes to connect with healthcare teams, families may struggle to access the services and supports they need during disasters. There is limited research about this topic, which has been pushed forward in importance as a result of the COVID-19 pandemic. The authors therefore conducted a rapid scoping review on this topic, with the intention to inform policy processes. Both the peer-reviewed and gray literatures on disaster, CMC, and communication were searched in summer 2020 and spring 2021. Twenty six relevant articles were identified, from which four main themes were extracted: 1. Cooperative and collaborative planning. 2. Proactive outreach, engagement, and response. 3. Use of existing social networks to connect with families. 4. Return to usual routines. Based on this review, good practices appear to involve including families, professionals, other stakeholders, and children themselves in pre-disaster planning; service providers using proactive outreach at the outset of a crisis event; working with existing peer and neighborhood networks for support; employing multiple and two-way communication channels, including social media, to connect with families; re-establishing care processes as soon as possible, which may include virtual connections; addressing mental health issues as well as physical functioning; and prioritizing the resumption of daily routines. Above all, a well-established and ongoing relationship among children, their caregivers, and healthcare teams could reduce disruptions when disaster strikes.
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Affiliation(s)
- Neale Smith
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Meghan Donaldson
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Craig Mitton
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Esther Lee
- Complex Care Program, British Columbia Children’s Hospital, Vancouver, BC, Canada
- Canuck Place Children’s Hospice, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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Rahmani M, Muzwagi A, Pumariega AJ. Cultural Factors in Disaster Response Among Diverse Children and Youth Around the World. Curr Psychiatry Rep 2022; 24:481-491. [PMID: 35953637 PMCID: PMC9371955 DOI: 10.1007/s11920-022-01356-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW Disasters and traumatic events are ever present globally but disproportionally impact culturally diverse low resource environments. Culture is an important context through which people experience disasters, develop adaptive strategies, and process external aid and support. This is even more critical for children and youth who are in the process of forming their cultural/ethnic identities. This review identifies literature on these important aspects of culture in disaster response. RECENT FINDINGS The literature supports that culture influences the experience of disasters, the development of coping and adaptational approaches, and the acceptability of external aid and support, especially mental health services. Cultural humility, awareness, and sensitivity are crucial in addressing the traumatic impact of disasters in children and youth, especially in the areas of the world that are most at risk for them.
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Affiliation(s)
- Mariam Rahmani
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Springhill 2 Building, 4197 NW 86th Terrace, Gainesville, FL, 32606, USA.
| | - Ashraf Muzwagi
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Springhill 2 Building, 4197 NW 86th Terrace, Gainesville, FL 32606 USA
| | - Andres J. Pumariega
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Springhill 2 Building, 4197 NW 86th Terrace, Gainesville, FL 32606 USA
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Boggs K, Goodwin T, Simpson J. Disaster Training Following COVID-19 for Pediatric Medical Residents: Demand and Format. Disaster Med Public Health Prep 2021; 16:1-4. [PMID: 34140056 PMCID: PMC8376853 DOI: 10.1017/dmp.2021.209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Assess the knowledge, confidence, and attitudes of residents toward disaster medicine education in the coronavirus disease 2019 (COVID-19) era. METHODS Survey distributed to pediatric residents at a tertiary care center, assessing confidence in disaster medicine knowledge and skills, and preferred educational methods. Based on residents' responses, virtual and in-person educational session implemented with a postsurvey to analyze effectiveness of education. RESULTS Distributed to 120 residents with a 51.6% response rate. Almost half (46.8%) of residents had less than 1 h of disaster training, with only 9.7% having experience with a prior disaster event. However, most residents were motivated to increase their knowledge of disaster medicine due to COVID-19 and other recent disasters, with 96.8% interested in this education as a curriculum standard. Simulation and peer learning were the most preferred method of teaching. Subsequent virtual and in-person educational session demonstrated improvement in confidence scores. However, 66.7% of the virtual subset conveyed they would have preferred in-person learning. CONCLUSIONS COVID-19 has highlighted to trainees that disasters can affect all specialties, and pediatric residents are enthusiastic to close the educational gap of disaster medicine. However, residents stressed that, although virtual education can provide a foundation, in-person simulation is preferred for effective training.
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Affiliation(s)
- Kaitlyn Boggs
- Children’s National Hospital, Washington, District of Columbia, USA
| | - Tress Goodwin
- Children’s National Hospital, Washington, District of Columbia, USA
| | - Joelle Simpson
- Children’s National Hospital, Washington, District of Columbia, USA
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School-Based Education Programs for Preparing Children for Natural Hazards: A Systematic Review. Disaster Med Public Health Prep 2021; 16:1229-1241. [PMID: 33818366 DOI: 10.1017/dmp.2020.479] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Schools have a significant role in disaster education to children. This study investigates the research works about school-based education programs in order to discover challenges and best practices. We conducted a systematic review of English language papers published in peer-review journals.The search identified 2577 publications and 61 articles meeting selection criteria and included in the review. Reviewed studies indicated that disaster education in schools is effective but yet insufficient in many countries. Lack of equipment, financial resources, policy gaps, and teachers' knowledge are common problems in programs. Main outcomes of this systematic review are showing methods used for health emergency preparedness of children of different ages and gender differences in school-based disaster preparedness, as well as the difference in their lifesaving skills in disasters.This study shows that some disaster education programs reported in the papers reviewed were not high-quality enough, which may lead to insufficient preparedness of children in disasters and consequently may put their health at risk, considering the increasing number of natural hazards.
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