International Journal of Public Health

, Volume 62, Issue 9, pp 1051–1058 | Cite as

Self-efficacy and barriers to disaster evacuation in Hong Kong

  • Elizabeth A. NewnhamEmail author
  • Satchit Balsari
  • Rex Pui Kin Lam
  • Shraddha Kashyap
  • Phuong Pham
  • Emily Y. Y. Chan
  • Kaylie Patrick
  • Jennifer Leaning
Original Article



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


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.


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.


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.


Disaster preparedness Self-efficacy Decision-making Evacuation Natural disaster Asia 



The study received funding from The Hong Kong Jockey Club Charities Trust, and the first author was supported by a National Health and Medical Research Council Early Career Fellowship and Curtin Research Fellowship. We wish to acknowledge the support of the Hong Kong Jockey Club Disaster Preparedness and Response Institute and the valuable contributions of Kai Hsaio, Kevin Hung, Derek Lam, May Yeung, Eva Lam, Celeste Tang, and our research assistants. We extend our heartfelt gratitude to the participants of the study.

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest.

Ethical approval

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. Ethical approval was received from the Harvard T. H. Chan School of Public Health Institutional Review Board and Hong Kong University Research Ethics Committee.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. Abramson DM, Redlener IE (2013) Hurricane Sandy: lessons learned, again. Disaster Med Public Health Preparedness 6:328–329CrossRefGoogle Scholar
  2. Allen KM (2006) Community-based disaster preparedness and climate adaptation: local capacity-building in the Philippines. Disasters 30:81–101CrossRefPubMedGoogle Scholar
  3. Bandura A (1977) Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84:191–215CrossRefPubMedGoogle Scholar
  4. Bandura A (1991) Social cognitive theory of self-regulation. Organ Behav Hum Decis Process 50:248–287CrossRefGoogle Scholar
  5. Becker JS, Paton D, Johnston DM, Ronan KR, McClure J (2017) The role of prior experience in informing and motivating earthquake preparedness. Int J Disaster Risk Reduct 22:179–193CrossRefGoogle Scholar
  6. Benight CC, Bandura A (2004) Social cognitive theory of posttraumatic recovery: the role of perceived self-efficacy. Behav Res Ther 42:1129–1148CrossRefPubMedGoogle Scholar
  7. Benight CC, Cieslak R, Waldrep E (2009) Social and cognitive frameworks for understanding the mental health consequences of disasters. In: Neria Y, Galea S, Norris FH (eds) Mental health and disasters. Cambridge University Press, New YorkGoogle Scholar
  8. Census and Statistics Department (2012) 2011 population census summary results. Hong Kong Special Administrative Region Government, Hong KongGoogle Scholar
  9. Census and Statistics Department (2017) Hong Kong in figures. Government of the Hong Kong Special Administrative Region, Hong KongGoogle Scholar
  10. Centers for Disease Control & Prevention (2013) Deaths associated with Hurricane Sandy-October–November 2012 MMWR. Morb Mortal Wkly Rep 62:393Google Scholar
  11. Chan EY (2013) Bottom-up disaster resilience. Nat Geosci 6:327–328CrossRefGoogle Scholar
  12. Chan E, Yue J, Lee P, Wang S (2016) Socio-demographic predictors for urban community disaster health risk perception and household based preparedness in a Chinese urban city. PLOS Curr Disasters. doi: 10.1371/currents.dis.287fb7fee6f9f4521af441a236c2d519 Google Scholar
  13. Cheung SK, Sun SYK (1999) Assessment of optimistic self-beliefs: further validation of the Chinese version of the General Self-efficacy Scale. Psychol Rep 85:1221–1224. doi: 10.2466/pr0.1999.85.3f.1221 CrossRefPubMedGoogle Scholar
  14. Christensen JJ, Richey ED, Castañeda H (2013) Seeking safety: predictors of hurricane evacuation of community-dwelling families affected by Alzheimer’s disease or a related disorder in south Florida. Am J Alzheimer’s Dis Other Dementias 28:682–692CrossRefGoogle Scholar
  15. Dash N, Gladwin H (2007) Evacuation decision making and behavioral responses: individual and household. Nat Hazards Rev 8:69–77CrossRefGoogle Scholar
  16. Demuth JL, Morss RE, Lazo JK, Trumbo C (2016) The effects of past hurricane experiences on evacuation intentions through risk perception and efficacy beliefs: a mediation analysis. Weather Clim Soc 8:327–344CrossRefGoogle Scholar
  17. Edirne T, Avci DK, Dagkara B, Aslan M (2011) Knowledge and anticipated attitudes of the community about bird flu outbreak in Turkey, 2007–2008: a survey-based descriptive study. Int J Public Health 56:163–168CrossRefPubMedGoogle Scholar
  18. Eisenman DP, Cordasco KM, Asch S, Golden JF, Glik D (2007) Disaster planning and risk communication with vulnerable communities: lessons from Hurricane Katrina. Am J Public Health 97:S109–S115CrossRefPubMedPubMedCentralGoogle Scholar
  19. Gibbs L et al. (2016) Post-bushfire relocation decision-making and personal wellbeing: a case study from Victoria, Australia. In: Awotona A (ed) Planning for community-based disaster resilience worldwide: learning from case studies in six continents. Ashgate Publishing Limited, OxfordGoogle Scholar
  20. Jonkman SN, Maaskant B, Boyd E, Levitan ML (2009) Loss of life caused by the flooding of New Orleans after Hurricane Katrina: analysis of the relationship between flood characteristics and mortality. Risk Anal 29:676–698CrossRefPubMedGoogle Scholar
  21. Kang JE, Lindell MK, Prater CS (2007) Hurricane evacuation expectations and actual behavior in Hurricane Lili. J Appl Soc Psychol 37:887–903CrossRefGoogle Scholar
  22. Lam RPK et al (2017) Urban disaster preparedness of Hong Kong residents: a territory-wide survey. Int J Disaster Risk Reduct 23:62–69CrossRefGoogle Scholar
  23. Leaning J et al (2015) Disaster preparedness in Hong Kong: a scoping study. FXB Center for Health and Human Rights, Harvard University, BostonGoogle Scholar
  24. Lindell MK, Perry RW (2012) The protective action decision model: theoretical modifications and additional evidence. Risk Anal 32:616–632CrossRefPubMedGoogle Scholar
  25. Maddux JE (2013) Self-efficacy, adaptation, and adjustment: theory, research, and application. Springer Science & Business MediaGoogle Scholar
  26. Marsh HW, Lüdtke O, Trautwein U, Morin AJS (2009) Classical latent profile analysis of academic self-concept dimensions: synergy of person- and variable-centered approaches to theoretical models of self-concept. Struct Equ Model Multidiscip J 16:191–225. doi: 10.1080/10705510902751010 CrossRefGoogle Scholar
  27. Martin WE, Martin IM, Kent B (2009) The role of risk perceptions in the risk mitigation process: the case of wildfire in high risk communities. J Environ Manag 91:489–498. doi: 10.1016/j.jenvman.2009.09.007 CrossRefGoogle Scholar
  28. Meilstrup C, Thygesen LC, Nielsen L, Koushede V, Cross D, Holstein BE (2016) Does self-efficacy mediate the association between socioeconomic background and emotional symptoms among schoolchildren? Int J Public Health 61:505–512CrossRefPubMedGoogle Scholar
  29. Morss RE, Demuth JL, Lazo JK, Dickinson K, Lazrus H, Morrow BH (2016) Understanding public hurricane evacuation decisions and responses to forecast and warning messages. Weather Forecast 31:395–417CrossRefGoogle Scholar
  30. Muthén LK, Muthén BO (2010) Mplus User’s Guide, 6th edn. Muthén & Muthén, Los AngelesGoogle Scholar
  31. Pastor DA, Barron KE, Miller BJ, Davis SL (2007) A latent profile analysis of college students’ achievement goal orientation. Contemp Educ Psychol 32:8–47. doi: 10.1016/j.cedpsych.2006.10.003 CrossRefGoogle Scholar
  32. Paton D (2003) Disaster preparedness: a social-cognitive perspective. Disaster Prev Manag Int J 12:210–216CrossRefGoogle Scholar
  33. Powell T, Hanfling D, Gostin LO (2012) Emergency preparedness and public health: the lessons of Hurricane Sandy. JAMA 308:2569–2570CrossRefPubMedGoogle Scholar
  34. Re Swiss (2014) Mind the risk: a global ranking of cities under threat from natural disasters. Swiss Reinsurance Company Ltd., ZurichGoogle Scholar
  35. Ronan K, Johnston D (2006) Promoting community resilience in disasters: the role for schools, youth, and families. Illustrated edn. Springer Science & Business Media, New YorkGoogle Scholar
  36. Ronan KR, Alisic E, Towers B, Johnson VA, Johnston DM (2015) Disaster preparedness for children and families: a critical review. Curr Psychiatry Rep 17:1–9CrossRefGoogle Scholar
  37. Schwarzer R, Jerusalem M (1995) Generalized self-efficacy scale. In: Weinman J, Wright S, Johnston M (eds) Measures in health psychology: a user’s portfolio. Causal and control beliefs. NFER-NELSON, Windsor, pp 35–37Google Scholar
  38. Steinberg A, Wukich C, Hao-Che W (2016) Central social media actors in disaster information networks. Int J Mass Emerg Disasters 34:147–174Google Scholar
  39. Thompson RR, Garfin DR, Silver RC (2017) Evacuation from natural disasters: a systematic review of the literature. Risk Anal. doi: 10.1111/risa.12654 Google Scholar
  40. Ung M, Luginaah I, Chuenpagdee R, Campbell G (2015) Perceived self-efficacy and adaptation to climate change in Coastal Cambodia climate 4:1. doi: 10.3390/cli4010001 Google Scholar
  41. UNISDR (2010) Early warning practices can save lives: selected examples good practices and lessons learned. UNISDR, BonnGoogle Scholar
  42. van der Keur P et al (2016) Identification and analysis of uncertainty in disaster risk reduction and climate change adaptation in South and Southeast Asia. Int J Disaster Risk Reduct 16:208–214CrossRefGoogle Scholar
  43. Yip MP, Ong BN, Meischke HW, Feng SX, Calhoun R, Painter I, Tu SP (2013) The role of self-efficacy in communication and emergency response in Chinese limited english proficiency (LEP) populations. Health Promot Pract 14:400–407. doi: 10.1177/1524839911399427 CrossRefPubMedGoogle Scholar

Copyright information

© Swiss School of Public Health (SSPH+) 2017

Authors and Affiliations

  • Elizabeth A. Newnham
    • 1
    • 2
    Email author
  • Satchit Balsari
    • 1
  • Rex Pui Kin Lam
    • 3
  • Shraddha Kashyap
    • 4
  • Phuong Pham
    • 5
  • Emily Y. Y. Chan
    • 6
  • Kaylie Patrick
    • 1
  • Jennifer Leaning
    • 1
  1. 1.FXB Center for Health and Human RightsHarvard T. H. Chan School of Public HealthBostonUSA
  2. 2.School of Psychology and Speech PathologyCurtin UniversityPerthAustralia
  3. 3.Emergency Medicine Unit, Li Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina
  4. 4.School of PsychologyThe University of Western AustraliaPerthAustralia
  5. 5.Harvard Humanitarian InitiativeHarvard UniversityCambridgeUSA
  6. 6.Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian ResponseChinese University of Hong KongHong KongChina

Personalised recommendations