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Disaster Preparedness for Children and Families: a Critical Review

Current Psychiatry Reports volume 17, Article number: 58 (2015) Cite this article

Abstract

Preparedness for disasters is universally low; children and families are particularly vulnerable groups. Against this backdrop, research on disaster preparedness for children and families is reviewed, with a focus on disaster preparedness and prevention education programs. Following definitions and theory/rationale, research is critically analyzed. While findings indicate a large growth in research in the past 15 years and largely positive findings, significant challenges remain. These challenges include issues related to methodological rigor, long-term effectiveness, and implementation. Recent research reflecting these important challenges is reviewed. At the same time, other recent research documents real potential for these programs, including findings which suggest that increased attention to incorporating theory- and evidence-supported components can enhance outcomes. Thus, despite some important limitations and challenges, research done to date signals promise for these programs in reducing risk and increasing resilience to disasters for children, families, and the households and communities in which they live.

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Notes

  1. Exposure reduction strategies are aimed at reducing actual hazard exposure; vulnerability reduction, reducing the effects of being exposed.

  2. Whereas running to a doorway used to be recommended, with findings that implicate “movement during shaking” as a primary risk for injury [10], this is no longer recommended as a risk reduction behavior.

  3. Various disaster mental-health-focused programs are available [11, 12], including those that are prevention-focused [13]. The aim in disaster preparedness programs as defined here is both physical and psychological preparedness and prevention. Owing to space limitations, a review of mental health prevention/resiliency programs was not possible, but the reader is referred to work by Pfefferbaum and colleagues on primary through tertiary approaches [11, 12] and by Wolmer on primary prevention as delivered by teachers in school settings [13, 35]. It is worth noting that one of these papers [11] includes a set of evidence-supported recommendations to help those who deliver these programs in various settings (e.g., pediatric, school) be more prepared. This paper also highlights school-based disaster prevention and preparedness programs, including those that are mental health/resiliency focused and those that are the subject of this review paper. Of course, as discussed in this paper, those disaster preparedness programs which incorporate a range of evidence-supported resiliency-enhancing components and principles would be thought to be more effective [11].

  4. In using conservative criteria to categorize findings as “mostly positive”, “mixed”, or “no effect”, some of the studies did have a number of positive findings but were classified as mixed. For example, one study classified as producing “mixed findings” had positive findings including DRR preparedness program participation being linked to significantly increased knowledge of key messages, benefits on emotional indicators and risk perceptions, with the exception of no differences seen in children’s reports of home-based preparedness indicators as a function of DRR education involvement.

  5. In previous research, the idea that children perceiving injury risk are more prone to being fearful has not been supported. In fact, research has demonstrated that children who participate in DRR education programs tend to have reduced disaster-related fears, including in instances where they have an increased perception of disasters causing injury. Theory would suggest that an increased sense of confidence and learning DRR skills would allow children to see potential injuries not in a fearful way but, rather, in a way where a potential injury is seen as a problem that has various solutions that the child feels increasingly capable of carrying out compatible with the idea of seeing a “challenge” versus seeing a “threat” [14, 15].

  6. Research supports the idea that parents are a main source of disaster-related fears for children. Alternatively, research also supports parents’ role in helping children cope more effectively. In fact, because of the strength of some findings, the adage that “as parents go in disasters (or other stressful events), so too their children” has a good deal of research support [2, 22].

  7. Falling and tripping were the most common causes of injury after the two major 2010–11 Christchurch earthquakes [10].

  8. Reprinted with permission.

  9. The same can be said for any DRR public education program, no study to date has followed cohorts over time, with one exception on reduction of house fires in Surrey, British Columbia that used a door-knocking campaign by firefighters to reduce the incidence of house fires in high-risk areas [34]. In addition, a mental health-focused teacher-delivered resilience program developed in Israel for children did follow children over time, including following disaster in Turkey [35] and Israel/closer to the Gaza Strip [13], and found reduced incidence of stress and trauma symptoms and increased adaptive functioning.

  10. A range of disaster-focused mental health interventions are available as signposts in the psychosocial sphere [12, 36]. So too are a useful set of recommendations in helping prepare those who deliver interventions through various settings, including pediatric settings and schools [11]. Drawing on other universal mental health prevention/resiliency-building programs is also recommended as these have been seen to reduce development of later problems and enhance social, emotional and other areas of functioning, including significant increases in achievement [37, 38].

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Wood MM, Mileti DS, Kano M, Kelley MM, Regan R, Bourque LB. Communicating actionable risk for terrorism and other hazards. Risk Anal. 2012;32(4):601–15.

    Article  PubMed  Google Scholar 

  2. Norris FH, Friedman MJ, Watson PJ, Byrne CM, Diaz E, Kaniasty K. 60, 000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981–2001. Psychiatry. 2002;65:207–60.

    PubMed  Google Scholar 

  3. United Nations Educational, Scientific and Cultural Organization/United Nations Childrens Fund. Disaster risk reduction in school curricula: Case studies from thirty countries. Geneva: UNESCO/UNICEF; 2012.

    Google Scholar 

  4. United Nations Educational, Scientific and Cultural Organization/United Nations Childrens Fund. Towards a learning culture of safety and resilience: Technical guidance for integrating disaster risk reduction in the school curriculum (Pilot Version). Geneva: UNESCO/UNICEF; 2013. Written by two DRR researchers (D. Selby & F Kagawa), this publication provides guidance for integrating DRR curriculum in school settings. It offers conceptual frameworks, including differing levels of DRR integration, depending on school resources, will, and other factors. It also provides tools for planning, implementation, and evaluation. Case examples are provided to bring different focal points to life.

    Google Scholar 

  5. Ronan, KR. Many advances, continuing challenges towards HFA2 and Post-2015: Policy-practice-research summary and recommendations. Hyogo Framework for Action Thematic Review: Priority for Action (PFA) 3 – Core Indicator (CI) 2: School curricula, education material and relevant training including disaster risk reduction and recovery concepts and practices. Background Chapter prepared for United Nations Office for Disaster Risk Reduction and the Global Assessment Report on Disaster Risk Reduction, 2015. UNESCO/UNICEF: Paris/Geneva; 2015. This background paper was written for the UNISDR Global Assessment Report on DRR, 2015. A focus in this paper is on the policy-practice-research nexus in relation to the HFA Core Indicator noted in the title. Based on desk and literature review and consultation with many key actors, this background paper documents progress and challenges across these three areas in relation to DRR education and teacher training. Due for publication in early 2015, it is also available from the author.

  6. Johnson VA, Ronan KR, Johnston DM, Peace R. Evaluations of disaster education programs for children: a methodological review. Int J Dis Risk Reduct. 2014;9:107–23. One of two systematic reviews done in this area in 2014. Main findings are presented in this paper and provide a base from which to improve design and methods and other important features linked to DRR preparedness education.

    Article  Google Scholar 

  7. Codreanu TA, Celenza A, Jacobs I. Does disaster education of teenagers translate into better survival knowledge, knowledge of skills and adaptive behavioral changes? A systematic literature review. Prehosp Disaster Med. 2014;29(6):1–14. The second of two systematic reviews in this area published in 2014. This review is more selective, focusing on teenagers in secondary school settings. In noting similar methodological limitations as described in this paper, it also concludes that DRR behavioral change in secondary school DRR programs was not documented in studies reviewed whereas there were indications of DRR-related knowledge changes (theoretical knowledge and, possibly, practical knowledge). The author’s overall conclusion was the following: “It seems that the best results are obtained by combining theoretical and practical activities in school, family, community, and self-education programs” (p. 10). They also conclude that research is necessary over longer time intervals to establish whether these programs can help youth develop the adaptive capacities to ensure such programs work as intended during hazard events.

    Google Scholar 

  8. Muris P, Merckelbach H, Collaris R. Common childhood fears and their origins. Behav Res Ther. 1997;35(10):929–37.

    Article  CAS  PubMed  Google Scholar 

  9. Johnson VA, Ronan KR. Classroom responses of school teachers following the 2011 Christchurch earthquake. Nat Hazards. 2014;72(2):1075–92.

    Article  Google Scholar 

  10. Johnston D, Standring S, Ronan KR, Lindell M, Wilson T, Cousins J, et al. The 2010/2011 Canterbury earthquakes: context and cause of injury. Nat Hazards. 2014. doi:10.1007/s11069-014-1094-7;1-11.

    Google Scholar 

  11. Pfefferbaum B, Shaw JA, the American Academy of Child Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI). Practice parameter on disaster preparedness. J Acad Child Adolesc Psychiatry. 2013;52(11):1224–38. This paper presents practice guidelines and provides a useful summary and set of actionable, evidence-driven recommendations to assist practitioners working in disaster contexts.

    Article  Google Scholar 

  12. Pfefferbaum B, Newman E, Nelson SD. Mental health interventions for children exposed to disasters and terrorism. J Ch Ad Psychopharmacol. 2014;24:24–31.

    Article  Google Scholar 

  13. Wolmer L, Hamiel D, Laor N. Preventing children’s posttraumatic stress after disaster with teacher-based intervention: a controlled study. J Am Acad Ch Ad Psychiatry. 2011;50:340–8.

    Article  Google Scholar 

  14. Ronan KR, Johnston DM. Correlates of hazard education programs for youth. Risk Anal. 2001;21:1055–63.

    Article  CAS  PubMed  Google Scholar 

  15. Ronan KR, Johnston DM. Hazards education for youth: a quasi-experimental investigation. Risk Anal. 2003;23:1009–20.

    Article  PubMed  Google Scholar 

  16. Ronan KR, Crellin K, Johnston DM. Community readiness for a new tsunami warning system: quasi-experimental and benchmarking evaluation of a school education component. Nat Hazards. 2012;61(3):1411–25.

    Article  Google Scholar 

  17. Ronan KR, Crellin K, Johnston DM. Correlates of hazards education for youth: a replication study. Nat Hazards. 2010;53(3):503–26.

    Article  Google Scholar 

  18. International Federation of Red Cross and Red Crescent Societies. Public awareness and public education for disaster risk reduction: key messages. Geneva: IFRC; 2013.

    Google Scholar 

  19. Towers B. Child-centred disaster risk reduction: Framework for evaluating education program content and delivery mechanisms. Manuscript in preparation; 2015.

  20. Johnson V., Peace R., Ronan KR, Johnston DM. Improving the impact and implementation of disaster education programs through theory-based evaluations. Manuscript under review (Risk Analysis); 2015.

  21. Webb M, Ronan KR. Interactive hazards education program in a low SES community: a quasi-experimental pilot study. Risk Anal. 2014. doi:10.1111/risa.12217.

    PubMed  Google Scholar 

  22. Ronan KR, Johnston DM. Promoting community resilience in disasters: The role for schools, youth, and families. New York: Springer; 2005.

    Google Scholar 

  23. Kelly B. Building best practice in child-centred disaster risk reduction: A literature review. Manuscript in preparation for publication; 2014.

  24. Fraser S, Leonard G, Matsuo I, Murakami H. Tsunami evacuation: Lesson from the Great East Japan earthquake and tsunami of March 11th 2011. Lower Hutt/Wellington: GNS Science Report; 2012.

    Google Scholar 

  25. Hasegawa R. Disaster evacuation from Japan’s 2011 Tsunami disaster and the Fukushima nuclear accident. Studies No: 05/13. IDDRI:Paris;2013. Retrieved from http://www.iddri.org

  26. Zhe E, Nickerson A. Effects of an intruder crisis drill on children’s knowledge, anxiety, and perceptions of school safety. Sch Psychol Rev. 2007;36(3):501–8.

    Google Scholar 

  27. Johnson D, Tarrant R, Tipler K, Coomer M, Pedersen S, Garside R. Preparing schools for future earthquakes in New Zealand: Lessons from an evaluation of a Wellington school exercise. Aust J Emerg Manag. 2011;26(1):24–30.

    Google Scholar 

  28. Johnson VA, Johnston DM, Ronan KR, Peace R. Evaluating children’s learning of adaptive response capacities from ShakeOut, an earthquake and tsunami drill in two Washington State school districts. J Homel Secur. 2014. doi:10.1515/jhsem-2014-0012.

    Google Scholar 

  29. Rose G. In: Khaw KT, Marmot M, editors. Rose’s strategy of preventive medicine. Oxford: University Press Oxford; 2008.

    Chapter  Google Scholar 

  30. Glisson C, Schoenwald S, Kelleher K, Landsverk J, Hoagwood KE, Mayberg S, et al. Therapist turnover and new program sustainability in mental health clinics as a function of organisational culture, climate, and service structure. Admin Policy Mental Health. 2008;35(1–2):124–33.

    Article  Google Scholar 

  31. Johnson VA, Ronan KR, Johnston DM, Peace R. Implementing disaster preparedness education in New Zealand primary schools. Disaster Prev Manag. 2014;23(4):370–80.

    Article  Google Scholar 

  32. Renwick J. Report of the 2012 “What’s the Plan, Stan?” survey of New Zealand primary schools.Research and Evaluation Services, Strategy and Governance Branch of the Department of Internal Affairs, Wellington, available at: www.civildefence.govt.nz/memwebsite.nsf/wpg_url/for-the-cdem-sector-public-education-whats-the-plan-stan?; 2012.

  33. Petal M, Sanduvac ZT. DREAMS for Turkey: A case study of scale and reach of disaster-learning self-study for individual and household preparedness and school disaster management. London: Risk RED; 2012.

    Google Scholar 

  34. Clare J, Garis L, Plecas D, Jennings C. Reduced frequency and severity of residential fires following delivery of fire prevention by on-duty fire fighters: cluster randomized controlled study. J Safety Res. 2012;43:123–8.

    Article  PubMed  Google Scholar 

  35. Wolmer L, Laor N, Dedeoglu C, Siev J, Yazgan Y. Teacher-mediated intervention after disaster: a controlled 3-year follow-up of children’s functioning. J Child Psychol Psychiatry. 2005;46:1161–8.

    Article  PubMed  Google Scholar 

  36. Pfefferbaum B, Sweeton JL, Nitiema P, Noffsinger MA, Varma V, Nelson SD, et al. Child disaster mental health interventions: therapy components. Prehos Disaster Med. 2014;29(5):494–502.

    Article  Google Scholar 

  37. Fisak B, Richard D, Mann A. The prevention of child and adolescent anxiety: a meta-analytic review. Prev Sci. 2011. doi:10.1007/s11121-011-0210-0:1-14.

    PubMed  Google Scholar 

  38. Durlak JA, Weissberg RP, Dymnicki AB, Taylor RD, Schellinger KB. The impact of enhancing students’ social and emotional learning: a meta-analysis of school-based universal interventions. Child Dev. 2011;82:405–32.

    Article  PubMed  Google Scholar 

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Acknowledgments

The funding support of Australia’s Bushfire and Natural Hazards Cooperative Research Centre (BNHCRC) is gratefully acknowledged. This review paper was part of a larger scoping and review exercise for a 3-year BNHCRC-funded project on “building best practice in child-centered disaster risk reduction.”

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Briony Towers, Victoria A. Johnson, and David M. Johnston declare that they have no conflict of interest.

Kevin R. Ronan has received a grant from the Bushfire and Natural Hazards Cooperative Research Centre. Dr. Ronan has also received payment for development of educational presentations and paid travel accommodations from the Australia-New Zealand initiative: Disaster Resilience Australia-New Zealand Schools Education Network (DRANZSEN).

Eva Alisic has received a grant from the Bushfire and Natural Hazards Cooperative Research Centre.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. School of Human, Health and Social Sciences, CQUniversity Australia, Bruce Hwy, Rockhampton, QLD 4701, Australia

    Kevin R. Ronan

  2. Trauma Recovery Lab, Monash Injury Research Institute, Monash University, Melbourne, VIC 3800, Australia

    Eva Alisic

  3. Centre for Risk and Community Safety, RMIT University, 124 LaTrobe St, Melbourne, VIC 3000, Australia

    Briony Towers

  4. Joint Centre for Disaster Research, Massey University, Building T20, Tasman St, Wellington, New Zealand

    Victoria A. Johnson

  5. Joint Centre for Disaster Research, GNS Science/Massey University, PO Box 30 368, Lower Hutt, 5010, New Zealand

    David M. Johnston

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  1. Kevin R. Ronan
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Correspondence to Kevin R. Ronan.

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This article is part of the Topical Collection on Child and Family Disaster Psychiatry

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Ronan, K.R., Alisic, E., Towers, B. et al. Disaster Preparedness for Children and Families: a Critical Review. Curr Psychiatry Rep 17, 58 (2015). https://doi.org/10.1007/s11920-015-0589-6

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Keywords

  • Disaster preparedness
  • Prevention
  • Disaster risk reduction (DRR)
  • DRR preparedness education programs
  • Children and families