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Effectiveness of a Primary Health Care Program on Urban and Rural Community Disaster Preparedness, Islamic Republic of Iran: A Community Intervention Trial

Published online by Cambridge University Press:  26 November 2013

Ali Ardalan ,
Hani Mowafi ,
Hossein Malekafzali Ardakani ,
Farid Abolhasanai ,
Ali-Mohammad Zanganeh ,
Hossein Safizadeh ,
Sirous Salari  and
Vahid Zonoobi
Ali Ardalan*
Affiliation:
Department of Disaster and Emergency Health, National Institute of Health Research, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts
Hani Mowafi
Affiliation:
Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts Yale University, School of Medicine, New Haven, Connecticut
Hossein Malekafzali Ardakani
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Farid Abolhasanai
Affiliation:
Department of Public Health, Tehran, School of Public Health, Tehran University of Medical Sciences, Iran
Ali-Mohammad Zanganeh
Affiliation:
Department of Public Health, Golestan University of Medical Sciences, Tehran, Iran
Hossein Safizadeh
Affiliation:
Department of Public Health, Kerman University of Medical Sciences, Tehran, Iran
Sirous Salari
Affiliation:
Department of Public Health, Kerman University of Medical Sciences, Tehran, Iran
Vahid Zonoobi
Affiliation:
Disaster Management Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
*
Address correspondence and reprint requests to Ali Ardalan MD, PhD, Associate Professor and Department Chair, Department of Disaster and Emergency Health, National Institute of Health Research, Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, No. 78, Italia Ave, Tehran, Iran (e-mail aardalan@tums.ac.ir).
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Abstract

Background

To evaluate the effectiveness of a capacity-building intervention administered through a primary health care (PHC) system on community disaster preparedness in Iran.

Methods

A controlled community intervention trial with pre- and postassessments was conducted in 2011 in 3 provinces of Iran. In each province, 2 areas were chosen and randomly selected as an intervention or control group. A total of 9200 households were in the intervention area and 10 010 were in the control area. In each study group in each province 250 households were sampled for pre- and postassessment surveys. Community health volunteers led by PHC staff administered an educational intervention covering elements of hazard awareness and preparedness, with a focus on earthquakes and floods. Relative changes for awareness and readiness scores were assessed to demonstrate changes in outcome variables from pre- to postassessments in intervention and control groups. An effectiveness test of significance was based on interaction between time and area.

Results

Households in intervention communities exhibited improved disaster awareness and readiness with respect to all outcome measures. Relative changes in awareness in intervention and control areas were 2.94 and -0.08, respectively (P < .001). Relative changes for readiness scores were 5.52 in intervention areas and 0.56 in control areas (P < .001). Relative changes for awareness and readiness were significantly correlated with a community's baseline risk perception and previous experience with natural disasters (P < .001).

Conclusions

An educational intervention administered through the PHC system effectively improved disaster awareness and readiness at a community level. For sustainability, community disaster reduction programs must be integrated into routine public health service delivery. (Disaster Med Public Health Preparedness. 2013;7:481-490)

Keywords

disasterpreparednessprimary health careIran
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 7 , Issue 5 , October 2013 , pp. 481 - 490
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2013 

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References

1.International Strategy for Disaster Reduction Secretariat. Global Assessment Report on Disaster Reduction. Geneva, Switzerland: United Nations International Strategy for Disaster Reduction; 2009.Google Scholar
2. The International Disaster Database, Emergency Database (EM-DAT), Brussels, Belgium, Centre for Research on Disaster Epidemiology, 2009. www.cred.be. Accessed March 16, 2012.Google Scholar
3.Ebi, KL, Schmier, JK. A stitch in time: improving public health early warning systems for extreme weather events. Epidemiol Rev. 2005;27:115-121.CrossRefGoogle ScholarPubMed
4.Keim, EM. Building human resilience: the role of public health preparedness and response as an adaptation to climate change. Am J Prev Med. 2008;35(5):508-516.Google Scholar
5.Tavassoli, M. Iranian health houses open the door to primary care. Bull World Health Organ. 2008;86(8):576-577.Google Scholar
6.Ardalan, A, Naieni, KH, Mahmoodi, M, etal. Flash flood preparedness in Golestan province of Iran: a community intervention trial. Am J Disaster Med. 2010;5(4):197-214.Google Scholar
7.Eisenman, DP, Glik, D, Gonzalez, L, etal. Improving Latino disaster preparedness using social networks. Am J Prev Med. 2009;37(6):512-517.Google Scholar
8.van Aalst, MK, Cannon, T, Burton, I. Community level adaptation to climate change: the potential role of participatory community risk assessment. Glob Environ Change. 2008;18(1):165-179.CrossRefGoogle Scholar
9.Nishikawa, S. Community-Based Flood Hazard Mapping: A Simple and Easy-to-Understand Tool for Public Awareness. Geneva, Switzerland: United Nations Office for Disaster Risk Reduction; 2003. www.unisdr.org/2003/campaign/english/8_Article_ADRC_eng.pdf. Accessed March 12, 2012.Google Scholar
10.Gregg, CE, Houghton, BF, Johnston, DM, etal. The perception of volcanic risk in Kona communities from Mauna Loa and Hualalai volcanoes, Hawaii. J Volcanol Geotherm Res. 2004;130:179-196.Google Scholar
11.Knocke, ET, Kolivras, KN. Flash flood awareness in southwest Virginia. Risk Anal. 2007;27(1):155-169.CrossRefGoogle ScholarPubMed
12.Miceli, R, Sotgiu, I, Settanni, M. Disaster preparedness and perception of flood risk: a study in an alpine valley in Italy. J Environ Psychol. 2008;28:164-173.Google Scholar
13. National Disaster Management Organization. NDMO's Guideline [Farsi]. Tehran, Iran: National Disaster Management Organization website.Google Scholar
14. Preparedness is the best flood defense [editorial]. Lancet. 2007;37:1008.Google Scholar
15.Ardalan, A, Masoomi, GR, Goya, M, etal. Disaster health management: Iran's progress and challenges. Iranian J Publ Health. 2009;38(suppl 1):93-97.Google Scholar
16. Hyogo Framework for Action. Geneva, Switzerland: United Nations Office for Disaster Risk Reduction; 2005. http://www.unisdr.org/we/coordinate/hfa. Accessed March 12, 2012.Google Scholar
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