Community-level disaster readiness is a major component of community health promotion. However, many readiness programs are focused on the response of emergency and health care personnel and not on the preparedness levels of local citizens. This potentially leaves the public unready and unprepared for emergency event response.

A 20-item survey on general states of disaster preparedness was delivered to the residents of a midsized midwestern county. The residents were asked to share their knowledge of local hazards, emergency systems, and personal preparedness.

A convenience sample of 423 residents responded to the survey. Fifty-seven percent (n=241) reported limited personal preparedness. Seventy-six percent (n=321) acknowledged little to no familiarity with residential emergency systems, and 52% (n=220) reported that they did not know how to gain information on public health emergencies, such as pandemic flu and evacuation response.

Local citizens should become educated on the methods to support personal disaster and emergency readiness. Health care and emergency management organizations are encouraged to include these concepts in routine community health promotion activities and to pay special attention to known areas of community vulnerability. Failure to do so creates a population unable to support themselves in the provision of basic health and safety measures. (Disaster Med Public Health Preparedness. 2015;9:239-244)

Unremitting natural disasters, deliberate threats, pandemics, and humanitarian suffering resulting from conflict situations necessitate swift and effective response paradigms. The European Union’s (EU) increasing visibility as a disaster response enterprise suggests the need not only for financial contribution but also for instituting a coherent disaster response approach and management structure. The DITAC (Disaster Training Curriculum) project identified deficiencies in current responder training approaches and analyzed the characteristics and content required for a new, standardized European course in disaster management and emergencies.

Over 35 experts from within and outside the EU representing various organizations and specialties involved in disaster management composed the DITAC Consortium. These experts were also organized into 5 specifically tasked working groups. Extensive literature reviews were conducted to identify requirements and deficiencies and to craft a new training concept based on research trends and lessons learned. A pilot course and program dissemination plan was also developed.

The lack of standardization was repeatedly highlighted as a serious deficiency in current disaster training methods, along with gaps in the command, control, and communication levels. A blended and competency-based teaching approach using exercises combined with lectures was recommended to improve intercultural and interdisciplinary integration.

The goal of a European disaster management course should be to standardize and enhance intercultural and inter-agency performance across the disaster management cycle. A set of minimal standards and evaluation metrics can be achieved through consensus, education, and training in different units. The core of the training initiative will be a unit that presents a realistic situation “scenario-based training.” (Disaster Med Public Health Preparedness. 2015;9:245-255)

To evaluate Medical Reserve Corps volunteers and public health workers in conducting chronic care triage by use of a rubric prior to sheltering to connect survivors with services.

Participants were randomly assigned to 1 of 3 algorithms or a control group during a simulated disaster scenario and were asked to rate 20 survivors arriving at a chronic care triage station with situation-appropriate transport services. Survivors were simulated on the basis of the expected disability distributions of mobility, sensory-visual, cognition, medical devices, capacity to perform activities of daily living (ADLs), age (18 to 90 years), weight, and gender expected in the general population but expanded to 90% of those presenting. Mean percentage correct scores were assessed by using one-way analysis of variance.

Accounting for personal care assistance and service methodology during chronic care triage increased efficiency by up to 8% in meeting chronic care health service needs during disaster community mass care management.

A chronic care triage process as part of community mass care management that considers the availability of personal care assistance and service methodology will enhance the allocation of functional needs support services and increase compliance with Americans with Disabilities Act requirements regarding not segregating persons because of disability. (Disaster Med Public Health Preparedness. 2015;9:265-274)

To examine patterns and predictors of primary mental health care service use following 2 major Australian natural disaster events.

Utilizing data from a national minimum dataset, descriptive and regression analyses were conducted to identify levels and predictors of the use of the Access to Allied Psychological Services (ATAPS) program over a 2-year period following 2 major Australian bushfire and flood/cyclone disasters.

The bushfire disaster resulted in significantly greater and more enduring ATAPS service volume, while service delivery for both disasters peaked in the third quarter. Consumers affected by bushfires (IRR 1.51, 95% CI 1.20–1.89), diagnosed with depression (IRR 2.57, 95% CI 1.60-4.14), anxiety (IRR 2.06, 95% CI 1.21-3.49), or both disorders (IRR 2.15, 95% CI 1.35-3.42) utilized treatment at higher rates.

The substantial demand for primary mental health care services following major natural disasters can vary in magnitude and trajectory with disaster type. Disaster-specific ATAPS services provide a promising model to cater for this demand in primary care settings. Disaster type and need-based variables as drivers of ATAPS use intensity indicate an equitable level of service use in line with the program intention. Established service usage patterns can assist with estimating capacity requirements in similar disaster circumstances. (Disaster Med Public Health Preparedness. 2015;9:275-282)

Critically insufficient pediatric hospital capacity may develop during a disaster or surge event. Research is lacking on the creation of pediatric surge capacity. A system of “reverse triage,” with early discharge of hospitalized patients, has been developed for adults and shows great potential but is unexplored in pediatrics.

We conducted an evidence-based modified-Delphi consensus process with 25 expert panelists to derive a disposition classification system for pediatric inpatients on the basis of risk tolerance for a consequential medical event (CME). For potential validation, critical interventions (CIs) were derived and ranked by using a Likert scale to indicate CME risk should the CI be withdrawn or withheld for early disposition.

Panelists unanimously agreed on a 5-category risk-based disposition classification system. The panelists established upper limit (mean) CME risk for each category as <2% (interquartile range [IQR]: 1–2%); 7% (5–10%), 18% (10–20%), 46% (20–65%), and 72% (50–90%), respectively. Panelists identified 25 CIs with varying degrees of CME likelihood if withdrawn or withheld. Of these, 40% were ranked high risk (Likert scale mean ≥7) and 32% were ranked modest risk (≤3).

The classification system has potential for an ethically acceptable risk-based taxonomy for pediatric inpatient reverse triage, including identification of those deemed safe for early discharge during surge events. (Disaster Med Public Health Preparedness. 2015;9:283-290)

The aims of this study were to assess the awareness of risk for suicidal behaviors and perspectives of Project Recovery counselors who provided crisis counseling services to hurricane survivors.

The Short Posttraumatic Stress Disorder Rating Interview–Extended, a quantitative disaster mental health measure, was used to assess distress and dysfunction to the recent hurricanes. Project Recovery counselor data were collected through a 22-item qualitative interview.

Seven out of 207 clients (3.4%) endorsed the quantitative item measuring suicidal ideation. Clients who reported suicidal ideation had significantly higher scores on items indicating a loss of enjoyment, feelings of depression, feeling less able to handle stress, and other mental health items. Counselor responses fell into 5 major themes: Assessment and Action, Client Characteristics, Services, Counselor Training and Preparedness, and Future Directions.

Suicidal behavior is a serious mental health emergency, yet it remains a challenging issue as suicidal behaviors are complex and disaster survivors with suicidal ideation may experience intense psychological reactions to the event. In order to provide competent care to survivors experiencing suicidal thoughts or behaviors, the need for counselors to receive adequate training in suicide assessment and management is essential. (Disaster Med Public Health Preparedness. 2015;9:291–300)

Recent disasters within the United States, such as Hurricanes Katrina and Sandy, have highlighted the vulnerability of older adults, and recent litigation has upheld the responsibility of government in assisting the public during mandatory evacuations. Older adults designated as homebound due to their disabilities are at greatest risk of poor outcomes in disasters. This study aimed at assessing the willingness and ability of homebound older adults to evacuate, as well as categorizing their medical needs in the event they are relocated to an emergency shelter.

Fifty-six homebound older adults and medical decision surrogates from 1 homebound primary care practice in Philadelphia were assessed with a novel structured interview.

Respondents reported limitations in both their ability and their willingness to evacuate their neighborhoods. Medical needs of homebound older adults were on par with those of nursing home residents.

Many homebound older adults are unable or unwilling to evacuate in a mandatory evacuation situation, highlighting a need for public assistance. Their complex medical needs will require significant preparation by special needs shelters. (Disaster Med Public Health Preparedness. 2015;9:301-306)

This study aimed to explore the correlation between the 2011 Great East Japan Earthquake and postpartum depression among perinatal subjects in the Miyako region of Iwate, an area damaged by earthquakes and tsunamis.

We retrospectively compared the percentages of women with scores ≥9 on the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS) among 3 groups of women who gave birth prior to the disaster (before-disaster group: n=141), within 3 months after the disaster (within-3-months group: n=70), and 4-6 months after the disaster (4-6-months group: n=89) at the Iwate Prefectural Miyako Hospital. The risk factors for EPDS scores ≥9 were estimated with multivariate logistic regression analyses.

Compared with the before-disaster group, a significantly greater number of women in the within-3-months group had EPDS scores ≥9 at hospital discharge (31.4% versus 9.9%, P<.0001), whereas women in the 4-6-months group did not (10.1% versus 9.9%, P=.96). In both the after-disaster groups, the destruction of their home (adjusted odds ratio [AOR], 3.68; 95% confidence interval [CI], 1.46-9.26) and dissatisfaction with their living conditions (AOR, 3.02; 95% CI, 1.20-7.59) were significantly associated with EPDS scores ≥9.

An increase in postpartum depression was observed after the Great East Japan Earthquake among perinatal women. (Disaster Med Public Health Preparedness. 2015;9:307-312)