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Research and Evaluations of the Health Aspects of Disasters, Part VII: The Relief/Recovery Framework

Published online by Cambridge University Press:  03 February 2016

Marvin L. Birnbaum*
Affiliation:
Emeritus Professor of Medicine and Physiology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin USA; Emeritus Editor-in-Chief, Prehospital and Disaster Medicine
Elaine K. Daily
Affiliation:
Nursing Section Editor, Prehospital and Disaster Medicine; Executive Secretary, World Association for Disaster and Emergency Medicine, Madison, Wisconsin USA
Ann P. O’Rourke
Affiliation:
Assistant Professor, Division of General Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin USA
*
Correspondence: Marvin L. Birnbaum, MD, PhD 610 N. Whitney Way, Suite 407 Madison, Wisconsin 53705 USA E-mail: mbirnbaum@wadem.org

Abstract

The principal goal of research relative to disasters is to decrease the risk that a hazard will result in a disaster. Disaster studies pursue two distinct directions: (1) epidemiological (non-interventional); and (2) interventional. Both interventional and non-interventional studies require data/information obtained from assessments of function. Non-interventional studies examine the epidemiology of disasters. Interventional studies evaluate specific interventions/responses in terms of their effectiveness in meeting their respective objectives, their contribution to the overarching goal, other effects created, their respective costs, and the efficiency with which they achieved their objectives. The results of interventional studies should contribute to evidence that will be used to inform the decisions used to define standards of care and best practices for a given setting based on these standards. Interventional studies are based on the Disaster Logic Model (DLM) and are used to change or maintain levels of function (LOFs). Relief and Recovery interventional studies seek to determine the effects, outcomes, impacts, costs, and value of the intervention provided after the onset of a damaging event. The Relief/Recovery Framework provides the structure needed to systematically study the processes involved in providing relief or recovery interventions that result in a new LOF for a given Societal System and/or its component functions. It consists of the following transformational processes (steps): (1) identification of the functional state prior to the onset of the event (pre-event); (2) assessments of the current functional state; (3) comparison of the current functional state with the pre-event state and with the results of the last assessment; (4) needs identification; (5) strategic planning, including establishing the overall strategic goal(s), objectives, and priorities for interventions; (6) identification of options for interventions; (7) selection of the most appropriate intervention(s); (8) operational planning; (9) implementation of the intervention(s); (10) assessments of the effects and changes in LOFs resulting from the intervention(s); (11) determination of the costs of providing the intervention; (12) determination of the current functional status; (13) synthesis of the findings with current evidence to define the benefits and value of the intervention to the affected population; and (14) codification of the findings into new evidence. Each of these steps in the Framework is a production function that facilitates evaluation, and the outputs of the transformation process establish the current state for the next step in the process. The evidence obtained is integrated into augmenting the respective Response Capacities of a community-at-risk. The ultimate impact of enhanced Response Capacity is determined by studying the epidemiology of the next event.

Birnbaum ML, Daily EK, O’Rourke AP. Research and Evaluations of the Health Aspects of Disasters, Part VII: The Relief/Recovery Framework. Prehosp Disaster Med. 2016;31(2):195–210.

Type
Special Reports
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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Footnotes

a

Task Force for Quality Control of Disaster Medicine, World Association for Disaster and Emergency Medicine, Nordic Society for Disaster Medicine. Health Disaster Management Guidelines for Evaluation and Research in the Utstein Style. Sundnes KO, Birnbaum ML (eds). Prehosp Disaster Med. 2003;17(Supplement 3).

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