Objective: To study when and how an urgent public health message about a boil-water order reached an urban population after the Massachusetts water main break.

Methods: In-person surveys were conducted in waiting areas of clinics and emergency departments at a large urban safety net hospital within 1 week of the event.

Results: Of 533 respondents, 97% were aware of the order; 34% of those who lived in affected cities or towns were potentially exposed to contaminated water. Among those who were aware, 98% took action. Respondents first received the message through word of mouth (33%), television (25%), cellular telephone calls (20%), landline calls (10%), and other modes of communication (12%). In multivariate analyses, foreign-born respondents and those who lived outside the city of Boston had a higher risk of exposure to contaminated water. New modes (eg, cellular telephones) were used more commonly by females and younger individuals (ages 18 to 34). Individuals who did not speak English at home were more likely to receive the message through their personal networks.

Conclusions: Given the increasing prevalence of cellular telephone use, public officials should encourage residents to register landline and cellular telephone for emergency alerts and must develop creative ways to reach immigrants and non–English-speaking groups quickly via personal networks.

(Disaster Med Public Health Preparedness. 2011;5:235–241)

Vulnerable populations tend to have the worst health outcomes during and after disasters; however, these populations are rarely included in the emergency planning process. In Philadelphia, the Department of Public Health and the Office of Emergency Management have reached out to community-based organizations that serve vulnerable populations to include these key stakeholders in emergency planning. In this article, we outline strategies for locating, engaging, and communicating with vulnerable populations about both organizational and personal emergency preparedness. Such strategies include creating a method for bidirectional communication via a free quarterly health newsletter that is distributed to community-based organizations serving vulnerable populations. We also note successes and next steps from engaging vulnerable populations in the planning process in Philadelphia.

(Disaster Med Public Health Preparedness. 2010;4:246-251)

Background: An influenza pandemic, such as that of the H1N1 virus, raises questions about how to respond effectively to a lethal outbreak. Most plans have focused on minimizing impact by containing the virus through quarantine, but quarantine has not been used widely in the United States and little is known about what would be the public's response. The purpose of this study was to investigate factors that influence an individual's decision to comply with a hypothetical avian influenza quarantine order.

Methods: A total of 1204 adult Pennsylvania residents participated in a random digit dial telephone sample. The residents were interviewed regarding their attitudes about and knowledge of avian influenza and about compliance with quarantine orders, including staying at home or traveling to a government-designated facility.

Results: Analysis of variance showed differences among demographic groups in willingness to comply with quarantine orders, with women and individuals not presently employed more willing to stay at home or to travel to a government-designated facility if ordered. Those who did not regularly attend religious services were significantly less willing than those who did attend regularly to comply with any type of quarantine order. Regression analysis indicated that demographic variables, overall knowledge of avian influenza, attitudes about its severity, and the belief that the respondent and/or his or her significant other(s) may contract it were predictive.

Conclusions: The results of this study can provide health planners and policy makers with information for improving their efforts to conduct a quarantine successfully, including crafting messages and targeting information to certain groups of people to communicate risk about the epidemic.

(Disaster Med Public Health Preparedness. 2010;4:135-144)

Background: During June 2008, heavy precipitation and 500-year flood events resulted in the displacement of thousands of families throughout eastern Iowa. The objectives of this study were to assess the effectiveness and preferred sources of health messages communicated to the public following the disaster.

Methods: Three hundred twenty-seven households were surveyed in 4 counties hit hardest by the flooding. A 48-item questionnaire containing items on demographics, housing, health information sources, and 8 specific health issues was administered.

Results: Almost all of the participants (99.0%) received information on at least 1 of the health topics covered by the survey. Most participants received information regarding vaccination (84.1%), mold (79.5%), safe use of well water (62.7%), respirator use (58.7%), or stress (53.8%). Television was the primary (54.7%) and preferred (60.2%) source of health information for most people, followed by the Internet (11.0% and 30.3% as source and preference, respectively).

Conclusions: Public health messages were received by a wide audience in the flood-affected communities. Along with more traditional health communication channels such as television, radio, or newspapers, continued emphasis on the development of health information Web sites and other technological alternatives may result in useful and effective health communication in similar situations.

(Disaster Med Public Health Preparedness. 2010;4:129-134)

The results of a field study of three sites that used video to link primary care medical centers to hospitals are reported. The analysis was concerned with identifying the people involved, the tasks carried out in collaboration at each end of the link, and how the different communications facilities helped or hindered. The results are summarized as six task characteristics and their design implications for this model of telemedical consultation are discussed.