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Chisholm LJ, Hale RL, Knight SL. Community Resilience After Hurricanes: Can Neuman's Systems Theory Guide Public Health Nursing? Res Theory Nurs Pract 2023; 37:84-100. [PMID: 36792315 DOI: 10.1891/rtnp-2022-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Objective: Examination of community resilience after Hurricane Harvey and -applicability of Neuman's systems model to the role of public health nurses in applying primary, secondary, and tertiary prevention strategies to communities susceptible to natural disasters. Design: Descriptive, exploratory study. Sample: A convenience sample (N = 1,470). Measurements: Hurricane Harvey Survey. Results: Respondents from seven counties in southeast Texas report previously experiencing a hurricane (80%) with no weather-related flooding (79%), adequate preparation (54%), failure to comprehend the potential severity of Hurricane Harvey (62%), damage to their homes (45%), and a 68% loss of personal belongings. Anxiety, frustration, disbelief, determination, and hopefulness were rated highest after the storm. Residents received updates from family and friends, social media, and online news reports regarding rising water, even though, in many cases, a mandatory evacuation was not officially announced. Only 35% of respondents reported being aware of resources available, possibly due to flooding or inaccessibility of typical resources (e.g., hospitals, shelters). Communicating through social networks (social media, family, and friends) provided avenues for arranging evacuations and assistance. Respondents report giving assistance to others and receiving assistance from family, friends, and their faith community. The majority of respondents reported that the community provided adequate services during the hurricane (59%), and they plan to stay in southeast Texas (70%). Conclusions: Southeast Texas residents demonstrated individual and community resilience which may be further supported with primary, secondary, and tertiary nursing interventions as illustrated by Neuman's systems model. The rise in positive emotional response traits demonstrates positive coping, which is consistent with resilience. Effective and timely communication through social networks provides an additional line of resistance to protect and promote the resilience of the community. The lack of medical resources indicates a break in the normal line of defense and an area for potential improvement with the utilization of mobile medical units to provide healthcare for areas not easily accessible during a disaster. Public health nurses are strategically positioned in the international community to lead prevention and recovery efforts by applying theory-based community interventions.
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Slemp CC, Sisco S, Jean MC, Ahmed MS, Kanarek NF, Erös-Sarnyai M, Gonzalez IA, Igusa T, Lane K, Tirado FP, Tria M, Lin S, Martins VN, Ravi S, Kendra JM, Carbone EG, Links JM. Applying an Innovative Model of Disaster Resilience at the Neighborhood Level : The COPEWELL New York City Experience. Public Health Rep 2020; 135:565-570. [PMID: 32735159 DOI: 10.1177/0033354920938012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Community resilience is a community's ability to maintain functioning (ie, delivery of services) during and after a disaster event. The Composite of Post-Event Well-Being (COPEWELL) is a system dynamics model of community resilience that predicts a community's disaster-specific functioning over time. We explored COPEWELL's usefulness as a practice-based tool for understanding community resilience and to engage partners in identifying resilience-strengthening strategies. In 2014, along with academic partners, the New York City Department of Health and Mental Hygiene organized an interdisciplinary work group that used COPEWELL to advance cross-sector engagement, design approaches to understand and strengthen community resilience, and identify local data to explore COPEWELL implementation at neighborhood levels. The authors conducted participant interviews and collected shared experiences to capture information on lessons learned. The COPEWELL model led to an improved understanding of community resilience among agency members and community partners. Integration and enhanced alignment of efforts among preparedness, disaster resilience, and community development emerged. The work group identified strategies to strengthen resilience. Searches of neighborhood-level data sets and mapping helped prioritize communities that are vulnerable to disasters (eg, medically vulnerable, socially isolated, low income). These actions increased understanding of available data, identified data gaps, and generated ideas for future data collection. The COPEWELL model can be used to drive an understanding of resilience, identify key geographic areas at risk during and after a disaster, spur efforts to build on local metrics, and result in innovative interventions that integrate and align efforts among emergency preparedness, community development, and broader public health initiatives.
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Affiliation(s)
- Catherine C Slemp
- 161119 Independent Consultant, Public Health Policy and Practice, Milton, WV, USA
| | - Sarah Sisco
- 2012 Office of Emergency Preparedness and Response, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Marc C Jean
- 2012 Office of Emergency Preparedness and Response, New York City Department of Health and Mental Hygiene, New York, NY, USA.,Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Munerah S Ahmed
- 5939 Division of Environmental Health, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Norma F Kanarek
- 25802 Center for Public Health Preparedness, Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.,1466 Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Monika Erös-Sarnyai
- 1466 Office of Community Resilience, Division of Mental Hygiene, Johns Hopkins University, Baltimore, MD, USA
| | - Ingrid A Gonzalez
- 2012 Office of Emergency Preparedness and Response, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Takeru Igusa
- 1466 Department of Civil Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Kathryn Lane
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Fernando P Tirado
- 5939 Center for Health Equity, Bronx Neighborhood Health Action Center, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Maryellen Tria
- 5939 Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Sen Lin
- 1466 Department of Civil Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Valter N Martins
- 137755 Disaster Research Center, University of Delaware, Newark, DE, USA
| | - Sanjana Ravi
- 25802 Center for Health Security, Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - James M Kendra
- 137755 Disaster Research Center, University of Delaware, Newark, DE, USA
| | - Eric G Carbone
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jonathan M Links
- 25802 Center for Public Health Preparedness, Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Links JM, Schwartz BS, Lin S, Kanarek N, Mitrani-Reiser J, Sell TK, Boddie CR, Ward D, Slemp C, Burhans R, Gill K, Igusa T, Zhao X, Aguirre B, Trainor J, Nigg J, Ingelsby T, Carbone E, Kendra JM. COPEWELL: A Conceptual Framework and System Dynamics Model for Predicting Community Functioning and Resilience After Disasters. Disaster Med Public Health Prep 2018; 12:127-137. [PMID: 28633681 PMCID: PMC8743042 DOI: 10.1017/dmp.2017.39] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Policy-makers and practitioners have a need to assess community resilience in disasters. Prior efforts conflated resilience with community functioning, combined resistance and recovery (the components of resilience), and relied on a static model for what is inherently a dynamic process. We sought to develop linked conceptual and computational models of community functioning and resilience after a disaster. METHODS We developed a system dynamics computational model that predicts community functioning after a disaster. The computational model outputted the time course of community functioning before, during, and after a disaster, which was used to calculate resistance, recovery, and resilience for all US counties. RESULTS The conceptual model explicitly separated resilience from community functioning and identified all key components for each, which were translated into a system dynamics computational model with connections and feedbacks. The components were represented by publicly available measures at the county level. Baseline community functioning, resistance, recovery, and resilience evidenced a range of values and geographic clustering, consistent with hypotheses based on the disaster literature. CONCLUSIONS The work is transparent, motivates ongoing refinements, and identifies areas for improved measurements. After validation, such a model can be used to identify effective investments to enhance community resilience. (Disaster Med Public Health Preparedness. 2018;12:127-137).
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Affiliation(s)
- Jonathan M. Links
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Center for Public Health Preparedness, Johns Hopkins University
| | - Brian S. Schwartz
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Sen Lin
- Department of Civil Engineering, Johns Hopkins Whiting School of Engineering
| | - Norma Kanarek
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Tara Kirk Sell
- UPMC Center for Health Security, University of Pittsburgh Medical Center, Baltimore, MD
| | - Crystal R. Boddie
- UPMC Center for Health Security, University of Pittsburgh Medical Center, Baltimore, MD
| | - Doug Ward
- Division of Public Safety Leadership, Johns Hopkins School of Education
| | | | | | - Kimberly Gill
- Disaster Research Center, University of Delaware, Newark, DE
| | - Tak Igusa
- Department of Civil Engineering, Johns Hopkins Whiting School of Engineering
| | - Xilei Zhao
- Department of Civil Engineering, Johns Hopkins Whiting School of Engineering
| | - Benigno Aguirre
- Disaster Research Center, University of Delaware, Newark, DE
| | - Joseph Trainor
- Disaster Research Center, University of Delaware, Newark, DE
| | - Joanne Nigg
- Disaster Research Center, University of Delaware, Newark, DE
| | - Thomas Ingelsby
- UPMC Center for Health Security, University of Pittsburgh Medical Center, Baltimore, MD
| | - Eric Carbone
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - James M. Kendra
- Disaster Research Center, University of Delaware, Newark, DE
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Houston JB, Spialek ML, First J, Stevens J, First NL. Individual perceptions of community resilience following the 2011 Joplin tornado. JOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT 2017. [DOI: 10.1111/1468-5973.12171] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pfefferbaum RL, Pfefferbaum B, Zhao YD, Van Horn RL, McCarter GSM, Leonard MB. Assessing community resilience: A CART survey application in an impoverished urban community. DISASTER HEALTH 2017; 3:45-56. [PMID: 28229014 DOI: 10.1080/21665044.2016.1189068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 05/09/2016] [Indexed: 10/21/2022]
Abstract
This article describes an application of the Communities Advancing Resilience Toolkit (CART) Assessment Survey which has been recognized as an important community tool to assist communities in their resilience-building efforts. Developed to assist communities in assessing their resilience to disasters and other adversities, the CART survey can be used to obtain baseline information about a community, to identify relative community strengths and challenges, and to re-examine a community after a disaster or post intervention. This article, which describes an application of the survey in a community of 5 poverty neighborhoods, illustrates the use of the instrument, explicates aspects of community resilience, and provides possible explanations for the results. The paper also demonstrates how a community agency that serves many of the functions of a broker organization can enhance community resilience. Survey results suggest various dimensions of community resilience (as represented by core CART community resilience items and CART domains) and potential predictors. Correlates included homeownership, engagement with local entities/activities, prior experience with a personal emergency or crisis while living in the neighborhood, and involvement with a community organization that focuses on building safe and caring communities through personal relationships. In addition to influencing residents' perceptions of their community, it is likely that the community organization, which served as a sponsor for this application, contributes directly to community resilience through programs and initiatives that enhance social capital and resource acquisition and mobilization.
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Affiliation(s)
- Rose L Pfefferbaum
- Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Liberal Arts, Phoenix Community College, Phoenix, AZ, USA
| | - Betty Pfefferbaum
- Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center , Oklahoma City, OK, USA
| | - Richard L Van Horn
- Terrorism and Disaster Center, University of Oklahoma Health Sciences Center , Oklahoma City, OK, USA
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Disaster Impact on Impoverished Area of US: An Inter-Professional Mixed Method Study. Prehosp Disaster Med 2016; 31:583-592. [DOI: 10.1017/s1049023x1600090x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractIntroductionIn the foothills of the Cumberland Mountains, in central Appalachia (a region that spans 13 states in the US), sits an economically distressed and rural community of the United States. Once a thriving coal-mining area, this region now is reported as one of the hardest places to live in the US. Southeastern Kentucky, located in a remote, rocky, mountainous area surrounded by rivers and valleys and prone to flooding, experienced a major flood in Spring 2013 causing significant damage to homes and critical infrastructure.PurposeAims of the study were to: (1) identify and better understand the contextual variables compounding the impact of a disaster event that occurred in Spring 2013; (2) identify ways participants managed antecedent circumstances, risk, and protective factors to cope with disaster up to 12 months post-event; and (3) further determine implications for community-focused interventions that may enhance recovery for vulnerable populations to promote greater outcomes of adaptation, wellness, and readiness.MethodsUsing an ethnographic mixed-methods approach, an inter-collaborative team conducted face-to-face interviews with (N=12) Appalachian residents about their disaster experience, documented observations and visual assessment of need on an observation tool, and used photography depicting structural and environmental conditions. A Health and Emergency Preparedness Assessment Survey Tool was used to collect demographic, health, housing, environment, and disaster readiness assessment data. Community stakeholders facilitated purposeful sampling through coordination of scheduled home visits.ResultsTriangulation of all data sources provided evidence that the community had unique coping strategies related to faith and spirituality, cultural values and heritage, and social support to manage antecedent circumstances, risk, and protective factors during times of adversity that, in turn, enhanced resilience up to 12 months post-disaster. The community was found to have an innate capacity to persevere and utilize resources to manage and transcend adversity and restore equilibrium, which reflected components of resilience that deserve greater recognition and appreciation.ConclusionResilience is a foundational concept for disaster science. A model of resilience for the rural Appalachia community was developed to visually depict the encompassing element of community-based interventions that may enhance coping strategies, mitigate risk factors, integrate protective factors, and strengthen access. Community-based interventions are recommended to strengthen resilience, yielding improved outcomes of adaptation, health and wellness, and disaster readiness.BanksLH, DavenportLA, HayesMH, McArthurMA, ToroSN, KingCE, VaziraniHM. Disaster impact on impoverished area of US: an inter-professional mixed method study. Prehosp Disaster Med. 2016;31(6):583–592.
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