Dementia Caregivers' Perspectives on Disaster Preparedness: Barriers, Resources, and Recommendations

BACKGROUND AND OBJECTIVES

Disaster preparedness is an urgent concern, particularly for caregivers of persons with dementia. Developing and executing plans for oneself and another person who needs care can be difficult when the care recipient is cognitively impaired. We sought to better understand caregivers' disaster preparedness for the purpose of generating guidance for future interventions to increase caregiver resilience.

RESEARCH DESIGN AND METHODS

We conducted a qualitative descriptive study of caregiver disaster experiences and perceptions of their preparedness. Fifty-two participants from diverse backgrounds participated in a focus group or interview. Deductive thematic data analysis was utilized to identify themes. Stress process models guided the interpretation of our findings.

RESULTS

Analyses of caregivers' experiences and observations revealed that disaster preparedness was challenging for caregivers, though also perceived to be an important responsibility. We identified 3 main themes: (a) barriers to preparing for a disaster as a caregiver for a person living with dementia, (b) why it is important for a caregiver to develop a disaster plan, and (c) how to facilitate preparedness for caregivers of persons living with dementia.

DISCUSSION AND IMPLICATIONS

This study highlighted the difficulties of preparing for a disaster while caring for a person with dementia. Applying stress process models to our results provided strong evidence that interventions could be developed to bolster caregivers' resources to cope with stressors associated with disaster preparedness. A key issue for public officials is the question of whether disaster shelters are appropriate for persons with dementia.

"One community at a time": promoting community resilience in the face of natural hazards and public health challenges

BACKGROUND

Resilience is vital for facing natural disasters and public health challenges. Despite the significance of resilience-building activities, there is a scarcity of locally-tailored planning and response strategies, leaving communities incapable of addressing the unique challenges posed by natural disasters and public health crises. This study aims to explore how the "One Community at a Time" approach enhances community resilience in facing natural hazards and public health challenges.

METHODS

A systematic review was conducted over journal articles published from January 2001 to April 2023 through PRISMA approach. Multiple databases such as Web of Science and Scopus were thoroughly searched. We used independent screening by two researchers and painstaking data extraction using standardized forms. This approach was adopted to assure the reliability, validity, and precision of our study selection and analysis. The included studies' quality was evaluated by the Mixed Methods Appraisal Tool.

RESULTS

In the evaluation, 35 studies were deemed eligible for inclusion and underwent in-depth examination. Several major components of "One Community at a Time" have been identified, including social capital and networks, local knowledge and learning, effective governance and leadership, preparedness and response capacity, and adaptive infrastructure and resources. This framework highlights the significance of individualized approaches to resilience-building initiatives, recognizing that each community has specific strengths, needs, and challenges.

CONCLUSION

Relevant stakeholders can adapt suitable resilient strategies to help prepare and recover from natural hazards and public health challenges. By adopting a localized strategy, stakeholders can collaborate to develop a culture of readiness and resilience, ultimately leading to more sustainable and resilient communities. This framework advises community-based groups, local government, and other stakeholders on prioritizing partnerships, preparedness planning, community participation, and leadership as essential components of creating and maintaining resilience. "One Community at a Time" framework offers practical guidance for community-based organizations, local government, and other stakeholders to prioritize partnerships, preparedness planning, community participation, and leadership as essential components of creating and sustaining resilience.

Quantitative flood disaster loss-resilience with the multilevel hybrid evaluation model

The severity of global flood disasters is growing, causing loss of human life and property. Building a high-resilience social system, an important means of sustainable flood control, can address these flood-related issues. Numerous studies have carried out disaster resilience evaluations and explored the correlation between flood disaster loss and intensity, but neglected to analyze the role of resilience construction in disaster loss reduction. This study proposed a research route for linking flood loss and disaster loss to quantify the relationship between the two. Take Guangdong Province, China as a study case, the mixed-effects (ME) model and multilevel hybrid evaluation model (MHEM) were established to assess disaster loss and resilience of cities, respectively. Subsequently, disaster resilience curves were built to quantitatively evaluate disaster resilience and corresponding disaster loss. The results show that (1) the ME model can concurrently build the disaster intensity-loss curves of multiple cities with high fitting accuracy. The MHEM combines multiple methods to determine the evaluation result with the highest consistency, showing high reliability. (2) The central and southern regions of Guangdong Province have low disaster loss and high resilience, while the northern regions have high disaster loss and low resilience. (3) With the improvement of disaster resistance, the reduction in disaster loss gradually decreases. Disaster loss in low-resilience cities exhibits greater randomness than that in high-resilience cities, and increasing their resilience can more significantly reduce their level of loss. This study provides a quantitative basis and available methods for comprehensive responses to natural disasters and adaptation to global climate change.

Human capital as a turnkey resource in resilience to cyclones and storm surges: Empirical evidence from coastal Bangladesh

What are the best methods to build cyclone and storm resilience in a developing country? We examine the multiple resources that contribute to storm resilience in the highly vulnerable ecological context of coastal Bangladesh, finding that human capital is a critical turnkey resource that enables and facilitates the use of other resources in household responses to floods, storm surges and other cyclone damage. Drawing on a household survey of nine coastal villages in different ecological zones of coastal Bangladesh, we use principal component analysis (PCA) and multiple regression to identify four components of storm resilience and a human capital index that, along with other household resources, predicts resilience to storms and cyclones. We then use this human capital index as a policy tool to map the proportion of highly resilient households in these nine villages and identify additional methods for building a stronger understanding of storm resilience.

Spatial-temporal characteristics of geological disaster resilience in poverty and disaster-prone areas in China: a case study of Ganzi Prefecture

Under the tremendous challenges of frequent disasters, disaster resilience is imperative for risk reduction and sustainable management in poverty and disaster-prone areas. Ganzi Prefecture has a complicated topography and vulnerable ecosystems. Geological disasters have historically been the most serious risks in the region. To fully understand the potential risks and strengthen resilience, the study investigates the resilience level of 18 counties in Ganzi. Firstly, the paper develops a multidimensional index system based on the Baseline Resilience Indicators for Communities (BRIC) framework. And the entropy weighting method is used to calculate Ganzi's disaster resilience level from the aspects of "society-economy-infrastructure-environment." Then, the study uses exploratory spatial data (ESDA) to analyze the spatial-temporal evolution of disaster resilience. Finally, Geodetector is used to investigate the main driving factors of disaster resilience and their interactions. The results indicated that Ganzi's disaster resilience had maintained an upward trend from 2011 to 2019, with significant spatial divergence, which shows high resilience in the southeast and low resilience in the northwest. The economic indicator is the driving factor in the spatial difference of disaster resilience, and the interaction factor has a significantly stronger explanatory power for resilience. Therefore, the government should strengthen ecotourism development to help alleviate poverty in special industries and promote synergistic regional development.

Establishing a regional interdisciplinary resilience center: a bottom-up approach

Both natural and manmade disasters have severely impacted the region of Southeast Texas over the past few decades, and this has negatively affected the socio-economic well-being of the region. The state of Texas has suffered 200-250 billion dollars in damages from natural and manmade disasters since 2010. Given the region's strategic importance to the nation's energy and security, developing resilience knowledge and multi-disaster resilience research focused on issues pertaining to the region is needed. This paper describes the structure and process of building a center for multi-disaster resilience at a regional public university. By utilizing a bottom-up approach, the Center's mission and design are broadly democratized through the participation of a variety of scholars and various stakeholders with whom they interact. Resilience needs specific to the Southeast Texas region are examined, as is the relationship between resilience and the academic disciplines of the stakeholders involved. The issues of resilience in the region are discussed as well as the future steps for the Center's continued growth and development for the study of resilience.

Virgin Islands

The environment plays a significant role in the global burden of disease for children. Climate-related disasters such as the 2017 Atlantic hurricane season are increasingly contributing to this burden. United Nations designated Small Island Developing States (SIDS) like Puerto Rico and the U.S. Virgin Islands are particularly at risk due to environmental health hazards caused by natural disasters, and health care structure vulnerabilities. United Nations' Sustainable Development Goals (UN SDG), specifically UN SDG 3, 13 and 17, focus on climate impacts via promotion of health preparedness and building partnerships between different sectors of society, respectively. The Pediatric Environmental Health Specialty Unit's (PEHSU) work is consistent with these most notably via the delivery of environmental health services along with training nurses, doctors, and other health professionals, formation of partnerships and linking resources. Therefore, training a diverse array of health professionals and linking these groups to relevant community resources is of utmost importance and has the potential to enhance the effective management and early prevention of top environmental health (EH) risks. Nursing is identified as a key health sector to engage for this initiative. This article describes the work of the Federal Region 2 PEHSU in Puerto Rico and the U.S. Virgin Islands that supports health professionals' knowledge building, development of environmental health services, and promotion of wide scale access to such services for children and families. The PEHSU's work is consistent with these most notably with regards to the delivery of environmental health services in pediatrics.

Housing and accessibility after the COVID-19 pandemic: Rebuilding for resilience, equity and sustainable mobility

A more sustainable post COVID-19 world requires urban transport policies aiming for resilience, social equity and decarbonisation. Instead of just focusing on the transport sector, the authors propose an integrated approach to housing and mobility. This approach acknowledges the challenges posed by inadequate housing and dependence on motorised transport during the COVID-19 crisis. In contrast, adequate housing and cycling became paramount resources while confronting the pandemic. Using Santiago de Chile as a case study, this research examines how different relocation scenarios for its current housing deficit cannot only affect the ability to implement stay-at-home measures, but also the potential of cycling as a relevant commuting alternative. The current location of the families suffering this deficit is compared to three scenarios: compact, pericentral and extended. In light of the learnings from the COVID-19 crisis, a housing-cycling policy becomes a tool for resilience; equity is achieved by enforcing the right to housing, by increasing job opportunities among the poor, and by reducing the dependence on expensive motorised transport; decarbonisation is achieved by promoting active transportation and reducing the dependence on motorisation.

An Approach for Guiding the Development and Assessing the Interdisciplinarity of New Methodologies for Community Disaster Resilience

There are critical and preventable inequalities in disaster impacts and postdisaster recovery. To formulate solutions for minimizing or preventing these unequal impacts, there is a great need for interdisciplinary methodologies that use social factors to set project scopes and drive engineering analyses and designs. At present time, however, limited guidance exists on how to develop and execute interdisciplinary methodologies, especially related to the study of community disaster resilience. This article offers an approach for developing and assessing interdisciplinary research methodologies. The framework incorporates insights from social science into structural engineering for integrated research focused on community disaster resilience. The two examples offered in the article assess the interdisciplinarity of two loss estimation methodologies. The goal of this perspectives article is to facilitate future interdisciplinary community disaster resilience research given its potential for transformative outcomes in terms of encouraging decision making that is driven by the needs of those who are often overlooked in disaster mitigation and recovery policies.

Rethinking the interplay between affluence and vulnerability to aid climate change adaptive capacity

Affluence and vulnerability are often seen as opposite sides of a coin-with affluence generally understood as reducing forms of vulnerability through increased resilience and adaptive capacity. However, in the context of climate change and an increase in associated hazards and disasters, we suggest the need to re-examine this dynamic relationship-a complex association we define here as the Affluence-Vulnerability Interface (AVI). We review research in different national contexts to show how a more nuanced understanding of the AVI can (a) problematize the notion that increasing material affluence necessarily has a mitigating influence on social vulnerability, (b) extend our analysis of social vulnerability beyond low-income regions to include affluent contexts and (c) improve our understanding of how psychosocial characteristics influence people's vulnerability. Finally, we briefly outline three methodological approaches that we believe will assist future engagement with the AVI.

Why predict climate hazards if we need to understand impacts? Putting humans back into the drought equation

Virtually all climate monitoring and forecasting efforts concentrate on hazards rather than on impacts, while the latter are a priority for planning emergency activities and for the evaluation of mitigation strategies. Effective disaster risk management strategies need to consider the prevailing "human terrain" to predict who is at risk and how communities will be affected. There has been little effort to align the spatiotemporal granularity of socioeconomic assessments with the granularity of weather or climate monitoring. The lack of a high-resolution socioeconomic baseline leaves methodical approaches like machine learning virtually untapped for pattern recognition of extreme climate impacts on livelihood conditions. While the request for "better" socioeconomic data is not new, we highlight the need to collect and analyze environmental and socioeconomic data together and discuss novel strategies for coordinated data collection via mobile technologies from a drought risk management perspective. A better temporal, spatial, and contextual understanding of socioeconomic impacts of extreme climate conditions will help to establish complex causal pathways and quantitative proof about climate-attributable livelihood impacts. Such considerations are particularly important in the context of the latest big data-driven initiatives, such as the World Bank's Famine Action Mechanism (FAM).

Disaster resilience assessment based on the spatial and temporal aggregation effects of earthquake-induced hazards

Since the "5.12" Wenchuan earthquake in 2008, frequent geologic hazards along the Longmenshan fault zone have had significant impacts on the socioeconomic conditions in the earthquake-stricken areas. Therefore, from the perspective of earthquake-induced hazards, this paper focuses on analyzing the change rules of disaster resilience under the spatial and temporal aggregation effects of earthquake-induced hazards, and this analysis provides an important basis for understanding the developmental characteristics of earthquake-induced hazards and disaster prevention, and mitigation after earthquakes. This paper takes Wenchuan County as an example. By collecting the 2008-2018 landslide geological hazards data, the global autocorrelation coefficient and local autocorrelation coefficient are adopted to analyze the temporal trends and spatial patterns of earthquake-induced hazards. At the same time, from the socioeconomic perspective, two disaster resilience indexes, the compatibility coefficient of industrial and employment structure and per capita GDP growth rate, were constructed to analyze the disaster resilience under the spatial and temporal aggregation effect of landslide geological hazards. The results show that, on the temporal trend, the temporal aggregation effect of earthquake-induced hazards has periodically decayed with time; in the spatial distribution, the spatial clustering effect as a whole increases first and then decreases, and the scope of the aggregation effect tends to narrow spatially. Disaster resilience (H_xy and R_GDP) showed a trend of increasing first and then decreasing, and could not recover to the level before the earthquake in 2017, indicating that Wenchuan County was greatly affected by earthquake-induced hazards in the post-earthquake reconstruction process.

Climate change impacts and disaster resilience among micro businesses in the tourism and hospitality sector: The case of Kratie, Cambodia

Cambodia is considered extremely vulnerable to climate change due to high poverty, limited infrastructure, and weak adaptive capacity. Kratie province, in particular, has suffered from climate-induced disasters, including floods, droughts, storms, lightning, and heatwaves. To date, climate change interventions in the province have primarily focused on impacts on agriculture. However, enhancing the climate resilience of micro businesses in the tourism and hospitality sector is also crucial since the provincial economy increasingly depends on the interlinkage between agriculture, tourism and related enterprises. This article examines how climate change has impacted micro businesses in Kratie Town, and how they responded to the impacts. This study is based on semi-structured interviews with micro entrepreneurs randomly selected in the town. Results show that businesses have been predominantly affected by floods and storms. Business exposures and locations, types of business, production and supply chains, and client bases determined different impacts of and responses to these climate-related hazards. Businesses adopted primarily temporary and reactive responses rather than long-term systematic measures. Strengthening adaptive infrastructure, both physical and informational, will improve businesses' capability to prepare for and cope with these disasters.

COVID, resilience, and the built environment

This article provides a perspective on the reciprocal relationships between public and private sector resilience planning activities and the ongoing COVID responses in the U.S. Through the lens of the built environment, this article provides selected insights into how various disaster, organizational, and engineering resilience activities have likely positively shaped COVID responses within the healthcare sector. These positive influences are contextualized within extensive efforts within public health and healthcare management to calibrate community resilience frameworks and practices for utilization in everything from advancing community health to the continuity of facilities operations. Thereafter, the article shifts focus to speculate on how ongoing experiences under COVID might yield positive impacts for future resilience designs, plans and policies within housing and the built environment. Through this perspective, the article hopes to explore those often overlooked aspects of the physical and social parameters of the built environment that may be understood as providing opportunities to inform future disaster, public health, and climate change preparations and responses.

Disaster Resilience in Aging Populations: Lessons from the 2011 Great East Japan Earthquake & Tsunami

Recovery after major disaster poses a unique set of challenges for the older population, including disruption of medical care for pre-existing conditions, functional limitations that impede recovery, and social isolation following involuntary resettlement. In this review, we summarize the lessons about disaster resilience that have been learned (so far) from a unique ongoing field study based in a community that was affected by the 2011 earthquake and tsunami in Japan. In the Iwanuma Study, baseline information about the health status and living conditions of older residents was collected seven months before the disaster. A follow-up survey was conducted 2.5 years after the disaster, allowing us investigate the risk and protective factors for a range of disaster-related health sequelae, including mental illness and cognitive disability. A consistent finding to emerge from our studies is the critical role of social connections (the "social capital" of a community) in protecting against the deleterious after-effects of psychological trauma and involuntary resettlement following the disaster. In contrast to the emphasis on investing in material infrastructure to prepare for disasters, a review of our studies suggests that repairing (or at least preserving) the social fabric of people's lives is a crucial ingredient in disaster resilience.

Developing a tool for measuring the disaster resilience of healthcare rescuers: a modified Delphi study

BACKGROUND

Disaster resilience is an essential personal characteristics of health rescue workers to respond to disasters in an effective manner, and maintain a state of adaptation after deployment. It is essential for disaster managers to recruit, assess, and prepare healthcare rescuers with this characteristic. A specific tool for measuring the disaster resilience of healthcare rescuers has yet to be devised.

OBJECTIVE

The purpose of this study was to establish the content validity of a tool for measuring the disaster resilience of disaster rescue workers.

METHODS

A modified Delphi approach was employed. Experts in disaster work and research were invited to rate the domains and items of a prototype tool for measuring disaster resilience in healthcare rescue workers. The panel of experts rated the relevance of the items using a 4-point Likert scale. The median and interquartile range, as well as the level of agreement, were calculated for each item using the Kendall coefficient W, to assess the consensus of the experts. The content validity index (CVI) was calculated to assess the content validity of this tool.

RESULTS

A total of 22 and 21 experts were involved in the first and second rounds of this modified Delphi study (response rate of 91.7 and 95.5%), respectively. After two rounds of expert query, an eight-domain and 27-item disaster resilience measuring tool was established. The median range of all of the included items was 3.50 to 4.00 and the interquartile range was 0.00 to 1.00, and all items achieved ≥85% agreement. The Kendall coordination coefficient W was 0.21 and 0.33 in the first and second rounds, respectively, with P < 0.01. The I-CVI ranged from 0.85 to 1.0, while the S-CVI/UA and S-CVI /Ave were 0.69 and 0.97, respectively.

CONCLUSION

Consensus was reached on a disaster resilience measuring tool covering 27 items. The content validity of this tool for measuring the disaster resilience of healthcare rescuers was excellent. This tool is validated and ready to be tested in a pilot study to assess its psychometric properties.

Enhancing community preparedness: an inventory and analysis of disaster citizen science activities

Background

Disaster citizen science, or the use of scientific principles and methods by “non-professional” scientists or volunteers, may be a promising way to enhance public health emergency preparedness (PHEP) and build community resilience. However, little research has focused on understanding this emerging field and its implications for PHEP. To address research gaps, this paper: (1) assesses the state of disaster citizen science by developing an inventory of disaster citizen science projects; (2) identifies different models of disaster citizen science; and (3) assesses their relevance for PHEP.

Methods

We searched the English-language peer-reviewed and grey literature for disaster citizen science projects with no time period specified. Following searches, a team of three reviewers applied inclusion/exclusion criteria that defined eligible disasters and citizen science activities. Reviewers extracted the following elements from each project: project name and description; lead and partner entities; geographic setting; start and end dates; type of disaster; disaster phase; citizen science model; and technologies used.

Results

A final set of 209 projects, covering the time period 1953–2017, were included in the inventory. Projects were classified across five citizen science models: distributed or volunteer sensing (n = 19; 9%); contributory (n = 98; 47%); distributed intelligence (n = 52; 25%); collaborative research (n = 32; 15%); and collegial research (n = 8; 4%). Overall, projects were conducted across all disaster phases and most frequently for earthquakes, floods, and hurricanes. Although activities occurred globally, 40% of projects were set in the U.S. Academic, government, technology, and advocacy organizations were the most prevalent lead entities. Although a range of technologies were used, 77% of projects (n = 161) required an internet-connected device. These characteristics varied across citizen science models revealing important implications for applications of disaster citizen science, enhancement of disaster response capabilities, and sustainability of activities over time.

Conclusions

By increasing engagement in research, disaster citizen science may empower communities to take collective action, improve system response capabilities, and generate relevant data to mitigate adverse health impacts. The project inventory established a baseline for future research to capitalize on opportunities, address limitations, and help disaster citizen science achieve its potential.

From SARS to pandemic influenza: the framing of high-risk populations

The 2003 global outbreak of severe acute respiratory syndrome (SARS) was a wake-up call for health systems in Canada, with realization of occupational health risks faced by health care workers and first responders in public health emergency response. The need for investment in critical social infrastructure-including explicitly articulated plans-became a priority for managing future pandemics. Over the past 15 years, pandemic planning has evolved with the adoption of a whole-of-society approach to disaster risk reduction. There is recognition of the social gradient of risk, which emerges from the interaction between social determinants of health, risk of exposure, and adverse impacts from a pandemic. Additionally, there is better understanding of the benefits of planning according to functional needs, rather than deficit-oriented labelling. In this paper, we reflect on how the framing of vulnerable or high-risk populations has evolved since SARS. Looking to the future, we present the imperative for the creation of institutional space for engagement of high-risk populations in pandemic planning processes, including participatory governance. Innovative consultation strategies are needed to enhance collective asset literacy and ensure planning is adaptive to the changing social fabric. Progressive pandemic planning in the next decade must be inclusive and sensitive to modern definitions of family, varied abilities, cultural practices and gender and sexual diversity, thereby reflecting a whole-of-society approach to disaster risk reduction.

Measuring the benefits of using market based approaches to provide water and sanitation in humanitarian contexts

The use of cash transfers and market based programming (CT/MBP) to increase the efficiency and effectiveness of emergency responses is gaining prominence in the humanitarian sector. However, there is a lack of existing indicators and methodologies to monitor activities designed to strengthen water and sanitation (WaSH) markets. Gender and vulnerability markers to measure the impact of such activities on different stakeholders is also missing. This study identifies parameters to monitor, evaluate and determine the added value of utilising CT/MBP to achieve WaSH objectives in humanitarian response. The results of the work revealed that CT/MBP can be used to support household, community and market level interventions to effectively reduce transmission of faeco-oral diseases. Efficiency, effectiveness, sustainability, appropriateness and equity were identified as useful parameters which correlated to widely accepted frameworks against which to evaluate humanitarian action. The parameters were found to be directly applicable to the case of increasing demand and supply of point of use water treatment technology for a) disaster resilience activities, and b) post-crisis response. The need for peer review of the parameters and indicators and pilot measurement in humanitarian contexts was recognised.