Between May 2010 and September 2011, the University of Minnesota School of Public Health partnered with the Minnesota Department of Health (MDH) to assess the effect of exercises on team performance during public health emergency response.

Participants were divided into 3 research teams exposed to various levels of intervention. Groups consisted of a control group that was given standard MDH training exercises, a didactic group exposed to team dynamics and communication training, and a treatment group that received the didactic training in addition to a post-exercise facilitated debriefing. To assess differences in team performance, teams engaged in 15 functional exercises.

Differences in team performance across the 3 groups were identified, although there was no trend in team performance over time for any of the groups. Groups demonstrated fluctuation in team performance during the study period. Attitudinal surveys demonstrated an increase in workplace satisfaction and confidence in training among all groups throughout the study period.

Findings from this research support that a critical link exists between training type and team performance during public health emergency response. This research supports that intentional teamwork training for emergency response workers is essential for effective public health emergency response. (Disaster Med Public Health Preparedness. 2017;11:7–10)

Environmental health assessments of disaster shelters are critical for monitoring the living conditions of the occupants. However, knowledge and levels of utilization of these assessments have never been estimated in the United States or its territories. We aimed to conduct a cross-sectional survey to ascertain knowledge and Utilization of environmental health disaster shelter assessments.

The State and Territorial Use of Shelter Assessments Survey (STUSA) of environmental health department directors (N=56) was carried out in 2013.

Survey responses were received from 55 of 56 targeted jurisdictions. Of those respondents, 92% of state jurisdictions and 100% of territories reported having knowledge about shelter assessments. However, only 40% of states and 60% of territories reported receiving formal training, and 53% of states and 50% of territories reported having operational procedures for shelter assessments. High levels of knowledge and familiarity and low levels of training and processes for operationalizing assessments were assessed.

Because environmental health assessments may provide useful information in disaster settings, we need to understand the barriers to their implementation. The results of these assessments may also help to validate their usefulness in protecting shelter occupants during disasters. (Disaster Med Public Health Preparedness. 2017;11:11–14)

Rana Plaza building collapse is the worst industrial disaster of Bangladesh so far. The 9-storied structure collapsed suddenly on April 24, 2013, with more than 4000 people inside. Bangladesh Armed Forces played a key role in the massive rescue operations.

We conducted a cross-sectional study with 423 victims who were treated at a Combined Military Hospital to review the pattern of injuries and management provided.

Middle-aged (35±12.75 years) females (68.32%) were the majority of the victims. Among the injured, 42.35% had soft tissue injury, 22.55% had abrasions, 18.79% had fractures, 3.75% had facial injuries, and 2.5% each had head and abdominal injuries. We treated the injured with various surgical approaches, such as soft tissue debridement (38.84%), fasciotomy (18.79%), amputation (3.75%), and other procedures. We had to refer 8.27% of the patients to different advanced centers. The mortality rate was 5.91%, including 1 volunteer rescuer.

Pattern of injuries and modalities of management needed in an industrial disaster is a valuable experience which can be utilized in preparing to face disasters in the future and beyond. Death of a voluntary rescuer once again warrants the necessity of using a helmet and safety gear during any rescue operation. (Disaster Med Public Health Preparedness. 2017;11:21–24)

In the 2011 Great East Japan Earthquake, as in Hurricanes Katrina and Rita in the United States, older individuals were at the greatest risk of mortality. Much concern has been raised about developing plans to reduce these risks, but little information has been provided about preparedness, and the key role played by caregivers has been largely unexplored. The aims of this study were thus to examine the preparedness of family caregivers of older adults with long-term care needs and to identify the characteristics of older adults and their caregivers that are associated with poor preparedness and greater concern about disasters.

Shortly after the Great East Japan Earthquake, the second wave of the Fukui Longitudinal Caregiver Study was administered to the family caregivers of older Japanese individuals with long-term care needs. The sample included 952 caregivers from 17 municipalities in Fukui prefecture. Logistic regression analyses were used to identify the factors associated with self-assessed preparedness, evacuation planning, and caregivers’ concerns about preparedness.

The majority (75%) of the caregivers had no concrete plans for evacuation in an emergency, and those caring for persons with dementia were 36% less likely to have any plan. In multivariate models, caregivers who were more experienced and wealthier and who reported more family and community support were more likely to feel well prepared. Caregivers with poor health or limited financial resources or who were responsible for older persons with mobility difficulties reported higher levels of anxiety about their disaster preparedness.

This study indicates that most caregivers are ill prepared to respond in emergencies and that caregiver resources, community support, and the needs of older care recipients influence both preparedness and concern about disasters. Education for caregivers and the development of community support programs could provide important sources of assistance to this vulnerable group. (Disaster Med Public Health Preparedness. 2017;11:31–38)

Individuals exposed to natural disasters are at risk for negative physical and psychological outcomes. Older adults may be particularly vulnerable; however, social support can act as a resource to help individuals respond to severe stressors. This study explored the challenges older people faced before, during, and after Hurricane Sandy in October 2012 and the people they turned to for support.

Semi-structured interviews were conducted with 20 older adults in New Jersey drawn from the ORANJ BOWL (Ongoing Research on Aging in New Jersey – Bettering Opportunities for Wellness in Life) research panel, who experienced high levels of primary home damage during Hurricane Sandy. Content analysis of interview transcripts classified older adults’ perceptions on how they “made it” through—the challenges they faced and the support they received.

The findings suggested that older adults experienced emotional, instrumental, social, and financial challenges before, during, and after the storm. However, by relying on family and friends, as well as neighbors and community networks, older people were able to respond to stressors.

Our findings carry implications for ensuring that older adults are connected to social networks before, during, and after disasters. The role of neighbors is particularly important when disasters strike. (Disaster Med Public Health Preparedness. 2017;11:39–47)

Elderly individuals are considered at elevated risk of disaster impacts owing to increased health concerns, reduced mobility, and fixed economic resources. Social capital can counteract these vulnerabilities by increasing the likelihood of hearing disaster warnings, providing social ties to assist with preparation and evacuation, and providing access to financial or nonfinancial resources. I aimed to analyze the relationship between age and perceptions of disaster-related social capital.

I used mailed surveys and in-person interviews with a sample of residents from 2 Florida counties to study perceptions of social capital available for disaster.

The results showed that age has a negative effect on perceptions of social capital resources available during a disaster. The elderly reported fewer social ties overall and much fewer social ties that could provide financial assistance, if necessary, during a disaster.

These results indicate that social capital may not counteract the social vulnerabilities of elderly persons to disaster impacts. (Disaster Med Public Health Preparedness. 2017;11:48–55)

Health agencies working with the homebound play a vital role in bolstering a community’s resiliency by improving the preparedness of this vulnerable population. Nevertheless, this role is one for which agencies lack training and resources, which leaves many homebound at heightened risk. This study examined the utility of an evidence-based Disaster Preparedness Toolkit in Veterans Health Administration (VHA) Home-Based Primary Care (HBPC) programs.

We conducted an online survey of all VHA HBPC program managers (N=77/146; 53% response rate).

Respondents with fewer years with the HBPC program rated the toolkit as being more helpful (P<0.05). Of those who implemented their program’s disaster protocol most frequently, two-thirds strongly agreed that the toolkit was relevant. Conversely, of those who implemented their disaster protocols very infrequently or never, 23% strongly agreed that the topics covered in the toolkit were relevant to their work (P<0.05).

This toolkit helps support programs as they fulfill their preparedness requirements, especially practitioners who are new to their position in HBPC. Programs that implement disaster protocols infrequently may require additional efforts to increase understanding of the toolkit’s utility. Engaging all members of the team with their diverse clinical expertise could strengthen a patient’s personal preparedness plan. (Disaster Med Public Health Preparedness. 2017;11:56–63)

We aimed to investigate the influence of social factors, especially social support, on psychological distress and the prevalence of health problems (HPs) among victims living in their homes 14 to 21 months after the Great East Japan Earthquake and tsunami.

A subgroup analysis was performed for elderly participants of a cross-sectional household survey in Ishinomaki area, Japan. The prevalence of psychological HPs was assessed by using a psychological distress questionnaire (K6) and by recording the number of subjective HPs. Perceived social support was assessed in 3 dimensions: informational, emotional, and instrumental support. Univariate and multivariate logistic regression models were used to examine the association between social factors and psychological health.

An elderly subgroup with 879 participants was used for analyses. Psychological distress (K6 score≥9) was observed in 6.8% of the participants aged 65 to 74 years and in 8.0% of those aged ≥75 years. Receiving a long-term care service was associated with having HPs, and discontinuation of attendance at a hospital as an outpatient was associated with psychological distress. Receiving emotional support was associated with lower psychological distress and not having HPs.

Emotional support was found to be an important factor for promoting health among elderly disaster victims. (Disaster Med Public Health Preparedness. 2017;11:64–71)

The purpose of this study was to explore how social capital or the impact of life and previous disaster experience facilitated resilience in older adults who experienced the 2011 and 2013 floods in Brisbane, Australia.

Data were drawn from in-depth interviews of 10 older adults from Brisbane who were evacuated in both the 2011 and 2013 floods. A combined qualitative approach drawing from the methods of constructivist grounded theory and narrative inquiry was applied and the data were analyzed by using (inductive) line-by-line and axial coding.

The narratives of the older adults revealed a strong theme of resilience linked to social capital (bonding, bridging, and linking) and previous disaster experience. The results reflected the changing face of disaster management strategies and sources of social capital.

Changes in disaster management polices (toward self-reliance) and more formalized sources of social capital highlight the need to build strong and healthy resilient communities that are capable of positively recovering from natural disasters. The results from this research emphasize the importance of initiatives that enhance social cohesion, trust, and social capital within local communities. (Disaster Med Public Health Preparedness. 2017;11:72–79)

This article conceptualized emergency preparedness as a complex, multidimensional construct and empirically examined an array of sociodemographic, motivation, and barrier variables as predictors of levels of emergency preparedness.

The authors used the 2010 wave of the Health and Retirement Study’s emergency preparedness module to focus on persons 50 years old and older in the United States by use of logistic regression models and reconsidered a previous analysis.

The models demonstrated 3 key findings: (1) a lack of preparedness is widespread across virtually all sociodemographic variables and regions of the country; (2) an authoritative voice, in the role of health care personnel, was a strong predictor of preparedness; and (3) previous experience in helping others in a disaster predisposes individuals to be better prepared. Analyses also suggest the need for caution in creating simple summative indexes and the need for further research into appropriate measures of preparedness.

This population of older persons was generally not well prepared for emergencies, and this lack of preparedness was widespread across social, demographic, and economic groups in the United States. Findings with implications for policy and outreach include the importance of health care providers discussing preparedness and the use of experienced peers for outreach. (Disaster Med Public Health Preparedness. 2017;11:80–89)

Exposure to multiple disasters, both natural and technological, is associated with extreme stress and long-term consequences for older adults that are not well understood. In this article, we address age differences in health-related quality of life in older disaster survivors exposed to the 2005 Hurricanes Katrina and Rita and the 2010 BP Deepwater Horizon oil spill and the role played by social engagement in influencing these differences.

Participants were noncoastal residents, current coastal residents, and current coastal fishers who were economically affected by the BP oil spill. Social engagement was estimated on the basis of disruptions in charitable work and social support after the 2005 hurricanes relative to a typical year before the storms. Criterion measures were participants’ responses to the SF-36 Health Survey which includes composite indexes of physical (PCS) and mental (MCS) health.

The results of logistic regressions indicated that age was inversely associated with SF-36 PCS scores. A reduction in perceived social support after Hurricane Katrina was also inversely associated with SF-36 MCS scores.

These results illuminate risk factors that impact well-being among older adults after multiple disasters. Implications of these data for psychological adjustment after multiple disasters are considered. (Disaster Med Public Health Preparedness. 2017;11:90–96)

Research on the impact of natural disasters on the mental health of older adults finds both vulnerabilities and resilience. We report on the rates of clinically significant depression among older adults (aged ≥60 years) living in areas affected by Hurricane Sandy in 2012 and the factors associated with mental health need.

The Sandy Mobilization, Assessment, Referral and Treatment for Mental Health (SMART-MH) program integrates community outreach and needs assessments to identify older adults with mental health and aging service needs. Older adults with significant anxiety or depressive symptoms were offered short-term psychotherapy. Social service referrals were made directly to community agencies. All SMART-MH activities were offered in Spanish, Russian, Mandarin/Cantonese, and English.

Across the full sample, 14% of participants screened positive for depression. Hurricane Sandy stressors predicted increased odds of depression, including storm injury, post-storm crime, and the total count of stressors. Outcomes varied significantly by age group, such that all Sandy-related variables remained significant for younger-old adults (aged 60–74 years), whereas only the loss of access to medical care was significant for older-old adults (aged ≥75 years).

Storm-affected communities show higher rates of depressive symptoms than seen in the general population, with storm stressors affecting mental health needs differentially by age group. (Disaster Med Public Health Preparedness. 2017;11:97–109)

Personal disaster and emergency support networks of rural older adults are described before and after participation in a disaster preparedness intervention, PrepWise.

At baseline, a total of 194 disaster support network members were identified by 27 older adults in a rural Midwest community. After the intervention, these participants identified 232 support network members. Multilevel logistic regression models were constructed to identify characteristics of the network members and social interactions associated with support providers at baseline as well as newly added support sources after the PrepWise intervention.

Member and interaction characteristics associated with being identified as emergency support sources at baseline were as follows: family, lived in close proximity, weekly or more frequent contact, and being someone whom participants shared concerns with, trusted, and exchanged emotional support with. After receiving PrepWise, participants on average identified 3 new sources of emergency support within their networks. Support sources added at follow-up tended to be nonfamily members and those participants trusted.

Enhancements in personal emergency support networks occurred after the intervention. Understanding characteristics of the network members and social interactions may assist in identifying additional emergency support sources. Larger studies investigating the impacts of enhanced support networks on disaster-related behaviors and outcomes will be beneficial. (Disaster Med Public Health Preparedness. 2017;11:110–119)