Theory-Based Approaches to Understanding Public Emergency Preparedness: Implications for Effective Health and Risk Communication

Abstract

Recent natural and human-caused disasters have awakened public health officials to the importance of emergency preparedness. Guided by health behavior and media effects theories, the analysis of a statewide survey in Georgia reveals that self-efficacy, subjective norm, and emergency news exposure are positively associated with the respondents' possession of emergency items and their stages of emergency preparedness. Practical implications suggest less focus on demographics as the sole predictor of emergency preparedness and more comprehensive measures of preparedness, including both a person's cognitive stage of preparedness and checklists of emergency items on hand. We highlight the utility of theory-based approaches for understanding and predicting public emergency preparedness as a way to enable more effective health and risk communication.

This research is a part of emergency and disaster preparedness project, supported by the Georgia Department of Human Resources–Public Health Division, with funds from the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. An earlier version of this article was presented at the 2008 National Communication Annual Convention in San Diego, CA, November 21–24.

Notes

¹SCT proposes causal, triadic interactions among the environment (both social and physical), people (and their intrinsic cognitive, affective, and biological traits), and the behavior (Bandura, 1997). In this theory, self-efficacy is critical to performing a particular behavior successfully (Glanz, Rimer, & Lewis, 2002).

²Using a multistage sampling method, all possible telephone numbers were divided into blocks that were defined by the last two digits of a 10-digit phone number. Strict procedures were implemented to improve response rate and to ensure that the hard-to-reach respondents had a chance to be interviewed, including the following: (1) a requirement of distributing call attempts by each interviewer at different times across different days; and (2) strict call-back rules stipulating that a number could not be abandoned unless it had been verified as being invalid or attempted at least 25 times. Within each household, the interviewer randomly selected the adult in the household who most recently celebrated a birthday in order to randomize within-household selection and to prevent bias associated with only speaking to the person who answers the telephone. The survey was composed of two sections: (a) one about emergency preparedness in general; and (b) the other soliciting citizens' knowledge and perceptions of avian flu and pandemic flu. The present analysis is based on the first section of the survey, where respondents were asked about their media use and attention related to emergency news, their perceptions and self-reported knowledge about emergency preparedness, various emergency supplies that they currently owned, and their stages of emergency preparedness.

³The CASRO rate is a formula suggested by the Council of American Survey Research Organizations (CASRO) and is largely used in nationwide and statewide surveys (e.g., Behavioral Risk Factor Surveillance System). Similar to American Association for Public Opinion Research (AAPOR) response rate formula 3, the CASRO rate was calculated as the number of interviews divided by the number of known and unknown eligible cases.

^a Gender and race were measured with dummy variables with female (male = 0) and White being 1 (other races = 0). Homeownership, urban residence, and past experience are measured with binary scale of yes or no. The numeric values reported are percentages.

^a Pearson correlation coefficient.

^b Betas are taken from the final equation with all the predictors entered.

*p ≤ .05, **p ≤ .01, ***p ≤ .001; All betas are standardized regression coefficients. Missing values were treated with pairwise solution.