Disaster Preparedness for Children and Families: a Critical Review

Exposure reduction strategies are aimed at reducing actual hazard exposure; vulnerability reduction, reducing the effects of being exposed.

Whereas running to a doorway used to be recommended, with findings that implicate “movement during shaking” as a primary risk for injury [10], this is no longer recommended as a risk reduction behavior.

Various disaster mental-health-focused programs are available [11, 12], including those that are prevention-focused [13]. The aim in disaster preparedness programs as defined here is both physical and psychological preparedness and prevention. Owing to space limitations, a review of mental health prevention/resiliency programs was not possible, but the reader is referred to work by Pfefferbaum and colleagues on primary through tertiary approaches [11, 12] and by Wolmer on primary prevention as delivered by teachers in school settings [13, 35]. It is worth noting that one of these papers [11] includes a set of evidence-supported recommendations to help those who deliver these programs in various settings (e.g., pediatric, school) be more prepared. This paper also highlights school-based disaster prevention and preparedness programs, including those that are mental health/resiliency focused and those that are the subject of this review paper. Of course, as discussed in this paper, those disaster preparedness programs which incorporate a range of evidence-supported resiliency-enhancing components and principles would be thought to be more effective [11].

In using conservative criteria to categorize findings as “mostly positive”, “mixed”, or “no effect”, some of the studies did have a number of positive findings but were classified as mixed. For example, one study classified as producing “mixed findings” had positive findings including DRR preparedness program participation being linked to significantly increased knowledge of key messages, benefits on emotional indicators and risk perceptions, with the exception of no differences seen in children’s reports of home-based preparedness indicators as a function of DRR education involvement.

In previous research, the idea that children perceiving injury risk are more prone to being fearful has not been supported. In fact, research has demonstrated that children who participate in DRR education programs tend to have reduced disaster-related fears, including in instances where they have an increased perception of disasters causing injury. Theory would suggest that an increased sense of confidence and learning DRR skills would allow children to see potential injuries not in a fearful way but, rather, in a way where a potential injury is seen as a problem that has various solutions that the child feels increasingly capable of carrying out compatible with the idea of seeing a “challenge” versus seeing a “threat” [14, 15].

Research supports the idea that parents are a main source of disaster-related fears for children. Alternatively, research also supports parents’ role in helping children cope more effectively. In fact, because of the strength of some findings, the adage that “as parents go in disasters (or other stressful events), so too their children” has a good deal of research support [2, 22].

Falling and tripping were the most common causes of injury after the two major 2010–11 Christchurch earthquakes [10].

Reprinted with permission.

The same can be said for any DRR public education program, no study to date has followed cohorts over time, with one exception on reduction of house fires in Surrey, British Columbia that used a door-knocking campaign by firefighters to reduce the incidence of house fires in high-risk areas [34]. In addition, a mental health-focused teacher-delivered resilience program developed in Israel for children did follow children over time, including following disaster in Turkey [35] and Israel/closer to the Gaza Strip [13], and found reduced incidence of stress and trauma symptoms and increased adaptive functioning.

A range of disaster-focused mental health interventions are available as signposts in the psychosocial sphere [12, 36]. So too are a useful set of recommendations in helping prepare those who deliver interventions through various settings, including pediatric settings and schools [11]. Drawing on other universal mental health prevention/resiliency-building programs is also recommended as these have been seen to reduce development of later problems and enhance social, emotional and other areas of functioning, including significant increases in achievement [37, 38].