5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & ...
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5th International Disaster and Risk Conference IDRC 2014 Integrative Risk Management - The role of science, technology & practice 24-28 August 2014 in Davos, Switzerland

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  • Study a Population At-Risk (selected study area)

    Representative of geographic, geologic, and socioeconomic conditions
    Potentially greater risk for isolation and displacement than other areas of region
    Multi-stage cluster sampling plan within 6 suburbs


  • My Primary Aim: address the need for evidence-based research.

    MEASURE WITH METHODOLOGICAL RIGOR:

    Contribute foundational scientific knowledge to the evidence base:

    Quantitative methods
    Solid sampling plan
    Measurable constructs
    Reliable, validated instruments
    Statistical power
    Representative
    Generalizable
    Relevant

    RESEARCH DESIGN (Measuring how and when?):

    Cross-sectional, quantitative baseline postal survey on resilience indicators

    RESEARCH AIM (Measuring what?):

    Explore indicators for resilience in attitude and behavior, in a prevention timeframe, and within a health promotion framework



  • Why health?

    What does resilience mean to me?

    A personal, individual process and outcome
    Biopsychosocial model (strengths/assets)
    Health-protective attitudes and behaviours
    Embodies disaster prevention
    Dynamic and multi-dimensional state of well-being and readiness – with a sense of agency
    Awareness
    Acceptance
    Empowering, protective outlook
    Engagement in preventive actions

    RESILIENCE AS A HOLISTIC, INTEGRATIVE, FLUID, and HEALTH-PROMOTING STATE

    FACILITATING ADAPTIVE POSTDISASTER TRAJECTORIES
  • Consistent with policy

    DRR
    WHO
  • Goal:

    Go beyond conceptual frameworks to probe for agency – associations between well-being and preparedness actions

    Drawing on:

    - Biopsychosocial Models
    - Quality of Life Models
    - Salutogenesis Models

    Gap: Poor QoL widely associated with low levels of health protective behaviours, yet relationships among health-promoting attributes with preparedness virtually unknown

    Study Aims:

    What is the status of HrQoL, well-being, preparedness in the general adult population
    How are HrQoL and global well-being related to preparedness?
    Does age or gender affect these relationships?
    How much variance can be explained?

    Hx: Adults with higher QoL will exhibit higher levels of engagement in preparedness for earthquake and tsunami evacuation

    Potential Implication: Prevent disaster by self-managing their risk and uncertainty


  • IDRC14-ppp-Gowan_Monica

    1. 1. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Integrative Disaster Resilience: bringing well-being to self-management of disaster risk and uncertainty Monica E. Gowan, PhD, MS, Mayo Clinic, USA Ray C. Kirk, PhD, University of Canterbury, New Zealand Jeff A Sloan, PhD, Mayo Clinic, USA
    2. 2. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org For detailed results, see www.hqlo.com/content/12/1/85 "Building resiliency: a cross-sectional study examining relationships among health-related quality of life, well-being, and disaster preparedness" (Gowan, Kirk & Sloan, 2014)
    3. 3. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Integrative Disaster Resilience: bringing well-being to self-management of disaster risk and uncertainty Evidence-based Training • 2014 – Results published www.hqlo.com/content/12/1/85 • 2014 – Postdoctoral research fellowship completed • 2012 – PhD awarded • 2010—2014 Canterbury Earthquake Sequence • 2008—2009 PhD data collection • 2006—2007 PhD study proposal • 2004—2006 Postgrad Certificate in Public Health Preparedness • Pre-2004—Earth Science career Acknowledgments • Mayo Clinic Division of Emergency Management (USA) • Mayo Clinic Department of Health Sciences Research (USA) • University of Canterbury Health Sciences Centre (NZ) • GNS Science (NZ) • Earthquake Commission (NZ) • Scholarships – University of Canterbury – NZ Ministry of Education
    4. 4. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Part I. HAZARDS AND RISKSCAPES
    5. 5. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org The Seismic Hazardscape - Tsunamis Trans-Pacific (distant) + Regional + Local Earthquakes + Submarine Landslides Image credit: US NWS Tsunami Warning Center
    6. 6. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Subduction Zone + Transform Plate Boundary + Regional + Local Faulting + Volcanic Activity Image credit: public domain The Seismic Hazardscape - Earthquakes
    7. 7. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Wellington Fault (GNS Science) Wellington M7+ Scenario (MCDEM) Integrative Disaster Resilience: bringing well-being to self-management of disaster risk and uncertainty
    8. 8. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Study Area (Statistics NZ) Tsunami Inundation Map (GNS) Integrative Disaster Resilience: bringing well-being to self-management of disaster risk and uncertainty
    9. 9. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Survey Distribution • Self-complete questionnaire posted to households • Sampling Frame n = 6312 • Sample Size n = 2451 • Response Rate n = 695 (28.5%) • Margin of error + 3.8% • 80% power r > 0.11 Integrative Disaster Resilience: bringing well-being to self-management of disaster risk and uncertainty
    10. 10. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Part II. THEORY, RESEARCH QUESTIONS, AND INSTRUMENTS FOR EXPLORING INTEGRATIVE DISASTER RESILIENCE
    11. 11. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Integrative Disaster Resilience: bringing well-being to self-management of disaster risk and uncertainty “Health is the extent to which an individual or group is able…to change or cope with the environment. Health is therefore…a positive concept emphasising social and personal resources, as well as physical capacities.” WHO Ottawa Charter, 1986 “Research and case studies from around the world provide convincing evidence that health promotion is effective." WHO Jakarta Declaration, 1997 “The Bangkok Charter identifies actions, commitments and pledges required to address the determinants of health in a globalised world through health promotion.” WHO Bangkok Charter, 2005
    12. 12. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Integrative Disaster Resilience: bringing well- being to self-management of disaster risk and uncertainty Concept Operational Definition Construct Indicator or Domain Measure or Specific Aspect Survey Question Social Well Being FS (Hawthorne, 2006) Q14 Emotional Well Being SOC13 (Antonovsky, 1987) Q16 Spiritual Well Being SS20 (Boyd-Wilson et al. 2004, 2006) Q17 Physical Health Status SF12(v1) (Ware et al. 1996) Health-related Quality of Life Mental Health Status SF12(v1) (Ware et al. 1996) Q19-28 Health- Protective Attitudes (Personal Health and Well-Being/ Quality of Life) Global Quality of Life Global Life Satisfaction/ Subjective Well Being SWLS (Diener et al. 1985) Q29 Q35.1Discussing Preparedness With Social Network With Neighbourhood Q35.2 Q35.3 Q35.4 Q35.6 Seeking Preparedness Information Risks & Consequences How to Prepare How to Respond How to Evacuate Q35.7 Q35.8Taking Preparedness Actions Earthquake Tsunami Q35.9 Q35.10 Q35.11 Evacuation Planning Survival/Escape Evacuation/Dislocation Communications Q35.12 Q35.13 Q35.14 Evacuation Plan Testing Evacuation Route Assembly Area Participated in Drill Q35.15 Q35.16 Q35.17 Q35.18 Health Management Resources (Protective Factors) Health- Protective Behaviours (Personal Disaster Preparedness) Earthquake and Tsunami Preparedness Evacuation Kit Readiness Survival/Escape Evacuation/Dislocation Communications Kit Accessible Q35.19 Multidimensional Health-Related QoL - Physical well-being - Mental well-being - Emotional well-being - Spiritual well-being - Social well-being Global QoL - Global well-being - Subjective well-being
    13. 13. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Integrative Disaster Resilience: bringing well- being to self-management of disaster risk and uncertainty Concept Operational Definition Construct Indicator or Domain Measure or Specific Aspect Survey Question Social Well Being FS (Hawthorne, 2006) Q14 Emotional Well Being SOC13 (Antonovsky, 1987) Q16 Spiritual Well Being SS20 (Boyd-Wilson et al. 2004, 2006) Q17 Physical Health Status SF12(v1) (Ware et al. 1996) Health-related Quality of Life Mental Health Status SF12(v1) (Ware et al. 1996) Q19-28 Health- Protective Attitudes (Personal Health and Well-Being/ Quality of Life) Global Quality of Life Global Life Satisfaction/ Subjective Well Being SWLS (Diener et al. 1985) Q29 Q35.1Discussing Preparedness With Social Network With Neighbourhood Q35.2 Q35.3 Q35.4 Q35.6 Seeking Preparedness Information Risks & Consequences How to Prepare How to Respond How to Evacuate Q35.7 Q35.8Taking Preparedness Actions Earthquake Tsunami Q35.9 Q35.10 Q35.11 Evacuation Planning Survival/Escape Evacuation/Dislocation Communications Q35.12 Q35.13 Q35.14 Evacuation Plan Testing Evacuation Route Assembly Area Participated in Drill Q35.15 Q35.16 Q35.17 Q35.18 Health Management Resources (Protective Factors) Health- Protective Behaviours (Personal Disaster Preparedness) Earthquake and Tsunami Preparedness Evacuation Kit Readiness Survival/Escape Evacuation/Dislocation Communications Kit Accessible Q35.19 Health-protective behaviours - Talking about disaster - Seeking preparedness information - Taking preparedness action - Making evacuation plans - Testing plans - Making disaster kits
    14. 14. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Integrative Disaster Resilience: bringing well-being to self-management of disaster risk and uncertainty The Transtheoretical Model (TTM) of Behaviour Change (Velicer, Prochaska, Fava, Norman, & Redding, 1998)
    15. 15. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Part III. RESULTS
    16. 16. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Integrative Disaster Resilience: bringing well-being to self-management of disaster risk and uncertainty • Regression analyses – Overall health and well- being explains 4.6-6.8% of the variance in evacuation preparedness behaviour – Spiritual well-being is the only QoL variable that significantly and uniquely explained variance in preparedness • Correlational analyses – No associations with evacuation preparedness: • Mental health status • Social well-being • Gender – Negative associations: • Physical health status – Positive associations: • Spiritual well-being • Emotional well-being • Global well-being • Increasing age (?)
    17. 17. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Perceived value of personal resources for coping with evacuation
    18. 18. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Level of concern for required evacuation
    19. 19. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Level of engagement in disaster preparedness, stratified by intention vs action
    20. 20. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Part IV. FINAL THOUGHTS
    21. 21. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org • Discussion – We observed complex, deeply personal relationships between well- being and preparedness • Well-being matters, measurably • Spiritual & emotional well-being; life satisfaction are strongest indicators • Meaningfulness uniquely important – Perceptual errors are common • Risks of disaster underestimated • "Preparedness" not well understood • "Readiness" for disaster focused more on on shelter-in-place and home mitigation • "Strengths/Assets" for resilience not fully recognised Strengths - Data set is robust, reliable, representative, and generalisable Limitations - Correlation does not imply causation - Response rate requires prudent interpretation - Results time-delimited - QoL not a strong barrier or predictor Integrative Disaster Resilience: bringing well- being to self-management of disaster risk and uncertainty
    22. 22. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Integrative Disaster Resilience: bringing well-being to self-management of disaster risk and uncertainty Risk perception Is highly variable Evacuation priorities are Strongly individualistic
    23. 23. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Nothing is permanent Everything is temporary Integrative Disaster Resilience: bringing well-being to self-management of disaster risk and uncertainty
    24. 24. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Conclusion 1: Everyone is vulnerable  Risk biases are universal; resilience is fluid and frequently situational  Broad-brush messages for the general population are thus important Conclusion 2: Living with risk can be expansionary  Meaningful actions empower and strengthen people to self-manage their own unique circumstances and the uncertainties they face  Adding resilience awareness to risk awareness can improve readiness  A strong, multidimensional health identity can promote integrative disaster resilience and translate to a resilient community Conclusion 3: Preventive health models have a place in promoting day-to-day and disaster resilience  Incorporating D3R into preventive timeframes is imperative Integrative Disaster Resilience: bringing well-being to self-management of disaster risk and uncertainty
    25. 25. 5th International Disaster and Risk Conference IDRC 2014 ‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland www.grforum.org Added value for the Post 2015 Framework for Disaster Risk Reduction • How did your work support the implementation of the Hyogo Framework for Action: – Used knowledge, novelty/innovation, and education to build a culture of safety and resilience – Identified and reduced underlying risk factors – Strengthened disaster preparedness for effective intervention and response • From your perspective what are the main gaps, needs and further steps to be addressed in the Post 2015 Framework for Disaster Risk Reduction in – Research: Support long-haul research that generates reliable data – Education & Training: Preparedness is more than surviving 72 hours – Implementation & Practice: Integrate risk management & resilience – Policy: Prepare people to be ready for change & suspend expectations

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