The Role of Social and Behavioral Factors on Disaster Planning in Home Care

社会和行为因素对家庭护理灾难规划的作用

基本信息

批准号：
8583732
负责人：
ROBYN R.M. GERSHON
金额：
$ 21.09万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-07 至 2015-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8583732
关键词：
Action Research Address Adult Affect Aging Area Attitude Back Behavioral Behavioral Research Belief Caring Characteristics Chinese People Chronic Cities Cognitive Communities Continuity of Patient Care Data Data Collection Data Sources Dependence Disabled Persons Disaster Planning Disasters Elderly Elements Emergency Situation Environment Event Expectancy Frail Elderly Goals Health Home Care Agencies Home Care Services Household Housing Impairment Inequality Interview Knowledge Language Lead Licensing Life Locales Modeling Morbidity - disease rate Nature New York City Outcome Participant Perception Pilot Projects Play Policies Population Prevention Provider Public Health Readiness Recovery Recruitment Activity Red Cross Reliance Reporting Research Research Personnel Resources Risk Role Sampling San Francisco Seasons Self Efficacy Services Shelter facility Social Work Social support Socioeconomic Status Source Structure Theoretical model Trust United States Vulnerable Populations Work authority behavior influence behavioral/social science caregiving demographics design disability empowerment expectation experience family structure functional disability high risk improved informant information framework man meetings member metropolitan mortality patient expectation patient home care pet animal psychosocial public health relevance response risk perception social social cognition theories tool

项目摘要

DESCRIPTION (provided by applicant): In response to PA-11-265, which calls for social and behavioral research on the elderly in disasters, we propose this R21 exploratory study to determine the role of behavioral and social factors on disaster preparedness in a particularly vulnerable subset of elderly people, namely home care recipients. As the recent super-storm Sandy underscored, this very large and rapidly growing population of community members may be at increased risk for disaster-related morbidity and mortality. Data from a pilot study we recently conducted, involving 253 mainly elderly and disabled community members, documented sub-optimal emergency preparedness planning. On a 7-item preparedness scale, the mean scale score was 2.32 (SD = 2.74, range 0- 7). Less than 50% of participants had even the most rudimentary elements of a preparedness plan, with only 26% of participants reporting back-up plans for obtaining personal assistance during a disaster event. Guided by a new social-cognition theory of preparedness, qualitative data on a wide range of social and behavioral factors associated with disaster preparedness will be collected and analyzed. A total of 100 participants will be recruited from two high risk geographic locales -- New York City and San Francisco. Each city relies primarily on very different models of home care assistance; in NYC formal home care is delivered through certified or licensed agencies, whereas in San Francisco, recipient-driven care, with oversight provided by the San Francisco Public Authority, is the norm. Thus we will have a unique opportunity to assess the influence of these data delivery models on psycho-social constructs that may predict preparedness planning. These constructs include: risk perception, outcomes expectancy, response self-efficacy, perceived responsibility, sense of community, personal empowerment, and trust, among others. Using the newly developed, "Ready, Willing and Able," preparedness framework, information will also be collected from the participants' home care agencies (in NYC), the San Francisco Public Authority, and from local response agencies in NYC and San Francisco (e.g., the Office of Emergency Management, Department of Health, Department on Aging, etc.) to determine their preparedness planning and response capabilities for home care recipients. These multiple sources of data will allow us to identify gaps between home care patients' expectations and home care and response agency capabilities, and the association of social and behavioral factors with these gaps. Information from this study will serve to inform important policy strategies that will lead to a reduction in risk of adverse disaster-related outcomes in this vulnerable population.

描述（由申请人提供）：针对呼吁对灾难中老年人进行社会和行为研究的 PA-11-265，我们提出了这项 R21 探索性研究，以确定行为和社会因素在特定情况下对备灾的作用。老年人中的弱势群体，即家庭护理接受者。正如最近的超级风暴桑迪所强调的那样，这一庞大且快速增长的社区成员人口可能面临与灾害相关的发病率和死亡率增加的风险。我们最近进行的一项试点研究（主要涉及 253 名老年人和残疾人社区成员）的数据记录了次优的应急准备计划。在 7 项准备量表中，平均量表得分为 2.32（SD = 2.74，范围 0-7）。不到 50% 的参与者拥有防备计划中最基本的要素，只有 26% 的参与者报告了在灾难事件期间获得个人援助的后备计划。在新的备灾社会认知理论的指导下，将收集和分析与备灾相关的各种社会和行为因素的定性数据。将从两个高风险地区——纽约市和旧金山——招募总共 100 名参与者。每个城市主要依赖不同的家庭护理援助模式；在纽约市，正式的家庭护理是通过经过认证或许可的机构提供的，而在旧金山，由接受者驱动的护理并由旧金山公共当局提供监督是常态。因此，我们将有一个独特的机会来评估这些数据交付模型对可以预测准备计划的心理社会结构的影响。这些结构包括：风险感知、结果预期、应对自我效能、感知责任、社区意识、个人赋权和信任等。使用新开发的“准备好、愿意和能够”准备框架，还将从参与者的家庭护理机构（纽约市）、旧金山公共当局以及纽约市和旧金山的当地响应机构收集信息（例如，应急管理办公室、卫生部、老龄化部门等）以确定其针对家庭护理接受者的准备计划和响应能力。这些多种数据来源将使我们能够确定家庭护理患者的期望与家庭护理和响应机构能力之间的差距，以及社会和行为因素与这些差距之间的关联。这项研究的信息将为重要的政策战略提供信息，从而减少这一弱势群体遭受灾害相关不利后果的风险。