Department of Disaster and Emergency Health, National Institute of Health Research, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Disaster Med Public Health Prep. 2013 Oct;7(5):481-90. doi: 10.1017/dmp.2013.93.
To evaluate the effectiveness of a capacity-building intervention administered through a primary health care (PHC) system on community disaster preparedness in Iran.
A controlled community intervention trial with pre- and postassessments was conducted in 2011 in 3 provinces of Iran. In each province, 2 areas were chosen and randomly selected as an intervention or control group. A total of 9200 households were in the intervention area and 10 010 were in the control area. In each study group in each province 250 households were sampled for pre- and postassessment surveys. Community health volunteers led by PHC staff administered an educational intervention covering elements of hazard awareness and preparedness, with a focus on earthquakes and floods. Relative changes for awareness and readiness scores were assessed to demonstrate changes in outcome variables from pre- to postassessments in intervention and control groups. An effectiveness test of significance was based on interaction between time and area.
Households in intervention communities exhibited improved disaster awareness and readiness with respect to all outcome measures. Relative changes in awareness in intervention and control areas were 2.94 and -0.08, respectively (P < .001). Relative changes for readiness scores were 5.52 in intervention areas and 0.56 in control areas (P < .001). Relative changes for awareness and readiness were significantly correlated with a community's baseline risk perception and previous experience with natural disasters (P < .001).
An educational intervention administered through the PHC system effectively improved disaster awareness and readiness at a community level. For sustainability, community disaster reduction programs must be integrated into routine public health service delivery.
评估通过初级卫生保健（PHC）系统实施的能力建设干预对伊朗社区备灾的有效性。
2011 年，在伊朗的 3 个省份进行了一项有预评估和后评估的对照社区干预试验。在每个省份，选择 2 个地区作为干预组或对照组。干预区共有 9200 户，对照组 10010 户。在每个省份的每个研究组中，对 250 户家庭进行预评估和后评估调查。由 PHC 工作人员领导的社区卫生志愿者实施了一项教育干预措施，涵盖了灾害意识和备灾的各个方面，重点是地震和洪水。评估意识和准备程度得分的相对变化，以展示干预组和对照组从预评估到后评估的结果变量的变化。基于时间和区域之间的相互作用，对显著性效果测试进行评估。
干预社区的家庭在所有结果测量方面都表现出了更好的灾害意识和备灾能力。干预区和对照组的意识相对变化分别为 2.94 和-0.08（P<0.001）。准备程度得分的相对变化分别为干预区的 5.52 和对照组的 0.56（P<0.001）。意识和准备程度的相对变化与社区的基线风险感知和以往自然灾害经历显著相关（P<0.001）。
通过 PHC 系统实施的教育干预措施有效地提高了社区层面的灾害意识和备灾能力。为了可持续性，社区减灾计划必须纳入常规公共卫生服务提供中。
