Glik Deborah C, Eisenman David P, Zhou Qiong, Tseng Chi-Hong, Asch Steven M
Department of Community Health Sciences, UCLA Fielding School of Public Health, 650 South Charles E. Young Drive, PO Box 95-1772, Los Angeles, CA 90095-1772, USA, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, California 90095-1736, USA, Department of Medicine, VA, Greater Los Angeles Health Care System, Los Angeles, CA 90073, USA.
Health Educ Res. 2014 Apr;29(2):272-83. doi: 10.1093/her/cyt109. Epub 2014 Jan 7.
Only 40-50% of households in the United States are currently disaster prepared. In this intervention study, respondent-driven sampling was used to select a sample (n = 187) of low income, Latino residents of Los Angeles County, randomly assigned into two treatment conditions: (i) household preparedness education received through 'promotora' (community health worker) led small group meetings, and (ii) household preparedness education received through print media. Weinstein's Precaution Adoption Process, a stage model appropriate for risk communication guided the intervention. Outcomes are conceptualized as stages of decision making linked to having disaster supplies and creating a family communication plan. Quantitative results showed a significant shift over time from awareness to action and maintenance stages for disaster communication plans and supplies in both study arms; however, the shift in stage for a communication plan for those in the 'platica' study arm was (P < 0.0001) than for those in the media arm. For changes in stage linked to disaster supplies, people in both media and 'platica' study arms improved at the same rate. Simple media-based communications may be sufficient to encourage disadvantaged households to obtain disaster supplies; however, adoption of the more complex disaster family communication requires interpersonal education.
目前，美国只有40%至50%的家庭为灾害做了准备。在这项干预研究中，采用应答驱动抽样法从洛杉矶县低收入的拉丁裔居民中选取了一个样本（n = 187），并将其随机分为两种治疗条件：（i）通过由“健康促进员”（社区卫生工作者）主持的小组会议接受家庭备灾教育，以及（ii）通过印刷媒体接受家庭备灾教育。温斯坦的预防采用过程，一个适用于风险沟通的阶段模型指导了此次干预。结果被概念化为与拥有灾害物资和制定家庭沟通计划相关的决策阶段。定量结果显示，随着时间的推移，两个研究组中关于灾害沟通计划和物资的决策阶段都从认知阶段显著转变为行动阶段和维持阶段；然而，“小组讨论”研究组中沟通计划阶段的转变（P < 0.0001）比媒体组的更大。对于与灾害物资相关的阶段变化，媒体组和“小组讨论”研究组的人改善速度相同。基于简单媒体的沟通可能足以鼓励弱势家庭获取灾害物资；然而，采用更复杂的灾害家庭沟通则需要人际教育。
