Mount Aloysius College,Cresson,Pennsylvania USA.
Prehosp Disaster Med. 2014 Aug;29(4):380-7. doi: 10.1017/S1049023X14000624. Epub 2014 Jul 1.
The aim of this study was to determine if a relationship exists between the development of adaptive capacity and disaster response and recovery outcomes. Hospitals and health care systems are a critical element in community planning for all phases of the disaster cycle. There is a lack of research, however, to validate the relationship between the development of these capabilities and improved response and recovery outcomes. Hypothesis/Problem Two hypotheses were formulated to address the research question. The first hypothesis argued that counties or parishes that developed adaptive capacity through pre-event planning, community engagement, training, and the use of national response frameworks would have improved response and recovery performance outcomes. The second hypothesis argued that adaptive capacity, along with response and recovery performance outcomes, predicts the trajectory of recovery progression.
This study employed a quantitative cross-sectional survey methodology and existing community demographic data to explore the development of adaptive capacity and its ability to predict disaster response and recovery outcomes in communities affected by major disaster in 2011. A total of 333 counties and parishes were included in the final sample, providing a 95% confidence interval with a 5% margin of error. Data were analyzed using both descriptive and inferential statistics. Multiple, hierarchical, and robust regression were used to find the best fitting model. Multi-level modeling with random intercepts was used to control for the nesting effects associated with county, state, and the Federal Emergency Management Agency (FEMA) region sampling.
Descriptive results provide a baseline assessment of adaptive capacity development at the community level. While controlling for other variables, hypothesis testing revealed that pre-event planning, community engagement, full-scale exercises, and use of national frameworks predicated overall response and recovery performance outcomes (R 2 = .43; F 13,303 = 13.34; P < .001). In terms of recovery progression, pre-event planning, overall response and recovery performance outcome, total time of disruption, and percent of people below poverty were significant (R 2 = .15; F14,302 = 4.53; P < .001).
Establishment of empirical data provides communities with reinforcement to continue resilience-building activities at the local level. However, findings from this study suggest that only full-scale exercises were significant in improving response and recovery outcomes. Implications for re-evaluation of disaster training warrant further exploration.
本研究旨在确定适应能力的发展与灾害应对和恢复结果之间是否存在关系。医院和医疗保健系统是社区规划中灾难周期各个阶段的关键要素。然而，缺乏研究来验证这些能力的发展与改善应对和恢复结果之间的关系。
假设/问题：提出了两个假设来解决研究问题。第一个假设认为，通过事前规划、社区参与、培训和使用国家应对框架来发展适应能力的县或教区，将有更好的应对和恢复绩效结果。第二个假设认为，适应能力以及应对和恢复绩效结果预测了恢复进展的轨迹。
本研究采用定量横断面调查方法和现有的社区人口统计数据，探讨了受灾社区适应能力的发展及其预测 2011 年重大灾害后应对和恢复结果的能力。共有 333 个县和教区被纳入最终样本，置信区间为 95%，误差幅度为 5%。使用描述性和推断性统计数据对数据进行分析。使用多元、分层和稳健回归来寻找最佳拟合模型。使用具有随机截距的多层次模型来控制与县、州和联邦紧急事务管理局（FEMA）区域抽样相关的嵌套效应。
描述性结果提供了社区层面适应能力发展的基线评估。在控制其他变量的情况下，假设检验表明，事前规划、社区参与、全面演习和使用国家框架预示着整体应对和恢复绩效结果（R 2 =.43；F13,303 = 13.34；P <.001）。就恢复进展而言，事前规划、整体应对和恢复绩效结果、中断总时间和贫困人口百分比具有显著意义（R 2 =.15；F14,302 = 4.53；P <.001）。
实证数据的建立为社区在地方一级继续进行韧性建设活动提供了支持。然而，本研究的结果表明，只有全面演习才能显著改善应对和恢复结果。需要进一步探讨对灾害培训进行重新评估的意义。
