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老年人灾难准备干预措施(老年人积极参与社区应急):一项准实验研究方案

Disaster Preparedness Intervention for Older Adults (Seniors' Positive Involvement in Community Emergencies): Protocol for a Quasi-Experimental Study.

作者信息

White-Lewis Sharon, Lightner Joseph, Crowley Julia, Grimes Amanda, Spears Kathleen, Chesnut Steven

机构信息

School of Nursing and Health Sciences, University of Missouri Kansas City, Kansas City, MO, United States.

School of Medicine, University of Missouri Kansas City, St. Joseph, MO, United States.

出版信息

JMIR Res Protoc. 2024 Dec 4;13:e58895. doi: 10.2196/58895.

Abstract

BACKGROUND

Older adults comprise a substantial proportion of the US population requiring support during disaster events. Previous research demonstrates that older adults are resilient but deficient in disaster preparedness and lacking in community engagement. There is a gap in high-quality research in this area.

OBJECTIVE

This study aims to fill this gap by developing a 4-phase intervention to improve mobility and balance, decrease fall risks (mitigation), increase knowledge of disaster preparedness (preparedness), improve community emergency operation plans (response), and improve self-efficacy in disaster recovery (recovery) for older adults.

METHODS

This is a community-based, 10-month study in a large Midwestern urban and suburban location targeting community-dwelling older adults. The 4 phases of interventions address mitigation, preparedness, response, and recovery-aspects improving outcomes from disaster events. In total, 4 to 6 one-hour seminars each month are provided to community-dwelling older adults to improve disaster preparedness and recovery planning. A critical incident packet with resources on essential information such as medications, a communication plan, evacuation resources, and supplies was started and is being reviewed. Preintervention surveys are orally given, with research assistants aiding in any difficulties the participants have. After the surveys, 2 individual 20-minute presentations separated by a short break for snacks and initial completion of their disaster plan preserve the older adult's attention. Mitigation efforts to improve mobility and safety are offered with 10 visits to the older adults' residences, adapting physical activity and balance exercises to the individual's needs. To address response needs, the emergency operations plans for 2 of the major cities are being amended for specific functional needs and access guidelines. Measurements include accelerometers to assess improvement in mobility, fall risk assessments, an abbreviated Federal Emergency Management Association Household Survey, an assessment for disaster engagement with partners tool, a brief pain inventory assessment, and the General Self-Efficacy Scale. We analyze data descriptively and compare pre- and postintervention data for each phase with paired-samples t test and other nonparametric techniques (proportion tests and Wilcoxon signed-rank tests). Overarching objectives prioritized during this intervention include underscoring respect for the experience and resilience found in older adults and engaging them in specialized roles to support their communities during disaster events.

RESULTS

The intervention was funded in July 2023; enrollment began in November 2023 and is continuing. We will conclude data collection by July 2025. Published study results can be expected in early 2025.

CONCLUSIONS

With improved disaster preparedness, mobility, recovery planning, and inclusion as a resource in community disasters, older adults are expected to be safer and be able to age in place. If successful, future studies will focus on outreach and sustainability. This study will serve as a model for older adult disaster preparedness and community involvement.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/58895.

摘要

背景

在美国人口中,老年人占相当大的比例,他们在灾难事件期间需要得到支持。先前的研究表明,老年人具有恢复力,但在灾难准备方面存在不足,且缺乏社区参与。该领域高质量研究存在空白。

目的

本研究旨在通过开展一项分4个阶段的干预措施来填补这一空白,以改善老年人的行动能力和平衡能力,降低跌倒风险(缓解阶段),增加灾难准备知识(准备阶段),完善社区应急行动计划(应对阶段),并提高老年人在灾难恢复中的自我效能感(恢复阶段)。

方法

这是一项在中西部一个大型城市及郊区开展的为期10个月的社区研究,目标是社区居住的老年人。干预措施的4个阶段涉及缓解、准备、应对和恢复方面,以改善灾难事件的结果。每月总共为社区居住的老年人提供4至6次一小时的研讨会,以改善灾难准备和恢复计划。启动并正在审查一个关键事件数据包,其中包含有关药物、通信计划、疏散资源和物资等基本信息的资源。干预前的调查通过口头方式进行,研究助理会协助解决参与者遇到的任何困难。调查后,进行2次各20分钟的个人陈述,中间有短暂的休息时间用于吃点心,同时让老年人初步完成他们的灾难计划,以保持他们的注意力。通过对老年人住所进行10次探访,根据个人需求调整体育活动和平衡练习,来努力改善行动能力和安全性。为满足应对需求,正在针对两个主要城市的应急行动计划进行修订,以满足特定功能需求和通行准则。测量指标包括用于评估行动能力改善情况的加速度计、跌倒风险评估、简化的联邦紧急事务管理局家庭调查、与合作伙伴的灾难参与评估工具、简短的疼痛量表评估以及一般自我效能量表。我们对数据进行描述性分析,并使用配对样本t检验和其他非参数技术(比例检验和Wilcoxon符号秩检验)比较每个阶段干预前后的数据。在此次干预过程中确定的首要总体目标包括强调对老年人经验和恢复力的尊重,并让他们在灾难事件期间担任特殊角色以支持其社区。

结果

该干预措施于2023年7月获得资助;2023年11月开始招募参与者,目前仍在继续。我们将于2025年7月结束数据收集。预计2025年初会公布研究结果。

结论

通过改善灾难准备、行动能力、恢复计划以及在社区灾难中作为一种资源被纳入其中,预计老年人会更安全,能够在原地养老。如果成功,未来的研究将侧重于推广和可持续性。本研究将成为老年人灾难准备和社区参与的一个典范。

国际注册报告标识符(IRRID):DERR1-10.2196/58895

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