Analysis of Risk Communication Strategies and Approaches with At-Risk Populations to Enhance Emergency Preparedness, Response, and Recovery: Final Report. Identification of Gaps and Commonalities

12/01/2008

In addition to the qualitative review of those resources labeled all-stars, we also analyzed the compendium itself to provide a general analysis of gaps and commonalities among those resources identified as emergency risk communications for vulnerable populations. Table 2 presents breakdowns of the 242 resources by key variables in the compendium. For ease of comprehension, categories have been ordered in descending frequency, except for stage of preparedness, which has a natural ordering.

The resources came almost equally from government and non-government sources. Text was the medium of choice, with relatively few audio/visual or interactive resources. Equal number of resources targeted members of vulnerable populations and their caregivers, with somewhat fewer resources targeting providers. Some of this latter effect may have been due to limiting the provider resources to just those specifically giving guidance on risk communication.

Among the resources that we found, there was great variation in the number of resources targeting different vulnerable populations. Many resources were directed at the disabled and children, with smaller but still sizeable numbers targeting the elderly and those with chronic medical conditions. Relatively few resources were found for the other vulnerable populations. It should be noted, however, that there was often considerable overlap among these categories, particularly between disabled and chronic medical conditions and between elderly and chronic medical conditions. Those resources labeled “other” for vulnerable population include those with mental or cognitive impairments, service animals, those with environmental illnesses or chemical sensitivities, and those dependent on medical devices.

Most of the resources were not specific to one type of emergency or took an all hazards approach. When they did specify an emergency type, it was most likely a natural disaster (an emergency type particularly common in resources targeting children). The remaining few focused on terrorist threats or incidents, infectious disease outbreaks, other emergencies (primarily fires), and man-made disasters. Virtually no resources specifically targeted pandemic diseases, which may differ from other public health emergencies in time horizon (two or three waves of 6-8 weeks duration versus days), greater immunologic risks for certain vulnerable populations, and greater need for personal resilience.

  TABLE 2. Compendium Resources by Source, Medium, Audience, Message, and Key Behavior  
Resource Characteristica   Percent (N = 242)  
SOURCE
   Government 55%
   Non-government 46%
MEDIUM
   Text 89%
   Interactive, electronic 7%
   Audio/visual 4%
   Interactive, personal <1%
RECIPIENT: TARGET AUDIENCE
   Vulnerable individual 53%
   Caregiver 53%
   Provider 38%
RECIPIENT: VULNERABLE POPULATION
   Disabled 42%
   Children 39%
   Elderly 22%
   Chronic medical disorders 20%
   Institutionalized 8%
   Pharmacologically dependent 4%
   Diverse cultures 3%
   Transportation disadvantaged 2%
   Pregnant women 2%
   Limited English or non-English speakers <1%
   Other 7%
MESSAGE: EMERGENCY TYPE
   Natural disaster 27%
   Terrorist threat or incident 7%
   Infectious disease outbreak 5%
   Other emergency 5%
   Man-made disaster 4%
   Infectious disease pandemic <1%
   Unspecified 65%
MESSAGE: STAGE OF PREPAREDNESS
   Preparation 76%
   Response 29%
   Mitigation and Recovery 32%
TARGET BEHAVIOR: FUNCTIONAL AREAS
   Communication 89%
   Medical care 33%
   Maintaining independence 15%
   Transportation 13%
   Supervision 3%
   Other 34%
  1. Categories are not mutually exclusive, so may add up to more than 100%.

As might be expected, given that we are normally looking toward future emergencies, most resources addressed a preparation stage of preparedness. However, a moderate amount also addressed response, mitigation, and recovery.

As might also be expected, given the focus on risk communication, most resources targeted communication issues. Many also dealt with medical care, with somewhat less of a focus on maintaining independence and transportation issues. Relatively few dealt with supervision. The bulk of those falling in the “other” functional area focused on stress, coping, and mental health.

Finally, of those resources compiled, only 24 (10 percent) were also found to be translated into other languages, with Spanish being the most common. It should be noted, however, that this compendium was not designed to capture all translated materials, but rather we flagged when materials that met other inclusion criteria were also translated. Nevertheless, surprisingly few resources targeting vulnerable populations are also available in other languages (or easily identified as such).

Table 3 presents a cross-tabulation of vulnerable population by emergency type. Within both natural disasters and unspecified emergencies, the two most common emergency types, the frequency of different vulnerable population resources parallels the total (presented in the final column), with disabled being the most common vulnerable population targeted. However, for terrorist threats, infectious disease outbreaks, and man-made disasters, children (or those caring for them) are much more likely to be the intended recipient, rather than the disabled. The sparseness of coverage for many vulnerable populations (noted above and in Table 2) is demonstrated here across different emergency types.

TABLE 3. Number of Resources Targeting Each Vulnerable Population by Emergency Type
Vulnerable Population Emergency Typea,b
  ND     TT     IDO     OE     MMD     UNS     Total  
Disabled 37 1 0 9 1 69 102
Children 24 13 6 2 8 54 94
Elderly 7 3 3 5 2 42 54
Chronic medical disorders 7 2 6 0 1 36 48
Institutionalized 1 1 5 0 0 13 19
Pharmacologically dependent 1 0 0 0 0 8 9
Diverse cultures 0 1 0 0 1 5 6
Transportation disadvantaged   0 0 0 0 0 5 5
Pregnant women 0 0 1 0 0 4 5
Other 7 1 0 1 1 10 16
Total 65 16 12 12 9 158 242
  1. Categories with fewer than 1% coverage (infectious disease pandemic, limited English or non-English speakers) are not tabulated. Categories are not mutually exclusive, so sum to more than 100%.
  2. ND = natural disaster; TT = terrorist threat or incident; IDO = infectious disease outbreak; OE = other emergency; MMD = man-made disaster; UNS = unspecified.

 

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