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Effectiveness of a Primary Health Care Program on Urban and Rural Community Disaster Preparedness, Islamic Republic of Iran: A Community Intervention Trial

Published online by Cambridge University Press:  26 November 2013

Ali Ardalan ,
Hani Mowafi ,
Hossein Malekafzali Ardakani ,
Farid Abolhasanai ,
Ali-Mohammad Zanganeh ,
Hossein Safizadeh ,
Sirous Salari  and
Vahid Zonoobi
Ali Ardalan*
Affiliation:
Department of Disaster and Emergency Health, National Institute of Health Research, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts
Hani Mowafi
Affiliation:
Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts Yale University, School of Medicine, New Haven, Connecticut
Hossein Malekafzali Ardakani
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Farid Abolhasanai
Affiliation:
Department of Public Health, Tehran, School of Public Health, Tehran University of Medical Sciences, Iran
Ali-Mohammad Zanganeh
Affiliation:
Department of Public Health, Golestan University of Medical Sciences, Tehran, Iran
Hossein Safizadeh
Affiliation:
Department of Public Health, Kerman University of Medical Sciences, Tehran, Iran
Sirous Salari
Affiliation:
Department of Public Health, Kerman University of Medical Sciences, Tehran, Iran
Vahid Zonoobi
Affiliation:
Disaster Management Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
*
Address correspondence and reprint requests to Ali Ardalan MD, PhD, Associate Professor and Department Chair, Department of Disaster and Emergency Health, National Institute of Health Research, Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, No. 78, Italia Ave, Tehran, Iran (e-mail aardalan@tums.ac.ir).
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Abstract

Background

To evaluate the effectiveness of a capacity-building intervention administered through a primary health care (PHC) system on community disaster preparedness in Iran.

Methods

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.

Results

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).

Conclusions

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. (Disaster Med Public Health Preparedness. 2013;7:481-490)

Keywords

disasterpreparednessprimary health careIran
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 7 , Issue 5 , October 2013 , pp. 481 - 490
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2013 

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