Community Advantage and Individual Self-Efficacy Promote Disaster Preparedness: A Multilevel Model among Persons with Disabilities.

Abstract

Disaster preparedness initiatives are increasingly focused on building community resilience. Preparedness research has correspondingly shifted its attention to community-level attributes that can support a community’s capacity to respond to and recover from disasters. While research at the community level is integral to building resilience, it may not address the specific barriers and motivators to getting individuals prepared. In particular, people with disabilities are vulnerable to disasters, yet research suggests that they are less likely to engage in preparedness behaviors. Limited research has examined what factors influence their ability to prepare, with no studies examining both the individual and community characteristics that impact these behaviors. Multilevel modeling thus offers a novel contribution that can assess both levels of influence. Using Los Angeles County community survey data from the Public Health Response to Emergent Threats Survey and the Healthy Places Index, we examined how social cognitive and community factors influence the relationship between disability and preparedness. Results from hierarchical linear regression models found that participants with poor health and who possessed activity limitations engaged in fewer preparedness behaviors. Self-efficacy significantly mediated the relationship between self-rated health and disaster preparedness. Living in a community with greater advantages, particularly with more advantaged social and housing attributes, reduced the negative association between poor self-rated health and preparedness. This study highlights the importance of both individual and community factors in influencing people with disabilities to prepare. Policy and programming should therefore be two-fold, both targeting self-efficacy as a proximal influence on preparedness behaviors and also addressing upstream factors related to community advantage that can create opportunities to support behavioral change while bolstering overall community resilience.