Abstract

In order to formulate effective communication and intervention strategies to respond to the widespread lack of preparedness for public health crises resulting from natural and human-made disasters, researchers have developed models describing the interrelationships between factors associated with emergency preparedness decisions. Empirical research has generally assumed that two key elements of most health behavior theories—self-efficacy and response efficacy—additively influence the decision to prepare, despite compelling theoretical rationale for an interactive relationship. The few studies that have investigated interactions in preparedness outcomes have not tested the Social Cognitive Theory prediction that non-zero levels of both efficacy types are required before individuals will engage in any preparedness behavior. Based on the responses of 3,101 participants in the National Survey of Disaster Experiences and Preparedness, this study tested additive, interactive, and conditional main effect hypotheses about the influence of self-efficacy and response efficacy for dealing with terrorism on preparedness due to terrorism six years after the September 11, 2001, terrorist attacks. A significant self-efficacy × response efficacy interaction effect on preparedness was found, in addition to a significant response efficacy effect when perceived self-efficacy was zero, contrary to the expectation from Social Cognitive Theory. These results offer insights into the cognitive processes underlying individuals’ decisions to prepare for disasters such as terrorist attacks, and highlight the importance of considering more complex theory-based cognitive interaction models in designing effective communication strategies to facilitate individual emergency preparedness.

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