Preparedness Plans Research Articles

Building resilience to the expected Marmara earthquake: Preparing for post-disaster population mobility in Istanbul

Along with other causes of migration, earthquakes have displaced millions of people worldwide over the last few decades, forcing them to move to other settlements within the country. As an "earthquake country", Turkey, where approximately 70% of its territory is located in the seismic zone, has faced a variety of environmentally forced migration that refers to a variety of demographic movements like evacuation, flight, displacement, resettlement, as well as forced migration. Disasters and disaster-related forced migrations as an aspect of survival anxiety have severe and irreversible consequences for the existence of physical security, human dignity, health, livelihoods, shelter, and social, economic, and cultural structures and processes of societies or their subunits. Therefore, disasters and disaster-induced migration, which can be defined as a process of significant vulnerability, are considered widespread and severe threats to the enjoyment and realisation of fundamental rights. Earthquake-related forced migration phenomenon is a widespread and high-risk factor, and this risk corresponds to a closer and more destructive possibility for the province of Istanbul. Therefore becomes vital to take preventive measures to mitigate the possible destructive effects as well as to eliminate the risks as much as possible. This study aims to determine whether relevant legislation is adequate to provide an effective and sufficient protection mechanism for environmental displacement that may occur in Istanbul after a significant earthquake for the purpose of “building resilience in crisis” in the view of international standards. Thus, it also emphasises the importance of the human rights approach and legal mechanisms in establishing resilience during crises. This study has been prepared by content analysing the disaster and emergency preparedness plans, policy texts, and relevant legal and regulatory provisions related to understanding and managing the earthquake-induced migration scenario in Istanbul.

“Challenges and Impact of Disaster on Vulnerable Families in Rapti Sonari Municipality, Banke District”

Nepal is exposed to multiple recurrent hazards. The country falls in the top 20th list of the most multi-hazard prone countries in the world. The country is ranked 4th, 11th and 30th in term of climate change, earthquake and flood risk respectively. The Rapti Sonari Rural Municipality of Banke district is traversed by the west Rapti River from in between. Communities living near the river coastal areas of the municipality are affected by floods every year. In addition to flooding their crops, the water seeps into their houses and damages their stored food and other materials. According to the district disaster preparedness and response plan (DPRP), communities living in the coastal areas of the river of formerly Fatehpur VDC and present Rapti Sonari Rural Municipality wards no. 6 and 7 have been mapped as being at high risk of flooding. Due to the fact that floods during the monsoon damage the paddy fields, the farmers who are vulnerable to the floods are not able to get agricultural production expected hence they are starting to promote winter and spring farming. Such phenomenon’s have caused loss of lives and property in different areas of Nepal and have posed severe hazards to physical infrastructure likes roads and bridges. The floods of August 2008 in Koshi River, Sept. 2008 in Western Nepal and July and August 1993 in the Bagmati and other rivers were the most devastating floods in Nepal. The primary data collection was accomplished himself by the researcher during March 2023. The exploration of gap between policy and practice is the main area of research. What are the best practices, skills and how they (Governmental and nongovernmental organizations) are using this knowledge solving the major problems of poor and vulnerable community is also the issue of research. This study will be helpful for policy makers, stakeholders, province and local government and other researcher to study the well-being and resilience among vulnerable families in targeted area.

The Climate Crisis and Breastfeeding: Opportunities for Resilience.

The climate crisis is an emerging global challenge that poses potential risks to breastfeeding practices and outcomes. There are multifaceted effects of climate change affecting the breastfeeding dyad across environmental, societal, and human health dimensions. Breastfeeding support in the face of climate change will require solutions at the structural level-healthcare, community, and workplace settings-and at the mother-infant dyad level. Breastfeeding can additionally be an adaptive response to crisis situations and can mitigate some of the environmental challenges associated with climate change. Despite the undeniable significance of climate change on breastfeeding (and vice versa), our perspective as experts in the field is that this topic has not been systematically addressed. Although we highlight some of the challenges, potential solutions, and co-benefits of breastfeeding in the context of climate change, there are numerous issues that could be further explored and necessitate additional preparedness planning.

Limited Preparedness: Challenges during Desert Locust Management in Kenya

Desert locust invasions could lead to serious food insecurity. However, effective and efficient management of the pest is usually faced with a myriad of constraints. This study sought to determine the challenges that Kenya faced during the 2019-2021 Desert locust management operations. The study used a mixed methods approach using ex-post facto evaluation and cross-sectional survey designs. The target population included Desert locust affected persons. Multi-stage stratified and purposive sampling were used to target a sample size of 900 respondents drawn from 30 counties that were affected by Desert locusts. Structured questionnaire and focus group discussion (FGD) were used to collect quantitative and qualitative data that was analysed through descriptive and inferential statistics as well as thematic review. The findings revealed that human resource and geographical challenges had 17% and 16% hindrance to Desert locust management, respectively. Technical and coordination challenges contributed 15% obstruction each; while financial limitations had 13% impediment. Political and sociocultural challenges contributed 12% hinderance each. The concludes that challenges during Desert locust management exacerbated human security risks from Desert locusts. The study recommends continuous capacity development through regular maintenance of equipment, continuous training of personnel and periodic update of preparedness plans.

Safety, Security, and Disaster Preparedness Plan of AIMS as Perceived by Internal Stakeholders: Towards the Enhancement of Institutional Safety and Security Plan

Employing descriptive-comparative design, the perception towards the safety, security and disaster preparedness of AIMS was taken from 167 employees and 343 students and strategically compared using T-test and analysis of variance (ANOVA). A standardized questionnaire adapted from the School Safety and Security Checklist by the New York State Police and the Virginia State Education Department was used as instrument during the data gathering period held last 1st Trimester of school year 2022-2023. Demographic profile and mean perception were also statistically treated using frequency, percentage and weighted mean. Based on the results, most of the employee respondents are newly-hired, single, not over 30 years old, physically fit and majority are females. They agreed that AIMS management have a safety and security management plan for its internal stakeholders. However, there are significant differences on their perception when grouped by Department, Position, and Years of Service at AIMS. Specifically, employees who are older and more mature seek improvement and enhancement on the services, facilities, and policies pertaining to safety.
 On the other hand, majority of the student respondents are male, BSMT first year students and claimed to be physically fit. Their perception towards the safety and security management of AIMS were higher compared to the employees. However, no significant difference was shown on their perception towards the safety and security management plan of AIMS when grouped according to their profile. For the school grounds, both respondents imply the need for parking facility improvement while on the school interior, it is recommended to conduct a psychological capability training and access to conflict resolution under the initiative of the Regiment Department.

DISASTER PREPAREDNESS OF COMMUNITY-DWELLING OLDER ADULTS

Abstract Older adults who depend on others for care are especially vulnerable to harm in a disaster. However, the extent to which they are protected depends on the setting in which they live. State and federal regulations require nursing homes and assisted living communities to have preparedness plans that specifically address the needs of their residents. For older adults living at home, however, protections are far less prescriptive, and in some cases lacking altogether, despite the increasing numbers of disabled older adults receiving care in their homes. In this policy-based study, we examined disaster preparedness for community-dwelling older adults in high-disaster states with high populations of older adults. We found that while many of the states required home-based providers to respond to the post-disaster needs of their older adult clients, few took steps to ensure that before the storm they were prepared. In this study, the state of Florida was an exception, with policies calling for service providers to identify and contact at-risk clients before and after an event. The plan further identifies disaster preparedness as a key component of a livable community. Hurricane Ian struck Fort Myers, Florida, in September 2022. Older adults made up a majority of the 148 killed during and immediately after the storm. Many others lost their homes. In the context of this recent event, we will discuss not only the state and local policies, but the practices that affect the health and well-being of community-dwelling older adults faced with a major disaster.

IMPROVING NURSING HOME DISASTER READINESS THROUGH IMPLEMENTATION SCIENCE

Abstract The new investigation on the state of emergency preparedness in nursing homes from the Senate Finance and Aging Committee Chairs is a call to action. As large-scale disasters continue to become increasingly common worldwide, nursing homes, whose residents are more vulnerable to disaster-related health and psychosocial shocks, and their staff, are carrying progressively more responsibility for healthcare readiness practices. Implementation science is a research discipline that seeks to improve uptake of evidence-based practices, such as healthcare readiness planning, and thus has potential to improve nursing home care delivery during and after disasters. The purpose of this review was to describe the limited field of existing evidence-based strategies in the peer-reviewed literature that seek to advance healthcare readiness in the nursing home setting and illustrate how implementation science can better support healthcare readiness planning for nursing homes. We discuss three main themes: 1) implementation science frameworks can strengthen nursing home staff engagement around healthcare readiness; 2) implementation science can support tailoring of emergency preparedness plans to individual nursing homes’ unique needs; and 3) implementation science can advance the integration of nursing homes into local, state, and federal healthcare readiness planning initiatives. Finally, research is urgently needed to both generate and disseminate implementation strategies that increase uptake of evidence-based health care readiness practices in the nursing home setting.

"We are still tired": staff and administrators’ experiences during the COVID-19 pandemic within California residential care facilities for older adults

BackgroundExtensive research has been conducted on the impacts of the COVID-19 pandemic on long-term care workers in specialized care facilities. However, little is known about the impacts faced by facilities that provide generalized long-term support and care, such as residential care facilities for older adults (RCFs). This study describes the challenges experienced by staff and administrators of RCFs during the COVID-19 pandemic.MethodsAn electronic questionnaire collecting data using both closed- and open-ended questions on staff experiences was sent to 5,721 unique RCF administrator emails within the state of California between June-December 2021. Email addresses were obtained from the public database of RCFs available through the California Health and Human Services Open Data Portal. Descriptive statistics were calculated on quantitative data regarding staff preparedness training, access to resources, and administrators’ confidence in meeting recommended guidelines during the pandemic. Inductive thematic analysis was conducted on qualitative data regarding the confidence levels in meeting pandemic guidelines and challenges faced related to staff stress and morale.ResultsA total of 150 RCF administrators across California (response rate of 2.6%) completed the survey. Over three-fourths of respondents indicated their facilities had a designated staff member to train other staff members on emergency preparedness plans and the most frequently used resources during the COVID-19 pandemic were the Department of Social Services Community Care Licensing Division (88.7%), the county health department (86.7%), and the Centers for Disease Control and Prevention (80.7%). Administrators felt least confident in their facilities’ ability to maintain adequate staffing (52.0%), communication with nearby hospitals (62.1%) and communication with state and local public health officials (69.8%) during the pandemic. Three central themes emerged from the thematic analysis on staff stress and morale: (1) physical safety, mental and emotional impact of the COVID-19 pandemic; (2) staffing issues; and (3) challenges with guidelines in managing the ongoing pandemic.ConclusionsFindings from this research study can be used to actively target training resources for facility administrators and staff that have been identified as most frequently used and relevant for emergency preparedness in these understudied facilities. Additionally, developing a better understanding of the staffing stress and morale difficulties in RCFs can provide insight on how policymakers can assist these critical facilities in better preparing for future crises.

Education for disaster resilience: Lessons from El Niño

This paper calls for greater attention to the role of youth and children as development actors in the context of education for disaster management. Drawing on debates in disaster studies and children’s geographies, we explore the possibilities offered by everyday formal education spaces, often overlooked in disasters management practice, to engage children in disaster preparedness and resilience planning. Using the case study of Peru, we examine the extent to which national responses to the restrictions that the COVID-19 pandemic placed on in-person teaching, opened-up opportunities to engage with disaster management in new ways. We draw on the case of an innovative digital curricula that uses intergenerational storytelling about the El Niño phenomenon to investigate livelihood opportunities and climate change pressures in northern coastal Peru, exploring how the phenomenon benefits desert populations. We assess the role of participatory virtual learning in facilitating disaster knowledge and climate adaptation awareness among students and critically examine the youth subjectivities that are constructed through these processes. We conclude calling for greater engagement with children’s formal education spaces in climate adaptation strategies, while cautioning against conceptualising children and young people as only ‘adults in the making’, rather than as impacted individuals with current agency and everyday capacities.

“One community at a time”: promoting community resilience in the face of natural hazards and public health challenges

BackgroundResilience is vital for facing natural disasters and public health challenges. Despite the significance of resilience-building activities, there is a scarcity of locally-tailored planning and response strategies, leaving communities incapable of addressing the unique challenges posed by natural disasters and public health crises. This study aims to explore how the “One Community at a Time” approach enhances community resilience in facing natural hazards and public health challenges.MethodsA systematic review was conducted over journal articles published from January 2001 to April 2023 through PRISMA approach. Multiple databases such as Web of Science and Scopus were thoroughly searched. We used independent screening by two researchers and painstaking data extraction using standardized forms. This approach was adopted to assure the reliability, validity, and precision of our study selection and analysis. The included studies’ quality was evaluated by the Mixed Methods Appraisal Tool.ResultsIn the evaluation, 35 studies were deemed eligible for inclusion and underwent in-depth examination. Several major components of “One Community at a Time” have been identified, including social capital and networks, local knowledge and learning, effective governance and leadership, preparedness and response capacity, and adaptive infrastructure and resources. This framework highlights the significance of individualized approaches to resilience-building initiatives, recognizing that each community has specific strengths, needs, and challenges.ConclusionRelevant stakeholders can adapt suitable resilient strategies to help prepare and recover from natural hazards and public health challenges. By adopting a localized strategy, stakeholders can collaborate to develop a culture of readiness and resilience, ultimately leading to more sustainable and resilient communities. This framework advises community-based groups, local government, and other stakeholders on prioritizing partnerships, preparedness planning, community participation, and leadership as essential components of creating and maintaining resilience. “One Community at a Time” framework offers practical guidance for community-based organizations, local government, and other stakeholders to prioritize partnerships, preparedness planning, community participation, and leadership as essential components of creating and sustaining resilience.

Disaster Preparedness and Staff Well-being in Healthcare Staff: A Comprehensive Study in the UAE

Purpose: This paper examines the crucial role of healthcare administrators in the United Arab Emirates (UAE) in ensuring both disaster preparedness and staff well-being.
 Methodology: It uses mixed methods to review the literature on emergency medical teams in disaster response and the prevalence and impact of burnout among healthcare workers. It also explores factors and interventions to prevent and reduce burnout in the UAE context.
 Findings: Key findings are that administrators have a vital role in preparedness and need strategies for service continuity and quality. They also need to address staff burnout and its impact on patient care by implementing interventions to prevent and reduce it.
 Unique Contribution to Theory, Practice and Policy: The paper proposes recommendations for healthcare administrators in the UAE to improve their disaster preparedness and staff well-being strategies based on evidence and best practices. Disaster preparedness and staff well-being are interrelated in healthcare administration, affecting patient care quality and safety. Administrators should integrate well-being initiatives into preparedness planning and leverage related resources and expertise. Recommendations for healthcare organizations include enhancing preparedness efforts, prioritizing staff well-being, and integrating related interventions for positive implications on staff and patient health and well-being, organizational resilience and performance, and community resilience. The paper emphasizes administrators' important roles in promoting preparedness and staff well-being in the UAE context.

Increased domestic violence during the COVID‐19 pandemic: India's response

AbstractMotivationDomestic abuse of women, despite being illegal, is common in India: on average, every 4.4 minutes a woman suffers abuse. During the pandemic, owing to curfew and lockdowns, women had additional caring responsibilities, but they lacked social support. A legal system made lethargic by lockdowns, lack of safety protocols for dealing with cases of domestic violence during the pandemic, extended delays in processing cases, and limited protection for victims—all combined to increase domestic violence nationwide.PurposeWhat was the response of the Indian government to domestic violence during the COVID‐19 pandemic? We evaluate policies and interventions through the lens of intersectional feminism and social equity.Methods and approachWe review publicly available documents and scholarly journals published between 2018 and 2022. We identify the national anti‐domestic violence and state‐specific programmes offered to women in India. We critically evaluate the country's anti‐domestic violence campaign. The policy analysis draws on the cultural knowledge and professional expertise of the authors.FindingsThe government's efforts to address domestic violence during the pandemic were limited. Pre‐existing vulnerabilities such as economic hardship, the gender‐based digital divide, and strict gender roles were exacerbated by the pandemic. Although the government tried to address domestic violence, through helplines, keeping shelters open and offering virtual court sessions, it also released convicted abusers from prison, increasing women's vulnerability. Government and non‐governmental organization interventions were not scaled up to meet demand. Many programmes had little oversight and quality control, resulting in differential results that often further victimized victims of domestic violence among vulnerable populations.Policy implicationsOur findings highlight the importance of services and policies on domestic violence being explicit and sensitive to the culture and context in disaster preparedness and public health emergency planning.

Planning with a gender lens: A gender analysis of pandemic preparedness plans from eight countries in Africa

BackgroundHealth planning and priority setting with a gender lens can help to anticipate and mitigate vulnerabilities that women and girls may experience in health systems, which is especially relevant during health emergencies. This study examined how gender considerations were accounted for in COVID-19 pandemic response planning in a subset of countries in Africa. MethodsMulti-country document review of national pandemic response plans (published before July 2020 and as of March 2022) from Ethiopia, Ghana, Kenya, Nigeria, Rwanda, South Africa, Uganda, and Zambia, supplemented with secondary data on gender representation on planning committees. A gender analysis framework informed the study design and the Morgan et al. matrix guided data extraction and analysis. ResultsAll plans reflected implicit and explicit considerations of the impacts of the pandemic responses on women and girls. Through a gender lens, the implicit considerations focused on ensuring safety and protections (e.g., training, access to personal protective equipment) for community and facility-based health care workers and broad engagement of the community in risk communication. The explicit gender considerations, reflected in a minority of plans, focused on addressing gender-based violence and providing access to essential services (e.g., sexual and reproductive health care, psychosocial supports), products (e.g., menstrual hygiene products) and social protection measures. Women were underrepresented on the COVID-19 planning committees in all countries. ConclusionsThe plans reflected varying national efforts to develop pandemic responses that anticipated and reflected unique vulnerabilities faced by women, though subsequent plans reflected further consideration of gender-relevant impacts compared to initial plans. Embedding a gender lens in emergency preparedness planning furthers equity and could support anticipation and timely mitigation of negative outcomes for women and girls who are often further marginalized during health emergencies.

Implications of trust, preparedness, risk perceptions, and local context on deprivation costs and disaster relief planning

Deprivation Costs Functions (DCFs) are key to designing effective relief distribution operations after disasters. In this paper, data are collected in Colombia and Ecuador to estimate DCFs for water and food, considering the influence of individuals' attitudes on preparedness, risk perception, and trust in response agents. Hybrid Choice Models are used to analyze and compare the estimated DCFs. The analyses confirm that DCFs differ by commodity. Additionally, socioeconomic characteristics of individuals influence their willingness to pay for critical supplies to reduce their own suffering. Preparedness, risk perceptions and trust in response agents impact individuals' behavior in disaster situations. The results also show that community and religious groups are considered the most trusted response agents in both countries. As a result, their involvement in official relief efforts should be more articulated. Colombia and Ecuador show significant differences in their estimated DCFs, confirming that deprivation costs are context-specific by nature. As such, DCFs should not be directly transferred among disaster locations. The findings from this study will support decision-makers in designing effective preparedness and response plans that are based on trust relationships that serve as foundations for community resilience.

FIND: A Synthetic weather generator to control drought Frequency, Intensity, and Duration

Water systems worldwide are experiencing climate change-induced shifts in drought properties like frequency, intensity, and duration, affecting water security and reliability. To develop and test effective drought preparedness plans, researchers often use synthetic weather generators to create hydrological scenarios that explore drought variability beyond historical records. Existing weather generators typically allow users to adjust streamflow statistics like percentiles or temporal correlation but do not directly control drought properties of frequency, intensity, and duration. To fill this gap, we propose FIND (Frequency, INtensity, and Duration) synthetic weather generator. FIND incorporates a standardized drought index to directly and independently control drought frequency, intensity, and duration in generated streamflow time series while preserving observed hydrological variability. Use cases for FIND include (i) water systems analysis applications that seek to train and test drought strategies under historical and plausible future drought conditions, and (ii) bottom-up vulnerability studies relating system vulnerability outcomes to specific changes in drought properties of frequency, intensity, and duration. We demonstrate FIND’s versatility through three experiments: replicating historically observed drought properties, generating streamflow scenarios for multiple sites preserving correlation between their drought conditions, and generating a set of scenarios with direct and independent changes in drought properties. FIND source code is openly available for applications beyond the scope of this paper.

Challenge of Managing Hospitals during the COVID-19 Pandemic: A Qualita-tive Study

Background: The COVID-19 pandemic has posed many challenges on the health system and hospitals to provide services. This study investigated the difference between factors affecting hospital management which considered in preparing a disaster management plan for hospital in the face of a pandemic based on the experiences of hospital managers.
 Methods: This qualitative research was conducted on selected hospitals affiliated in Alborz University of Medical Sciences in 2021. Data were gathered with purposive sampling and semi-structured interviews with 16 hospital managers. MAXQDA 10 and framework analysis were used to analyze the data.
 Results: The results were categorized in four categories: 1) Mitigation including staffing, bed capacity, enough space for quarantines, protective equipment, diagnosis and treatment equipment, funding, medicines, patient follow-up, management and leadership; 2) Preparedness such as crisis committee, preparedness and response plan, measures, action plan; 3) Response including motivating health workers, cooperation and coordination; 4) Recovery and lessons learned including providing facilities, expediting patient processes, control, economic conditions, and planning better, passive defense, regular crisis committee meetings, human resources, documentation and use of information systems in planning.
 Conclusion: In addition to providing the necessary infrastructure, it is important to plan for fair distribution of resources and effective supply chain management. A mechanism should also be developed at the national level to anticipate future health crises and to prevent and control diseases in the most effective way.

COVID-19 risk communication gaps, needs, and strategies related to pandemic preparedness plans among vulnerable, Black American subgroups: A qualitative study

ObjectiveImproving current and future risk communication plans is critical mitigate the COVID-19 pandemic and begin to prepare for future pandemics. Minority groups, particularly African Americans, have been limited in engagement to prepare these plans which has been demonstrated to disadvantageous. We report findings from a qualitative study that describes gaps, needs, and strategies to improve communication among vulnerable, Black American subgroups during the COVID-19 pandemic. MethodsSixty-two Black Americans in uniquely, vulnerable subgroups participated in qualitative, semi-structured interviews from May to September 2020. Thematic analyses were used to identify themes. ResultsParticipants were 16 essential workers, 16 parents, 15 young adults, and 15 individuals with underlying medical conditions. Emerging themes were: (1) Poor communication and miscommunication fueled fear and confusion; (2) Information sources and channels: How do I choose one?; (3) Communication needs were simple yet complex; (4) All information sources are not trusted information sources; (5) Preferred yet trusted channels and types of information; and (6) Dissemination of COVID Research: Why and How. Subgroups varied in information sources and processes for choosing the source, communication needs, and channels and types of information needed. They shared why they did and did not trust certain sources along with the importance of COVID research dissemination to promote informed decision-making throughout the pandemic. DiscussionThis study found that Black American subgroups had diverse, yet trusted and non-trusted messages, messengers, and strategies for communication and wanted research results disseminated. We describe multi-level stakeholders and strategies to help improve risk communication for pandemics, and potentially preparedness and health outcomes.

Insights and viewpoints from a small-scale survey on current nuclear disaster preparedness measures in Japan after the Fukushima Daiichi Nuclear Power Plant accident

In nuclear disaster prevention, it is essential not only to make daily efforts to prevent accidents from occurring but also to properly apply lessons learnt from actual disasters. Although significant changes have been made to nuclear disaster preparedness in Japan since the Fukushima Daiichi Nuclear Power Plant accident, there is insufficient information on whether these changes have been evaluated as practical and appropriate for the needs of the Japanese public. In this survey, 20 officials of the Cabinet Office and Japan Atomic Energy Agency, in charge of planning nuclear disaster prevention policy, were asked to evaluate the current nuclear disaster prevention plan through a questionnaire, and compare it with that before the accident, and indicate what elements are lacking in the current plan. The survey results revealed that 30% of the participants (six respondents) had a positive view of the enhancement of resources, including physical and human assets. However, as many as 60% (12 respondents) expressed negative sentiments, primarily due to perceived deficiencies in organisational measures, particularly the coordination of these resources. Moreover, the participants expressed keen interest in obtaining health data during evacuation, along with information on the physical and mental effects on evacuees living in evacuation centres. These crucial insights can inform the formulation of effective future preparedness plans for evacuation and radiation protection.

Delivering health promotion during school closures in public health emergencies: building consensus among Canadian experts

Abstract School-based health promotion is drastically disrupted by school closures during public health emergencies or natural disasters. Climate change will likely accelerate the frequency of these events and hence school closures. We identified innovative health promotion practices delivered during COVID-19 school closures and sought consensus among education experts on their future utility. Fifteen health promotion practices delivered in 87 schools across Alberta, Canada during COVID-19 school closures in Spring 2020, were grouped into: ‘awareness of healthy lifestyle behaviours and mental wellness’, ‘virtual events’, ‘tangible supports’ and ‘school-student-family connectedness’. Two expert panels (23 school-level practitioners and 20 decision-makers at the school board and provincial levels) rated practices on feasibility, acceptability, reach, effectiveness, cost-effectiveness and other criteria in three rounds of online Delphi surveys. Consensus was reached if 70% or more participants (strongly) agreed with a statement, (strongly) disagreed or neither. Participants agreed all practices require planning, preparation and training before implementation and additional staff time and most require external support or partnerships. Participants rated ‘awareness of healthy lifestyle behaviours and mental wellness’ and ‘virtual events’ as easy and quick to implement, effective and cost-effective, sustainable, easy to integrate into curriculum, well received by students and teachers, benefit school culture and require no additional funding/resources. ‘Tangible supports’ (equipment, food) and ‘school-student-family connectedness’ were rated as most likely to reach vulnerable students and families. Health promotion practices presented herein can inform emergency preparedness plans and are critical to ensuring health remains a priority during public health emergencies and natural disasters.

Abstract A107: The role of social network and provider support on access to care in Puerto Rican and US Virgin Islands gynecologic cancer patients post-Hurricanes Maria and Irma

Abstract Background: Hurricanes Irma and Maria touched down on Puerto Rico (PR) and the US Virgin Islands in 2017 with devastating impacts. Essential infrastructure, services, and the overall environment were impacted, forcing residents to adapt or migrate amid these natural disasters. With Gynecologic cancers representing over 15% of all cancer in Puerto Rican women, these patients were at a high risk of experiencing challenges and barriers detrimental to their health outcomes. This study assessed how social networks (i.e., immediate family, friends, and neighbors) and provider (i.e., oncologists, oncology associations, and hospitals) support played a role in accessing health services by gynecologic cancer patients in the aftermath of the hurricanes. Methods: In-depth interviews were conducted to assess hurricane-related stressors and disaster responses. PR (n=24) and US Virgin Island (n=2) gynecologic cancer patients participated across 4 focus groups (December 2018-April 2019). Key cancer stakeholders were individually interviewed, consisting of oncology care providers and administrators (n=23) providing services in PR. All interviews were recorded, transcribed (verbatim), and coded with emerging themes using inductive methods. Results: The analysis highlighted the impact of stressors and multi-level responses on health outcomes for the patients. The identified emerging themes and subcodes included: 1) Health Access; 2) Stressors; 3) Emergency Response to Communication methods. Participants highlighted how their health needs were satisfied or not during the aftermath of the disasters primarily based on the availability of support from their social network and on recorded responses of available providers and clinics. They also detailed the expression of diverse stressors (i.e., primary, secondary, psychosocial, environmental) experienced while searching for health services. Regarding communications, patients and providers detailed several mechanisms of non-traditional patient-provider communication, such as WhatsApp group messaging, telephone robocalls for texting, leaving written notes at clinics or homes, and traveling outside PR to communicate with outside and local resources. Conclusion: The study demonstrated that social and provider support was critical in patients accessing care. A supportive social network facilitated access to health management, treatments, and primary service (i.e., water and electricity). Conversely, patients with minimal to no social support expressed difficulty improving these areas. Health providers also played an essential role with their patients and in the community by providing innovative alternative resources beyond planned emergency response. Implications for safety data management and sharing are in place when managing adverse outcomes in emergency planning. These results are imperative to include in future emergency preparedness plans for PR to prevent and mitigate the effects of natural disasters among vulnerable populations, such as cancer patients. Citation Format: Celeste M. Charchalac-Zapeta, Edna Acosta-Perez, Sandra I Garcia-Camacho, Mirza Rivera, Ana Patricia Ortiz Martinez. The role of social network and provider support on access to care in Puerto Rican and US Virgin Islands gynecologic cancer patients post-Hurricanes Maria and Irma [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A107.