Risk Reduction Activities Research Articles

A structured methodology to peer review disaster risk reduction activities: The Viable System Review

This paper develops a theoretically underpinned peer review approach (called Viable System Review) to assess and strengthen disaster risk reduction (DRR) practices. This topic is timely as countries and cities look to learn lessons from others to respond to global priorities on DRR. Unlike other peer review methodologies which rely on expert intuition to navigate peer review issues, our new methodology structures the peer review process through an organising framework of concepts. That framework is theoretically underpinned by systems thinking and concepts from the Viable System Model which provides a comprehensive, tested approach to assess organisational performance. The paper explores the development and application of our new peer review methodology (which we call Viable System Review) to the policy developed by Concepcion Province (Chile) on involving spontaneous volunteers in disaster situations. The peer review took place over six days, involved seven reviewers, and focused on identifying good practices, opportunities to enhance practice, and lessons they could take back to their home organisations. The paper presents our Viable System Review methodology, reflects on its application, and discusses its practical and theoretical contributions.

The assessment of quantitative risk to road users from debris flow

BackgroundA methodology for the quantitative risk assessment (QRA) of the impact of debris flow in a road environment has been developed and applied to two sites that are typically subject to high frequency-low magnitude and low frequency-high magnitude events. The methodology considers the probability of an event of a typical size, and the conditional probabilities of a vehicle being affected, given an event, and of damage (fatality) occurring given that the vehicle is affected. Scenarios covering a vehicle being hit by a debris flow and of a vehicle hitting a debris flow are considered. The computed Personal Individual Risk (PIR) is used to calculate worst case fatality probabilities for commuters and logistics truck drivers. The overall risk to society is expressed both by the annual probability of fatality amongst all road users, the Potential Loss of Life (PLL), and using the F-N diagram and is used to demonstrate the effect of a programme of management and mitigation works on the societal risk at one of the sites. The authors believe that this is the first full, formal quantitative risk assessment for debris flow risk to road users.ResultsThe PIR for a single trip through the sites ranges between 1.147E-10 for the low frequency-high magnitude site and 1.583E-09 for the high frequency-low magnitude site. These figures increase to 1.248E-07 and 1.922E-06, respectively, when more frequent travellers are considered. The PLL for the two sites ranges between 2.616E-04 for the low frequency-high magnitude site and 4.083E-03 for the high frequency-low magnitude site. The F-N diagrams illustrate the Broadly Acceptable level of risk at the low frequency-high magnitude site and the partially Unacceptable level of risk at the high frequency-low magnitude site. The risk at the high frequency-low magnitude site is reduced to ALARP levels when management and mitigation measures extant as of October 2014 are considered.ConclusionsThe QRA proves an effective technique for understanding, comparing and articulating the differences in levels of risk and the temporal changes in risk at a given site as a result of landslide risk reduction activities.

Investigating causal relationship of disaster risk reduction activities in the Indian context

This study focuses on the identification of disaster risk reduction (DRR) activities which are carried out during pre and post-disasters to save the lives of the population under risk of disasters. Odisha, one of the disaster-prone states in India has been taken as a case study to identify the relevant DRR activities for cyclone and later the efforts were made to explore the strength of identified DRR activities and causal relationship between them by using decision-making trial and evaluation laboratory (DEMATEL) method. The activities used in these processes were finalised after the detailed discussion with policymakers and academicians working at the various levels and capacities of disaster management and allied domain of DRR. The results of this study show that cause group activities influence effect group activities, and emergency planning at various levels was found to be the most influencing DRR activity among other activities.

Investigating causal relationship of disaster risk reduction activities in the Indian context

This study focuses on the identification of disaster risk reduction (DRR) activities which are carried out during pre and post-disasters to save the lives of the population under risk of disasters. Odisha, one of the disaster-prone states in India has been taken as a case study to identify the relevant DRR activities for cyclone and later the efforts were made to explore the strength of identified DRR activities and causal relationship between them by using decision-making trial and evaluation laboratory (DEMATEL) method. The activities used in these processes were finalised after the detailed discussion with policymakers and academicians working at the various levels and capacities of disaster management and allied domain of DRR. The results of this study show that cause group activities influence effect group activities, and emergency planning at various levels was found to be the most influencing DRR activity among other activities.

Methodological approach to risk-assignment for joint ventures in energy industry

The article provides guidance about risk allotment regarding to joint ventures operating in energy industry. Energy industry has been overwhelmed by risk, in compare to other branches. To diminish the chance of failure on international partnership, risk management techniques should be based on methodological principals. The paper presents outlook to risk in response to the stage of a joint project. The methodological approach is structured in accordance with risk group hierarchy received with Delphi evaluation method. Thus, joint ventures parties are allowed to complete an effective review in order to implement risk reduction actions.

Support for regulatory and voluntary approaches to wildfire adaptation among unincorporated wildland-urban interface communities

Regulation of building standards and residential development practices in the wildland-urban interface (WUI) is increasingly advocated as a possible avenue for wildfire risk reduction. However, many documented instances of successful wildfire adaptation occur in incorporated communities with local governments or formalized structures for channeling such efforts. Less research has explored whether regulatory approaches might be a viable option for adaptation in unincorporated communities without local governments, particularly from the perspective of community members and local professionals. The research presented here attempts to understand strategies, programs or incentives that local residents think would best advance fire adaptation in their communities given local social context, with a focus on both regulatory and voluntary approaches. Data presented come from focus groups of residents and professionals in Story, Wyoming, and Timber Lakes, Utah. Participants in both communities displayed low support for regulatory approaches due to distrust in local, state, or federal governments, preferring instead to conduct wildfire risk reduction activities on a voluntary basis. Each population was willing to consider regulatory approaches only if associated standards or policies were specifically tailored to their community, channeled through a trusted organizing body and organized by community leaders. Residents were interested in regulatory efforts that allowed community members the opportunity to act at the local level, govern efforts themselves, and produce tangible benefits for their community. We discuss implications for identifying appropriate voluntary and regulatory wildfire risk reduction approaches in unincorporated or rural communities and provide suggestions for encouraging collective action in similar local contexts.

Cross-Cultural Adaptation and Validation of the 10-Item Conjoint Community Resiliency Assessment Measurement in a Community-Based Sample in Southwest China

Community resilience has received growing attention in disaster risk management policies and practices, especially in China. However, few applicable instruments are available as a baseline for profiling and estimating a community’s resiliency in the face of disasters. The purpose of this study is to cross-culturally adapt and validate the original version of the 10-Item Conjoint Community Resiliency Assessment Measurement (CCRAM-10) in China. Our study further investigates if and to what extent community members translate their participation in disaster risk reduction (DRR) activities into perceived community resilience. A Chinese version of CCRAM-10 was generated and applied to 369 participants from a rural and an urban community in southwest China affected by the 2008 Wenchuan Earthquake. Internal consistency reliability and confirmatory factor analyses were performed to test the assessment instrument’s applicability. The Communities Advancing Resilience Toolkit Assessment Survey was used to establish the convergent validity for the Chinese version of CCRAM-10. Multiple linear regression models were used to explore the correlations between respondents’ participation in activities and their perception of community resilience, while controlling for basic socio-demographic variables. Analysis results demonstrated good internal consistency reliability (Cronbach’s alpha = 0.85) and satisfactory convergent validity for the Chinese version of the CCRAM-10. Construct validity was also confirmed (χ2/df = 2.161; CFI = 0.977; GFI = 0.971; NFI = 0.958; RMSEA = 0.056; SRMR = 0.030). The regression analysis results indicated that respondents’ participation in DRR activities was positively correlated with their perception of community resilience. This study contributes to the wider collection of disaster studies by providing a tested tool for assessing community resilience in the context of China. Community workers and practice researchers may be interested in applying CCRAM-10 to evaluate the effect of specific DRR programmatic activities for improving community resilience.

Vulnerability framework of tourism to natural disasters

Natural disaster is a major challenge to tourism destinations. Thus, a vulnerability analysis is required as a part of disaster risk reduction to ensure their sustainability. This study aimed to present an analysis of the tourism vulnerability framework for those areas that face natural prone disasters. To achieve the study purpose, the framework was developed through a review of research papers that focusing on the application of vulnerability approach in sustainable tourism discourse. The search databases used for literature review including Google Scholar, SCOPUS and Science Direct. The primary result is discussed using the constructs of Vulnerability Framework for Sustainable Tourism Development (VFSTD), which composed of several elements: shocks-stressors, exposure, sensitivity and system adaptiveness. The VFSTF is fundamentally adopted from Turner Vulnerability Analysis in Sustainability Science, which highlights the integration of vulnerability approach and sustainability science as a system. For tourism as a core, VFSTD would helpful in clarifying the fundamental of vulnerability analysis and enhancing the effectiveness of risk reduction action for tourism in disaster-prone areas. Particularly, users of VFSTD would able to explore the factors and processes that create and perpetuate vulnerability to natural disasters in tourism destinations and elicit adjustment and feedback to encourage tourism sustainability more holistically. Keywords: conceptual framework, natural disaster, sustainable tourism, tourism destination, tourism vulnerability, vulnerability analysis

The natural environment as a disaster hazard

PurposeThe rapid deterioration of the earth’s natural ecosystems are increasing the risk of human morbidity and mortality worldwide. Hydrometeorological hazards are concentrating contaminants from the damaged environment and exposing large vulnerable populations to life threating illnesses and death. This study performed a retrospective health risk assessment on two recent events where such impacts unfolded, namely, the 2015 south east Equatorial Asia smoke haze disaster and the 2016 Melbourne thunderstorm asthma epidemic. The purpose of this paper is to test if the characterisation of health risk warranted earlier and more effective risk reduction activities prior to the disasters occurring.Design/methodology/approachA retrospective health risk characterisation assessment was performed combing United Nations International Strategy for Disaster Risk Health Aspect in Disaster Risk Assessment (2017) framework with a thematic and targeted word literature review to identify the level of risk knowledge prior to each event. A risk characterisation matrix was then created to characterise the health risk of each hazard event.FindingsThe 2015 south east Equatorial Asia smoke haze disaster risk assessment was characterised as “extreme” health risk and the 2016 Melbourne thunderstorm asthma epidemic was characterised as “high” health risk.Practical implicationsReaching the goals of the Sendai Framework require strategies and plans which urgently address the catastrophic level of mortality risk posed by exposure to environmental contaminants.Originality/valueInnovative approaches and partnerships are necessary to mitigate the risk from the deteriorating health of the environment and natural ecosystems, along with disaster response initiatives that reduce exposure of vulnerable people on a large scale.

Protecting against disaster risks: Why insurance and prevention may be complements

We examine mechanisms as to why insurance and individual risk reduction activities are complements instead of substitutes. We use data on flood risk reduction activities and flood insurance purchases by surveying more than 1000 homeowners in New York City after they experienced Hurricane Sandy. Insurance is a complement to loss reduction measures undertaken well before the threat of suffering a loss, which is the opposite of a moral hazard effect of insurance coverage. In contrast, insurance acts as a substitute for emergency preparedness measures that can be taken when a loss is imminent, which implies that financial incentives or regulations are needed to encourage insured people to take these measures. We find that mechanisms leading to preferred risk selection are related to past flood damage and a crowding out effect of federal disaster assistance as well as behavioral motivations to reduce risk.

South African community in Auckland

PurposeThe purpose of this paper is to investigate the resilience of the South African community in Auckland to a potential hazard event.Design/methodology/approachThe research collected data from both primary and secondary sources. The research used parametric and non-parametric analytical procedures for quantitative data and a general inductive approach to qualitative data analysis and a three-step coding cycle for interviews. A content analytical process of theme formation was used to analyse secondary materials. The research discussed findings in line with related studies on community resilience.FindingsThe aggregate community resilience index was above average on the scale of 1–5. The highest and lowest contributions to the resilience of the South African community came from communication and information and physical capacities of the community. Although the highest contribution came from the communication domain, there is a need to sensitise the community on the importance of real-time information for resilience. Community ability to respond as a first responder and to access diverse sources was low because of a lack of interest in disaster risk reduction activities and membership of associations. Intervention in the economic domain and affordable housing is needed to assist low-income earners in coping with a potential disaster and enhance future resilience.Research limitations/implicationsThe practical resilience of the community is limited to the time of this research. The state of resilience might change in longitudinal research due to changes in resources and ecosystem. The research did not consider institutional and natural domains because its focus was to predict resilience at the individual level.Practical implicationsAt-risk societies could enhance their resilience through a periodic audit into its resources, identify indicators of low resilience and carry out interventions to address potential vulnerabilities. Besides the importance of resource in resilience, the research illuminates the need to address the question of who is resilient and resources distribution in the community. The issues are imperative in community resilience as they underpinned the personal ability to preparedness, response and recover from a disaster.Originality/valueAlthough the research provides insight into the resilience of the South African community, it constitutes preliminary research towards a further understanding of the resilience of the South African community in Auckland.

A REVIEW OF THE OUTCOME OF THE GLOBAL PLATFORM FOR DISASTER RISK REDUCTION IN 2019: AN AZERBAIJANI PERSPECTIVE

The main objectives of successful disaster risk reduction activities are the integration of risk reduction into national recovery programs, the development of policies and the progress of capacities designed to enhance and innovate preventive measures, awareness and risk assessment. This includes the analysis of threats and other vulnerabilities, as well as the development of knowledge, such as education, training of the population, in addition to emergency response protocols and the development of forecasting and early warning systems. A number of states have now become actively involved in the strengthening of their national capacities for disaster preparedness and risk reduction. Efforts are being made to ensure a systematic approach to identifying and assessing risks and minimizing the social and economic consequences of disasters. Therefore, the Global Platform's contributions to states and to other stakeholders have been of significant importance. Countries such as the Republic of Azerbaijan are currently in the process of creating their own strategies concerning disaster risk reduction. It is also important to recognize the Global Platform for Disaster Risk Reduction in 2019 as a platform for viewing and analyzing the progress that the Republic of Azerbaijan has made on the Sendia Framework for Disaster Risk Reduction since 2015.Keywords: disaster risk reduction, Global Platform, AzerbaijanJEL Classifications: Q5, O2, I3, F5, R5DOI: https://doi.org/10.32479/ijefi.8524

Koordinasi Publik untuk Pengurangan Risiko Bencana (PRB) Banjir pada Pelaksanaan Pembangunan Berkelanjutan Gorontalo

In flood-prone areas, coordination between parties in disaster risk reduction (DRR) activities is very important. This is because the consequences of disasters will directly affect the disruption of people's lives and livelihoods, and also hinder the process of sustainable development. The study aims to develop a public coordinating scheme for disaster risk reduction (DRR) activities based on public resources in Gorontalo Regency. Public resources from government agencies and society are available in Gorontalo Regency with their respective tasks at the stages before, during and after the disaster. Public coordination is expected to support the implementation of DRR-based sustainable development in Gorontalo Regency. The preparation of public coordination scheme begins with geospatial flood hazard assessment based on the characteristics of the Limboto Watershed using a Geographic Information System (GIS) tool. The result provides a basis for the implementation of public coordination arrangements for DRR. Gorontalo Regency is dominated by a coastal land parcel adjacent to Tomini Bay, stretching from lowland plains to hilly mountains. High rainfall, critical land use and settlements in the lowlands have caused the study area categorized into high- to very high-risk zones of flooding. To ensure sustainable development runs effectively, its implementation must be based on DRR policy with public coordination. Public coordination is carried out between government agencies and society, who cooperate in compliance with their respective roles and tasks at the stage before, during and after the disaster. The results show that the involvement of more sectoral parties is needed at the stage before and during the disaster. This indicates that public coordination before the disaster performs risk prevention and reduction activity that should be prioritized in the implementation of development before inhibiting its sustainability.

Use of mild cognitive impairment and prodromal AD/MCI due to AD in clinical care: a European survey

IntroductionThe diagnosis of mild cognitive impairment (MCI) refers to cognitive impairment not meeting dementia criteria. A survey among members of the American Association of Neurology (AAN) showed that MCI was considered a useful diagnosis. Recently, research criteria have been proposed for the diagnosis of Alzheimer’s disease (AD) in MCI based on AD biomarkers (prodromal AD/MCI due to AD). The aim of this study was to investigate the attitudes of clinicians in Europe on the clinical utility of MCI and prodromal AD/MCI due to AD criteria. We also investigated whether the prodromal AD/MCI due to AD criteria impacted management of MCI patients.MethodsAn online survey was performed in 2015 among 102 members of the European Academy of Neurology (EAN) and the European Alzheimer’s Disease Consortium (EADC). Questions were asked on how often criteria were used, how they were operationalized, how they changed patient management, and what were considered advantages and limitations of MCI and prodromal AD/MCI due to AD. The questionnaire consisted of 47 questions scored on a Likert scale.ResultsAlmost all respondents (92%) used the MCI diagnosis in clinical practice. Over 80% of the EAN/EADC respondents found a MCI diagnosis useful because it helped to label the cognitive problem, involve patients in planning for the future, and start risk reduction activities. These findings were similar to those reported in the AAN survey. Research criteria for prodromal AD/MCI due to AD were used by 68% of the EAN/EADC respondents. The most common reasons to use the criteria were increased certainty of diagnosis (86%), increased possibilities to provide counseling (51%), facilitation of follow-up planning (48%), start of medical intervention (49%), and response to patients’ wish for a diagnosis (41%). Over 70% of the physicians considered that a diagnosis of prodromal AD/MCI due to AD had an added value over the MCI diagnosis.ConclusionsThe diagnostic criteria of MCI and prodromal AD/MCI due to AD are commonly used among EAN/EADC members. The prodromal AD/MCI due to AD were considered clinically useful and impacted patient management and communication.

How Are Disaster Risk Reduction Activities in Indonesian Villages Financed?

This study aimed to analyses how villages finances their Disaster Risk Reduction Activities in 5 villages in Banda Aceh, Indonesia. Data was collected through document analysis and interviews. The period of data collection is from January to April 2019. The interviewees are head of villages, representatives from disaster agencies and representatives of institutions that provide funding to villages. The data is analyzed by using qualitative method. The results of the study unveil that the studied villages in Syiah Kuala sub-district had allocated village budgets for DRR activities, although the amount was very small compared to the total budget received in the current year (less than one percent). The main source of funding is the village fund.

Anthropogenic changes in the alluvial plains of the Tyrrhenian Ligurian basins

Riverbeds and floodplains in the Mediterranean area have been largely affected by anthropogenic modifications mainly with incision, narrowing and channeling of the riverbed. In many cases these changes have also involved the river network, from braided to single thread.The Ligurian coastal floodplains are historically affected by flooding. In recent decades, an increase in floods has been observed either for the variation of the rainfall regime and for man-made landforms that influenced the geomorphological processes.This paper provides a first analysis of the morphological evolution of the ‘floodplain-riverbed’ system in the recent past in Ligurian Tyrrhenian basins. Human activities have modified the environment of the coastal floodplains: in all the analyzed cases the narrowing and the culverting of the riverbed have been found above all in theterminal stretch. Other changes concern diversion of watercourses and progradation of the coastline due to embankment.In many cases, the extent of the changes obliterated the presence of watercourses, reducing or eliminating the perception of risk.The knowledge of anthropic changes should therefore be used as a management and planning tool in the framework of risk reduction activities.

Policy Instruments for NBS to Landslide Risk Management in Urban Areas in the Hilly Areas of Sri Lanka

Landslides had been traditionally considered as an insignificant disaster is now a common occurrence in the hilly areas of Sri Lanka. The recent landslides have not only natural causes, but they are also due to factors related to the location of population settlements and their behavior. The demand for land in hilly areas has led to the use of marginal land, prone to landslides in unstable slopes. Control of landslides in upland areas requires an integrated approach and the issues in these areas need to be addressed in a comprehensive way by enforcing new policies and land management regulations, planning landslide risk reduction activities, improving early warning systems, improving community level landslide preparedness, developing monitoring and evaluation systems for monitoring the vulnerable slopes, and formulating necessary policies. In many areas, the risk-informed nature-based solutions and hybrid solutions can be effective in reducing the impacts of landslides. Therefore, the authors present a review of the existing Legal, regulatory and institutional frameworks for landslides mitigation and make recommendations to strengthen the existing development and agriculture related policies and to formulate suitable policies for NBSs for landslide management in Sri Lanka.

Integrated Intimate Partner Violence and Human Immunodeficiency Virus Interventions in Sub-Saharan Africa: A Systematic Review Targeting or Including Adolescents.

Adolescents in Sub-Saharan Africa are at disproportionately high risk for intimate partner violence (IPV) and human immunodeficiency virus (HIV). The interconnected risks for IPV and HIV present the opportunity for interventions to concurrently seek to reduce violence and sexual risk behaviors among young people. Accordingly, the present systematic review evaluates interventions that concomitantly address IPV and HIV risk among adolescents in Sub-Saharan Africa. The authors systematically reviewed electronic databases for studies meeting the following criteria: use of randomized control trials (RCT) or quasi-RCT in Sub-Saharan African countries; inclusion of adolescents aged 13-18 years; use of a comparison group (wait listed, designated to a comparative treatment, or treatment as usual); and incorporation of IPV and HIV outcome assessments. Results suggested that six studies have utilized rigorous research methodologies to evaluate integrated IPV/HIV interventions; however, few have targeted adolescents. The six studies meeting inclusion criteria indicate that current research on IPV/HIV is conducted with rigorous study designs among target populations with high IPV/HIV risk, using gender-specific risk reduction activities. The authors' findings indicate there is also the need for consistent application of valid and reliable outcome measurements of IPV and HIV risk. Additional research is needed to identify best practices for reducing IPV and HIV incidence among vulnerable adolescent populations in Sub-Saharan Africa.

Web-Based Skin Cancer Prevention Training for Massage Therapists: Protocol for the Massage Therapists Skin Health Awareness, Referral, and Education Study

BackgroundSkin cancer, the most common cancer in the United States, is costly and potentially deadly. Its burden can be reduced by early detection and prevention activities. The scope of skin cancer requires going beyond traditional health care providers to promote risk reduction. Partnering with the nonbiomedical workforce, such as massage therapists (MTs), may reach more individuals at risk. MTs see much of their clients’ skin and are amenable to performing skin cancer risk reduction activities during massage appointments.ObjectiveThe objective of this study is to describe the Massage Therapists Skin Health Awareness, Referral, and Education protocol, presenting an overview of our systematic approach to developing rigorous e-training for MTs to enable them to be partners in skin cancer risk reduction. We also describe procedures for usability and feasibility testing of the training.MethodsWe developed an integrated electronic learning system that includes electronic training (e-training) technology, simulated client interactions, online data collection instruments, and in-person assessment of MTs’ application of their training.ResultsA total of 20 participants nationally scored the e-training as high for usability and satisfaction. We have screened an additional 77 MTs in Arizona for interest and eligibility, and currently have 37 enrolled participants, of whom 32 have completed the Web-based training.ConclusionsThe structured and rigorous development approach for this skin cancer risk reduction and brief behavioral intervention e-training for MTs begins to fill a gap in skin cancer risk reduction research. Iterative usability testing of our asynchronous Web-based training resulted in positive participant response. Our e-training approach offers greater learner accessibility, increased convenience, and greater scalability than the few existing programs and has the potential to reach many MTs nationally.International Registered Report Identifier (IRRID)DERR1-10.2196/13480

Reach and Use of Diabetes Prevention Services in the United States, 2016-2017

Coordinated efforts by national organizations in the United States to implement evidence-based lifestyle modification programs are under way to reduce type 2 diabetes (hereinafter referred to as diabetes) and cardiovascular risks. To provide a status report on the reach and use of diabetes prevention services nationally. This nationally representative, population-based cross-sectional analysis of 2016 and 2017 National Health Interview Survey data was conducted from August 3, 2017, through November 15, 2018. Nonpregnant, noninstitutionalized, civilian respondents 18 years or older at high risk for diabetes, defined as those with no self-reported diabetes diagnosis but with diagnosed prediabetes or an elevated American Diabetes Association (ADA) risk score (>5), were included in the analysis. Analyses were conducted for adults with (and in sensitivity analyses, for those without) elevated body mass index. Absolute numbers and proportions of adults at high risk with elevated body mass index receiving advice about diet, physical activity guidance, referral to weight loss programs, referral to diabetes prevention programs, or any of these, and those affirming engagement in each (or any) activity in the past year were estimated. To identify where gaps exist, a prevention continuum diagram plotted existing vs desired goal achievement. Variation in risk-reducing activities by age, sex, race/ethnicity, educational attainment, insurance status, history of gestational diabetes mellitus, hypertension, or body mass index was also examined. This analysis included 50 912 respondents (representing 223.0 million adults nationally) 18 years or older (mean [SE] age, 46.1 [0.2] years; 48.1% [0.3%] male) with complete data and no self-reported diabetes diagnosis by their health care professional. Of the represented population, 36.0% (80.0 million) had either a physician diagnosis of prediabetes (17.9 million), an elevated ADA risk score (73.3 million), or both (11.3 million). Among those with diagnosed prediabetes, 73.5% (95% CI, 71.6%-75.3%) reported receiving advice and/or referrals for diabetes risk reduction from their health care professional, and, of those, 35.0% (95% CI, 30.5%-39.8%) to 75.8% (95% CI, 73.2%-78.3%) reported engaging in the respective activity or program in the past year. Half of adults with elevated ADA risk scores but no diagnosed prediabetes (50.6%; 95% CI, 49.5%-51.8%) reported receiving risk-reduction advice and/or referral, of whom 33.5% (95% CI, 30.1%-37.0%) to 75.2% (95% CI, 73.4%-76.9%) reported engaging in activities and/or programs. Participation in diabetes prevention programs was exceedingly low. Advice from a health care professional, age range from 45 to 64 years, higher educational attainment, health insurance status, gestational diabetes mellitus, hypertension, and obesity were associated with higher engagement in risk-reducing activities and/or programs. Among adults at high risk for diabetes, major gaps in receiving advice and/or referrals and engaging in diabetes risk-reduction activities and/or programs were noted. These results suggest that risk perception, health care professional referral and communication, and insurance coverage may be key levers to increase risk-reducing behaviors in US adults. These findings provide a benchmark from which to monitor future program availability and coverage, identification of prediabetes, and referral to and retention in programs.