The number of times I have been asked, (mainly by our communications people), could you give us the stats that show that preparedness works. There’s usually an uneasy shifting of feet, averting of eyes, a bit of mumbling, and the answer “Well its not that easy…..”
When I moved into the preparedness space, I made the assumption that the preparedness advice given was based on peer reviewed evidence. I didn’t really have time to go to look for it, but thought, yeah we know preparedness works. A few times over the years, we’ve tried to delve a bit further but have not come up with much. Not only that, but taking a unique approach, as we do with Rediplan, which focuses on “preparing for recovery” or a psychosocial approach to preparedness, it becomes a lot more complicated
As we have moved to a more evidence informed approach to our work, and employing talented and highly educated people, the demands for evidence for what we do have increased. Equally though, employing such people, they also have the skills to go looking for answers. My colleague Agathe Randrianarisoa, in our Research and Insights team is equipped with a killer grasp of quantitative analysis and a French sensibility to boot.
We set out to find some answers. I said I’d undertake a literature review, and Agathe would design a survey and analyse it. Along the way, our colleagues Kate Brady and Laure-Emmanuelle Leguy would kick in as well. The literature review surprised me. I searched on terms like disaster preparedness efficacy and disaster preparedness. I found about 900 articles. Most of the research into disaster preparedness was focused upon behavioural aspects. “How do we get people to prepare” In the end I found 1 paper that linked preparedness actions in Hong Kong with short term survival outcomes, and two papers from Germany that linked preparedness with recovery outcomes in flood events. THere were a number of papers that actually mentioned the absence of any systematic review.
Oh dear. I thought. Have I built the last 14 years of my work on an illusion? But that’s not necessarily the case. The more I delved the more it seemed to me that preparedness advice resulted from a consensus approach, ie a bunch of experts get in a room and agree on a number of questions. Pretty much the same way psychological first aid has been developed a technique. Most of the advice is pretty practical and based on experience, eg the lights are out, you need a torch, water is not potable, you need water. This is effectively how we built rediplan. The difference being we extended out the impacts you should plan for. (BTW, the plan for 72 hours concept seems to have emerged from the idea of the limits of human physiology and those people who survive trapped in earthquake rubble). When you have nothing else, a consensus approach is the best way forward.
So, we found there wasn’t a lot of evidence to back us. A bit like setting sail over the ocean with a kids atlas. Agathe said no worries, we’ll find some people (165 of them) who have been through emergencies, and are happy to help, and we’ll ask them what their experience was, and how prepared they were, and then I’ll put it all in a big SPSS box, shake it around and find some answers. I believe its a bit more sophisticated than that, but having failed first year statistics, I am not in a position to comment.
How did we define recovery? Well, that is also the other $64million question. as I have written a in other blog posts, there is no one single defining measure. The work of David Abrahamson and is colleagues is instructive here, when they say recovery outcomes and trajectories are multidimensional. Fortunately, Daniel Aldrich just happened to be in town and was talking about the work they have done in Japan after the 3/11 tsunami and spoke about a self reported recovery measure. This was the answer. This is something that I have been interested in for a while. There’s a whole body of literature on self reported quality of life measures, and lets face it, recovery is all about quality of life (as the incomparable Anne Leadbeater say, recovery is when you wake up and begin to enjoy the life you are leading). So we adopted this as our measure.
What did we find? I won’t go into all of the details, because that’s what the report and The Conversation article are for. But we saw that people’s reported recovery varied, and while many indicated that they felt like they had recovered, many indicated it took six months or more. And while we might think “oh a couple of weeks or a couple o months isn’t that long, just think about how disruptive lockdowns are. Well, most importantly there was a link between being prepared, which led to a reported reduced stress level during and after the emergency, of feeling in control during the emergency and comfortable with the decisions that were made, and with a reduced stress level peoples self reported recover was faster. Not surprisingly the more people prepared, the less stress they felt. These are exciting findings, but the ones that are really cool (and would not have been discovered without Agathe’s smarts) are the clustering of actions that people took, and helped us suggest there might be personas. People who do the practical stuff, people who are motivated by emotional connects, people who gather a lot of information, and the people who don’t do much. If you were “ready” or “sentimental” your self reported recovery rates were faster than those who were “planners” or “unsure” . This is extremely helpful as it further reinforces the notion that preparedness programs can’t be one size fits all.
Sure, its a small study, and I am sure people might have issues with the process we undertook, but we’ve had a go. Perhaps it will provoke bigger research institutions with bigger budgets to look at these questions. It gives us confidence in our programming and what we are doing, and importantly, when we go out and have conversations with people about the importance of preparedness, we can say it works for many people.