title: Effectiveness of a primary health care program on urban and rural community disaster preparedness, Islamic Republic of Iran: a community intervention trial.
abstract: BACKGROUND
  To evaluate the effectiveness of a capacity-building intervention administered through a primary health care (PHC) system on community disaster preparedness in Iran.
  
  
  METHODS
  A controlled community intervention trial with pre- and postassessments was conducted in 2011 in 3 provinces of Iran. In each province, 2 areas were chosen and randomly selected as an intervention or control group. A total of 9200 households were in the intervention area and 10 010 were in the control area. In each study group in each province 250 households were sampled for pre- and postassessment surveys. Community health volunteers led by PHC staff administered an educational intervention covering elements of hazard awareness and preparedness, with a focus on earthquakes and floods. Relative changes for awareness and readiness scores were assessed to demonstrate changes in outcome variables from pre- to postassessments in intervention and control groups. An effectiveness test of significance was based on interaction between time and area.
  
  
  RESULTS
  Households in intervention communities exhibited improved disaster awareness and readiness with respect to all outcome measures. Relative changes in awareness in intervention and control areas were 2.94 and -0.08, respectively (P < .001). Relative changes for readiness scores were 5.52 in intervention areas and 0.56 in control areas (P < .001). Relative changes for awareness and readiness were significantly correlated with a community's baseline risk perception and previous experience with natural disasters (P < .001).
  
  
  CONCLUSIONS
  An educational intervention administered through the PHC system effectively improved disaster awareness and readiness at a community level. For sustainability, community disaster reduction programs must be integrated into routine public health service delivery.
authors.affiliation: Department of Disaster and Emergency Health, National Institute of Health Research, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Ardalan
authors.forename: Hani
authors.initials: H
authors.lastname: Mowafi
authors.forename: Hossein
authors.initials: H
authors.lastname: Malekafzali Ardakani
authors.forename: Farid
authors.initials: F
authors.lastname: Abolhasanai
authors.forename: Ali-Mohammad
authors.initials: AM
authors.lastname: Zanganeh
authors.forename: Hossein
authors.initials: H
authors.lastname: Safizadeh
authors.forename: Sirous
authors.initials: S
authors.lastname: Salari
authors.forename: Vahid
authors.initials: V
authors.lastname: Zonoobi
mesh_terms: D002959:Civil Defense / Q000458:organization & administration*; D003153:Community Health Services / Q000458:organization & administration; D003906:Developing Countries; D004189:Disaster Planning / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D011634:Public Health; D012424:Rural Population; D014505:Urban Population