title: Factors Associated with Discussion of Disasters by Final Year High School Students: An International Cross-sectional Survey.
abstract: Introduction The effect on behavioral change of educational programs developed to reduce the community's disaster informational vulnerability is not known. This study describes the relationship of disaster education, age, sex, and country-specific characteristics with students discussing disasters with friends and family, a measure of proactive behavioral change in disaster preparedness.
  
  
  METHODS
  Three thousand eight hundred twenty-nine final year high school students were enrolled in an international, multi-center prospective, cross-sectional study using a pre-validated written questionnaire. In order to obtain information from different educational systems, from countries with different risk of exposure to disasters, and from countries with varied economic development status, students from Bahrain, Croatia, Cyprus, Egypt, Greece, Italy, Portugal, Romania, and Timor-Leste were surveyed. Logistic regression analyses examined the relationship between the likelihood of discussing disasters with friends and family (dependent variable) and a series of independent variables (age, gender, participation in school lessons about disasters, existence of a national disaster educational program, ability to list pertinent example of disasters, country's economic group, and disaster risk index) captured by the questionnaire or available as published data.
  
  
  RESULTS
  There was no statistically significant relationship between age, awareness of one's surroundings, planning for the future, and foreseeing consequences of events with discussions about potential hazards and risks with friends and/or family. The national educational budget did not have a statistically significant influence. Participants who lived in a low disaster risk and high income Organization for Economic Co-operation and Development (OECD) country were more likely to discuss disasters. While either school lessons or a national disaster education program had a unique, significant contribution to the model, neither had a better predictive utility.
  
  
  CONCLUSIONS
  The predictors (national disaster program, school lessons, gender, ability to list examples of disasters, country's disaster risk index, and level of economic development), although significant, were not sufficient in predicting disaster discussions amongst teenagers.
authors.affiliation: 1West Australian Country Health Services,Bunbury and Busselton Hospitals,Critical Care Directorate,Emergency Department, Bunbury,Australia.
authors.forename: Tudor A
authors.initials: TA
authors.lastname: Codreanu
authors.affiliation: 2Faculty of Medicine,Dentistry and Health Sciences,University of Western Australia,Perth,Western Australia,Australia.
authors.forename: Antonio
authors.initials: A
authors.lastname: Celenza
authors.affiliation: 3Royal Medical Services,West Riffa,Kingdom of Bahrain.
authors.forename: Ali A Rahman
authors.initials: AA
authors.lastname: Alabdulkarim
mesh_terms: D000293:Adolescent; D003142:Communication; D003430:Cross-Sectional Studies; D004189:Disaster Planning; D005260:Female; D006801:Humans; D008297:Male; D013334:Students; D011795:Surveys and Questionnaires
keywords: CSR Cox and Snell R square; DRE disaster reduction education; EMDM European Master in Disaster Medicine; EMDM-A European Master in Disaster Medicine Alumni; GDP gross domestic product; HLT Hosmer and Lemeshow goodness of fit test; IDNDR United Nations’ International Decade for Natural Disaster Reduction; NR Nagelkerke R square; OECD Organization for Economic Co-operation and Development; disaster education; high school; teenagers