title: Early postdisaster health outreach to modern families: a cross-sectional study.
abstract: OBJECTIVE
  This study investigated whether the early outreach programme following the Utøya massacre reached out to the parents of the young survivors. Additionally, we explored whether specialised mental healthcare services were provided to parents presenting elevated levels of PTSD and depression reactions.
  
  
  METHODS
  Cross-sectional survey, face-to-face interviews and questionnaires.
  
  
  METHODS
  Norway, aftermath of the Utøya massacre, 4-7 months postdisaster.
  
  
  BACKGROUND
  Following the Utøya massacre, proactive early outreach programmes were launched in all municipalities that were affected, facilitating access to appropriate healthcare services.
  
  
  METHODS
  A total of 453 parents of the Utøya survivors aged 13-33 years took part. Overall, 59.8% of the survivors were represented by one or more parent in our study.
  
  
  METHODS
  Engagement with the proactive early outreach programme (psychosocial crisis teams and contact persons in the municipalities), utilisation of healthcare services (general practitioner and specialised mental healthcare services) and mental distress (UCLA PTSD-RI and HSCL-8).
  
  
  RESULTS
  A majority of the participants reported contact with the proactive early outreach programme (crisis team, 73.9%; and contact person, 73.0%). Failure of outreach to parents was significantly associated with non-intact family structure (crisis team: OR 1.69, 95% CI 1.05 to 2.72, p=0.032) and non-Norwegian origin (crisis team: OR 2.39, 95% CI 1.14 to 4.98, p=0.021). Gender of the parent was not significantly associated with failure of the outreach programme (p ≥ 0.075). Provision of specialised mental healthcare services was significantly associated with higher levels of PTSD (OR 2.08, 95% CI 1.55 to 2.79, p<0.001) and depression (OR 2.42, 95% CI 1.71 to 3.43, p<0.001) and not with the sociodemography (p ≥ 0.122).
  
  
  CONCLUSIONS
  Proactive early outreach strategies may be helpful in identifying healthcare needs and facilitating access to the required services in a population struck by disaster. Our findings prompt increased attention to the complexity of family structures in reaching out universally to modern families following a disaster.
authors.affiliation: Norwegian Centre of Violence and Traumatic Stress Studies, Oslo, Norway Faculty of Medicine, University of Oslo, Institute of Clinical Medicine, Oslo, Norway.
authors.forename: Jon Magnus
authors.initials: JM
authors.lastname: Haga
authors.affiliation: Norwegian Centre of Violence and Traumatic Stress Studies, Oslo, Norway Department of Social Pediatrics, Women and Children's Division, Oslo University Hospital, Oslo, Norway.
authors.forename: Lise Eilin
authors.initials: LE
authors.lastname: Stene
authors.affiliation: Norwegian Centre of Violence and Traumatic Stress Studies, Oslo, Norway Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
authors.forename: Tore
authors.initials: T
authors.lastname: Wentzel-Larsen
authors.affiliation: Norwegian Centre of Violence and Traumatic Stress Studies, Oslo, Norway.
authors.forename: Siri
authors.initials: S
authors.lastname: Thoresen
authors.affiliation: Norwegian Centre of Violence and Traumatic Stress Studies, Oslo, Norway Faculty of Medicine, University of Oslo, Institute of Clinical Medicine, Oslo, Norway.
authors.forename: Grete
authors.initials: G
authors.lastname: Dyb
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology* / Q000628:therapy; D003866:Depressive Disorder / Q000453:epidemiology / Q000628:therapy; D004190:Disasters; D005191:Family Characteristics; D005260:Female; D006708:Homicide; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D009664:Norway; D016017:Odds Ratio; D010290:Parents; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000628:therapy; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D023481:Terrorism / Q000523:psychology*; D055815:Young Adult
keywords: PRIMARY CARE; PUBLIC HEALTH