title: Challenging Assumptions: What Do We Need to Address in Our Disaster Risk Reduction Efforts?
abstract: Introduction Specific knowledge and skills are required, especially in the first 72 hours post-disaster, to bridge the time gap until essential services are restored and Emergency Medical Services (EMS) can focus on individuals' needs. This study explores disaster knowledge and preparedness in the first 72 hours as a function of the individual's engagement in discussions about disasters, and several other factors (both at personal and community/country level), as well as the entities/organizations perceived by the individual as being responsible for disaster risk reduction (DRR) education.
  
  
  METHODS
  A prospective, cross-sectional survey of 3,829 final-year high-school students was conducted in nine countries with different levels of disaster risk and economic development. Regression analyses examined the relationship between a 72-hour disaster preparedness composite outcome (ability to make water safe for drinking, knowledge of water potability, home evacuation skill, and improvising a safe room) and a series of independent predictors.
  
  
  RESULTS
  Respondents from countries with lower economic development were significantly better prepared for the first 72 hours post-disaster than those from developed countries (OR=767.45; CI=13.75-48,822.94; P=.001). While several independent predictors showed a significant main effect, combined disaster risk education (DRE) efforts, as a partnership between school and local government, had the best predictive value (OR=3.52; CI=1.48-8.41; P=.005).
  
  
  CONCLUSIONS
  Disaster preparedness in final-year high-school students is significantly better in developing countries. Further improvement requires a convergent effort in aligning the most effective educational policies and actions to best address the individual's and the community needs. Codreanu TA , Ngo H , Robertson A , Celenza A . Challenging assumptions: what do we need to address in our disaster risk reduction efforts? Prehosp Disaster Med. 2017;32(2):134-147.
authors.affiliation: 1West Australian Country Health Services,Busselton Health Campus,Emergency Department,Busselton,Western Australia,Australia.
authors.forename: Tudor A
authors.initials: TA
authors.lastname: Codreanu
authors.affiliation: 2Discipline of Emergency Medicine, Faculty of Medicine,Dentistry,and Health Sciences,University of Western Australia,Crawley,Western Australia,Australia.
authors.forename: Hanh
authors.initials: H
authors.lastname: Ngo
authors.affiliation: 3Disaster Management,Regulation,and Planning,Public Health Division,Department of Health,Government of Western Australia,Western Australia,Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Robertson
authors.affiliation: 2Discipline of Emergency Medicine, Faculty of Medicine,Dentistry,and Health Sciences,University of Western Australia,Crawley,Western Australia,Australia.
authors.forename: Antonio
authors.initials: A
authors.lastname: Celenza
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004189:Disaster Planning; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013334:Students; D011795:Surveys and Questionnaires
keywords:  72-RP 72-hours response preparedness;  AHP analytical hierarchy processing;  DRE disaster risk education;  DRR disaster risk reduction;  EMS Emergency Medical Services;  NDEP national disaster educational program;  OECD Organization for Economic Co-operation and Development; 72-hour response preparedness; disaster; education; teenagers