Face-to-face interventions increase household preparedness for disasters
Successful Fix-it intervention increased earthquake and fire preparedness cross-culturally using face-to-face workshops and observations of preparedness in people’s homes. Evaluated longitudinally. Higher outcome expectancy and being a home owner predicted increased preparedness.
About 11 years ago Tiziana Rossetto, an engineer, knocked on my office door to ask if I would join her in setting up EPICentre: the Earthquake and People Interaction Centre (UCL). She was a junior academic and said she wanted us to apply for a major grant to fund interdisciplinary work on the people in the buildings that civil engineers make earthquake safe. I thought it was a great idea, especially following my interest in this topic after 9/11 (see https://newhumanist.org.uk/articles/1796/the-unthinkable-by-amanda-ripley) but that our chances were slim. They weren’t – we got it. In the first of two such grants (both from the UK’s Engineering and Physical Research Council – EP/F012179/1; EP/F012179/1) we examined people’s representations of earthquakes in matched samples in Osaka (Japan), Izmir (Turkey) and Seattle (USA) (https://www.earthquakespectra.org/doi/abs/10.1193/1.4000138). All three cities are highly seismic, coastal (and so at risk of tsunami too) and had not experienced a recent major earthquake. Once we understood people’s worldviews regarding earthquakes – such as the existence of higher levels of fatalism and anxiety in Turkey and greater feelings of control over earthquake damage in the USA, we were in a position to devise an intervention to change earthquake and fire preparedness in Turkey and the USA. We chose these two cultures for the intervention because they were polar opposites in terms of the sense of control experienced and also represented different levels of development socio-economically.
For the intervention we drew on the disaster prevention literature, the burgeoning behaviour change literature as well as our past study and what had worked in terms of organisations preparing households for earthquakes and fires internationally. Incidentally, we coupled these two hazards as we wanted participants to link the behaviour change required for one with a short (fire) and one with a long (earthquake) return period. The intervention worked (see https://rdcu.be/bufdj DOI 10.1038/s41562-019-0563-0) pointing to the power of evidence-based interventions in ‘real world’ settings.
So in the process of developing our work we went multihazard and learned about how to conduct controlled interventions with the help of Robert West and Susan Michie, both doyens within the Behaviour Change field: Robert inspired much of smoking behaviour change in the UK and Susan is propelling behaviour change science to centre-stage internationally. This led us to Henry Potts, a psychologist and health scientist who is an expert on controlled trial statistics, as well as having many other attributes, such as calming us down in the face of the extreme volatility of data in a real world, as opposed to a lab, setting. Let’s just say that mid-study a coup took place in Turkey and Seattle had a major article written about it stating that a sizeable earthquake would be likely to wreak major destruction (https://www.newyorker.com/magazine/2015/07/20/the-really-big-one). This made us really appreciate that we had a control group as the people in it were exposed to these events in the same way that those in the intervention group were. Control groups are commonly used in healthcare research, but are much less common in the hazards literature. Further major assets of the project were our amazing Gabriela Perez-Fuentes, a clinical psychologist who was the key post-doctoral researcher on the project and implementer of the Seattle workshops, as well as our local academics in Turkey, Canay Dogulu and Ervin Gul, without whom we could not have collected such systematic, longitudinal data.
So interdisciplinarity allowed us to design a successful earthquake and fire preparedness intervention that drew on multiple sets of expertise. We now require a new set of alliances to get the Fix-it workshops and/or home visit observations adopted more widely. We are also in the process of extending the knowledge acquired to other cultures and contexts.