Author Profile

Mike Clarke

Affiliation: Director, All Ireland Hub for Trials Methodology Research; Evidence Aid

Recent Posts

The Effectiveness of Disaster Risk Communication: A Systematic Review of Intervention Studies

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Introduction: A disaster is a serious disruption to the functioning of a community that exceeds its capacity to cope within its own resources. Risk communication in disasters aims to prevent and mitigate harm from disasters, prepare the population before a disaster, disseminate information during disasters and aid subsequent recovery. The aim of this systematic review is to identify, appraise and synthesise the findings of studies of the effects of risk communication interventions during four stages of the disaster cycle.
Methods: We searched the Cochrane Central Register of Controlled Trials, Embase, MEDLINE, PsycInfo, Sociological Abstracts, Web of Science and grey literature sources for randomised trials, cluster randomised trials, controlled and uncontrolled before and after studies, interrupted time series studies and qualitative studies of any method of disaster risk communication to at-risk populations. Outcome criteria were disaster-related knowledge and behaviour, and health outcomes.
Results: Searches yielded 5,224 unique articles, of which 100 were judged to be potentially relevant. Twenty-five studies met the inclusion criteria, and two additional studies were identified from other searching. The studies evaluated interventions in all four stages of the disaster cycle, included a variety of man-made, natural and infectious disease disasters, and were conducted in many disparate settings. Only one randomised trial and one cluster randomised trial were identified, with less robust designs used in the other studies. Several studies reported improvements in disaster-related knowledge and behaviour.
Discussion: We identified and appraised intervention studies of disaster risk communication and present an overview of the contemporary literature. Most studies used non-randomised designs that make interpretation challenging. We do not make specific recommendations for practice but highlight the need for high-quality randomised trials and appropriately-analysed cluster randomised trials in the field of disaster risk communication where these can be conducted within an appropriate research ethics framework.

The Use of Systematic Reviews and Other Research Evidence in Disasters and Related Areas: Preliminary Report of a Needs Assessment Survey

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Objectives: This paper presents the initial data analysis for a survey to identify the attitudes towards systematic reviews and research of those involved in the humanitarian response to natural disasters and other crises; their priorities for evidence, and their preferences for accessing this information.

Methods: Snowballing sampling techniques were used to recruit participants who identified themselves as humanitarian aid workers, with or without experience in providing funding to aid agencies. An online questionnaire with both quantitative and qualitative questions was made available to participants using a variety of e-mail lists. Quantitative responses from 85 participants to a selection of questions were descriptively analysed using SPSS.

Results: Findings indicated that respondents had positive opinions about systematic reviews and using research evidence when planning and responding to disasters. Seventy participants answered the question on the usefulness of reviews before, during and after disasters and, of these, 83% said that systematic reviews are useful in disasters, and the remaining 17% said they did not know. No-one selected the option that systematic reviews are not useful. The most preferred format for access to systematic reviews was the whole reviews, supplemented by comments from experts in the humanitarian sector (61%), 33% choose access to the full review, 20% choose the summary of reviews and 50% choose summary of reviews plus context-specific information. Inadequate access was the most commonly reported barrier to the use of systematic reviews (70%). This was followed by the lack of time to use reviews (59%) and insufficient knowledge about reviews (49%). Respondents selected scientific evidence as the most preferred type of evidence for influencing their decisions (80%), 11% ranked personal experience highest, 6% said their organisation’s usual practice, 1% said anecdotal evidence and 1% said intuition would be their first choice. 69% of participants “strongly agreed” that evidence from systematic reviews could have a positive role in humanitarian interventions and a further 29% “agreed” with the same statement. 66% thought they would like to access them when a natural disaster is not known to be imminent, compared to 34% who said that they would not wish to access systematic reviews at such a time. 70% would like to access systematic reviews during the period of prediction that a disaster will happen

Conclusion: These preliminary findings from the Evidence Aid survey emphasise the need for “global” evidence but also the need that this be supplemented by local and context-specific knowledge. Systematic reviews could play a central role in improving the effectiveness of humanitarian aid in the planning, delivery and recovery phases of a disaster.

Keywords: Evidence base, humanitarian planning, delivery and recovery, systematic review

Evidence for disaster risk reduction, planning and response: design of the Evidence Aid survey

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Systematic reviews are now regarded as a key component of the decision making process in health care, and, increasingly, in other areas. This should also be true in disaster risk reduction, planning and response. Since the Indian Ocean tsunami in 2004, The Cochrane Collaboration and others have been working together to strengthen the use and usefulness of systematic reviews in this field, through Evidence Aid. Evidence Aid is conducting a survey to identify the attitudes of those involved in the humanitarian response to natural disasters and other crises towards systematic reviews and research in such settings; their priorities for evidence, and their preferences for how the information should be made accessible. This article contains an outline of the survey instrument, which is available in full from www.EvidenceAid.org. The preliminary findings of the survey will be published in future articles.

Dealing with disaster databases – What can we learn from health and systematic reviews?

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There is an increasing move towards facilitating the use of research findings in policy and practice relating to disaster risk reduction and response. One of the key issues is the quality of the evidence available to decision-makers. Disaster databases, as a key resource, represent a tremendous investment of effort and goodwill. However, their usefulness is limited by the variability in how they are compiled, differences in the output they produce, a general lack of comparability and standardization, and the fact that they might produce different results due to the ways they have been created or by chance. One possible solution to this, which has been applied successfully in evidence synthesis in health care is the systematic review. In this study we attempt to show how the systematic review process may be applied to information and data that is held in disaster databases. We demonstrate that systematic reviews of disaster databases can be achieved in a technical sense and the potential value of such reviews, but also discuss the practical difficulties that arise.