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Journal of Health Care for the Poor and Underserved 20 (2009): 330–345.
PART I: BRIEF COMMUNICATION
Developing a Disaster Preparedness Campaign
Targeting Low-Income Latino Immigrants:
Focus Group Results for Project PREP
David P. Eisenman, MD, MSHS
Deborah Glik, ScD
Richard Maranon
Lupe Gonzales
Steven Asch, MD
Abstract: Low-income immigrant Latinos are particularly vulnerable to disasters because
they are both ill-prepared and disproportionately aected. Disaster preparedness programs
that are culturally appropriate must be developed and tested. To develop such a program,
we conducted 12 focus groups with low-income immigrant Latinos to understand their
perceptions and understanding of disaster preparedness, and facilitators and obstacles to
it. Participants were concerned about remaining calm during an earthquake. Obstacles
to storage of disaster supplies in a kit and developing a family communication plan were
mentioned frequently. Misunderstandings were voiced about the proper quantity of water to
store and about communication plans. Several focus groups spontaneously suggested small
group discussions (platicas) as a way to learn about disaster preparedness. ey wanted
specic help with building their family communication plans. ey rated promotoras de salud
highly as potential teachers. Results will guide the development of a disaster preparedness
program tailored to the needs of low-income Latino immigrants.
Key words: Latino health, immigrant health, disaster preparedness, formative research.
Hurricanes Katrina and Rita demonstrated to the nation what many researchers
already believed: that U.S. racial/ethnic minority groups, including Latinos, are
both disproportionately aected by disasters1–5 and less disaster prepared compared
with Whites.1 In Los Angeles, for instance, 42.7% of Latino residents have disaster sup-
plies compared with 56.6% of non-Latino Whites, and these dierences remain aer
controlling for socio-demographic factors, language, and health status.6
DAVID EISENMAN is aliated with the David Geen School of Medicine at UCLA—Division of
General Internal Medicine and Health Services Research. DEBORAH GLIK and RICHARD MARANON
are aliated with UCLA School of Public Health—Community Health Sciences. LUPE GONZALES is
aliated with the Coalition for Community Health. STEVEN ASCH is aliated with West Los Angeles
Veterans Administration—Department of Medicine. Please address correspondence to Dr. Eisenman
at the David Geen School of Medicine at UCLA—Division of General Internal Medicine and Health
Services Research, 911 Broxton Plaza, Los Angeles, CA 90095-1736; (310) 794-2452; deisenman@
mednet.ucla.edu.
331
Eisenman, Glik, Maranon, Gonzales, and Asch
A paucity of culturally and linguistically appropriate disaster-related services
contributes to disparities in disaster preparedness.7–9 Despite improvements in this
arena since the attacks of September 11th, 2001, disaster warnings are oen available
only in English, are written at readability levels higher than recommended for popula-
tions with high prevalence of low literacy, or are dicult to obtain for people without
Internet access.10–14 Even in Southern California, Latinos, who constitute over 30% of all
households in the region,15 still report facing diculty obtaining preparedness resources
and an absence of locally available preparedness materials in Spanish.16,17
To address the challenges of developing disaster preparedness programs for under-
served Latino communities, we formed Project PREP (Programa Para Responder a
Emergencias con Preparación), a community-based, participatory research program
that developed, delivered, evaluated, and tested a culturally targeted disaster prepared-
ness program using lay health workers (promotoras de salud). e target population
was Latino immigrants living in low-income neighborhoods in Los Angeles County.
Using focus groups, we sought to understand participants’ perceptions, understandings,
facilitators, and obstacles to disaster preparedness.
Methods
Study design. We conducted 12 focus groups from August to December 2005. Partici-
pants were recruited from low-income neighborhoods in Los Angeles County with high
concentrations of Latino immigrants from Mexico and Central America, as determined
by the U.S. Census. e focus group questions appear in Box 1.
Recruitment and participants. Spanish and English language yers describing the
study were posted in the community. Individuals were eligible to participate if they
self-identied as Latino, were 18 years old or older and were born in Central America
Box 1.
FOCUS GROUP INTERVIEW QUESTIONS
General
1. I’d like to start by talking about the dierent types of disasters you may think
about happening in Los Angeles. What disasters are you concerned about
happening in Los Angeles?
2. Now lets discuss what you think about when we talk about “preparing your
home and family for a disaster.” [PROBES: What comes to mind when we say
“preparing your home and family for a disaster”? What are some things you
can do at home to prepare for a disaster?]
3. Do you think preparing is useful?
4. inking about the disasters you are concerned could happen in Los Angeles,
which of these disasters is it useful for you to prepare for? Why?
(Continued on p. 332)
332 Developing a disaster preparedness campaign
Box 1. (continued)
Preferred Terms for Disaster Supplies
5. [Some of you talked about having certain items in your house for use aer a
disaster such as (ashlight, canned food, other ‘disaster supplies’ mentioned by
group)]. inking about them as things you get to help you in a disaster, what
do you call them as a group of things? How would you describe these items in
a conversation?]
a. Have people heard of the term ‘disaster supplies’ or ‘emergency supplies’?
b. Which term do people prefer we call them during the rest of our
discussion? [PROBE: Which term makes sense to everyone? Which term
would be best understood in your family or neighborhood?]
Current Disaster Supplies
6. What ‘supplies’ or [other term agreed to by group] do you have in your home?
7. Where are these items stored?
8. Are there other supplies that have been recommended to you that you don’t
have? Which ones?
9. Did you buy them only for disaster supplies and not for other uses? Do you
not use them or do you use them and then replenish them?
10. How many people have heard of the term “disaster supply kit” or “emergency
supply kit”? [GET SHOW OF HANDS AND STATE NUMBER FOR TAPE]
a. For those of you who have NOT heard of a disaster supply kit [PROVIDE
OUR DEFINITION AND SEE IF THEY CALL IT SOMETHING ELSE
ONCE THEY RECOGNIZE WHAT WE’RE TALKING ABOUT.
Denition of Disaster Kit: Items stored altogether in one place for an
individual’s or household’s health and safety in case a disaster occurs.
11. Which term do people prefer we call it during the rest of our discussion?
12. How easy or hard is it to get supplies together and put it into a single disaster
supply kit? [PROBES: What is easy about making a kit? What is hard? Is it
hard to put these things in one place? Where do you store it?]
Preferred Terms for Family Communication Plan
13. [Earlier some of you talked about having a plan to meet up with your family]
What do people in your family or neighborhood call this [plan] for use in a
disaster? [PROBE: What do people prefer to call them?]
OR
Have people heard of the term ‘family communications plan’?
For those of you who have not heard of a family communications plan:
[PROVIDE OUR DEFINITION AND SEE IF THEY CALL IT SOMETHING
ELSE ONCE THEY RECOGNIZE WHAT WE’RE TALKING ABOUT.
A family communication plan is how you will contact or meet each other if a
disaster occurs.
[GET SHOW OF HANDS AND STATE NUMBER FOR TAPE]
a. Which term do people prefer we call it during the rest of our discussion?
(Continued on p. 333)
333
Eisenman, Glik, Maranon, Gonzales, and Asch
or Mexico. One adult per household was eligible. One hundred and two of the 133
persons who called participated (six were ineligible, seven could not be reached despite
calls back, and 18 called aer enrollment closed). Participation was anonymous and
all participants provided written informed consent. e UCLA Institutional Review
Board approved the protocol.
Most participants (72%) were female, and the average age was 40 years old. Sixty-one
percent were married or lived with someone as though married, 62% had dependent
children at home, and 74% had two or more other adults living in the household. is
sample of Mexican and Central American immigrants had lived in the United States
an average of 19 years, rented their apartments and homes (85%), and reported annual
family incomes below $30,000.
Data collection. e discussion guide was draed in English, reviewed by Latino
study members and revised, then professionally translated into Spanish. e Spanish-
language version was reviewed by native Spanish speakers for clarity and comprehension
and modied accordingly. e questions were in the following domains, which we pre-
identied as important to developing PREP: 1) to learn what disasters participants are
concerned about, how participants dene preparedness, and social norms and attitudes
about the usefulness of preparedness; 2) to understand motivators, obstacles, and facilita-
tors to preparedness; 3) to learn the sources of current understanding of preparedness;
4) to understand needs for education and to understand if promotoras may be accept-
able for teaching preparedness (promotoras had not previously been used for teaching
preparedness in the United States.) ese domains come from theories employed in
disaster research, such as risk perception18–20 and value-expectancy theories.21,22
Bilingual and bicultural Latina facilitators led groups held at community sites.
Between six and 10 participants attended and groups lasted two hours. Participants
received dinner, on-site childcare and $40 cash. Separate groups were held in English
and Spanish. e groups were audiotaped and transcribed. Spanish language tapes were
professionally transcribed and translated into English.
Analysis. We performed a content analysis to identify core consistencies and patterns
Box 1. (continued)
Family Communication Plan
14. What is in a [communication plan]? Who specically does it include?
15. What is easy about making a plan? What is hard?
16. Are there specic reasons why people have not made a communication plan?
[PROBE: Do not know who to include? Phones numbers change oen? Don’t
understand the reason for it?]
What Would Help Improve Preparedness
17. How would you most like to learn more about preparing your home and family
for a disaster? [PROBES: people to listen to that you would believe? sources of
information?]
334 Developing a disaster preparedness campaign
Box 2.
THEMES AND REPRESENTATIVE QUOTATIONS
Disaster Experience
“I have a lot of experience, because as I said, in El Salvador when I was
studying, sometimes they’d close the stores and I learned a lot of things. And I
tell my children what to do in case of an attack tell them how you can prepare
yourself for those things.”
“Because I had an experience in the past with an earthquake in my country
and . . . I learned because in my family nobody was prepared, you know, for the
earthquake, so my family went crazy. No food, no water, no nothing. We waited
for somebody to come and help us.”
“In my country, we always had earthquakes every four years so they taught us
to get prepared in school. I mean, it’s something that you do constantly. And
they taught us how to dehydrate the meat so we can maintain it dried, and
always store water. It’s a habit that I also continue doing here.”
Disaster Consequences
“But it’s important to remain calm, more than anything.”
“To keep calm and not run out.”
“. . . when we had that earthquake . . . and I was in a 4 story building, and the
earthquake came while I was taking a bath. I ran out, and it really hurt me,
because I ran out like a crazy woman from the tub to the living room. And the
father of my child was talking to me saying control yourself, control yourself,
nothing is going to happen, but it was tremendous. You feel it really hard in
a building. I was screaming, my kids, my kids. And he’d say control yourself,
nothing is going to happen to them. He ran and threw a sheet over me because
I was going to run out like that.” (Continued on p. 335)
in the interviews, which we called themes. We used a grounded theory approach,23
which emphasizes discovering themes that emerge from the data, while recogniz-
ing that themes also come from our pre-identied domains. First, we read through
all the transcripts and, in team discussions, identied themes and sub-themes in the
texts.24,25 Identication of themes was completed when no new sub-themes, properties,
dimensions, or relationships within or among them came out during discussions.26
Second, each transcript was reviewed by the investigators, who independently coded
participants’ statements within themes and sub-themes. ird, the coders met and dif-
ferences in coding were resolved by consensus.27 Initial agreement was 90%, requiring
10% of codes to be settled by consensus. Final coded transcripts were managed using
Atlas.ti soware version 5.0 (Atlas.ti Scientic Soware Development GmbH, Berlin,
Germany). We report the themes and sub-themes we identied as most relevant to
developing our intervention. e quotations selected in the text and Box 2 exemplify
the nature of common responses within themes and sub-themes.
335
Eisenman, Glik, Maranon, Gonzales, and Asch
“I just have my son, and I tell him that if there’s an earthquake at night, that he
shouldn’t get scared, because he makes me more nervous.”
“What I’ve told my children in case of a disaster, an earthquake, if they’re in
school that they should stay calm, if they want to run out, that they should stay
together where everyone is, and that they shouldn’t get nervous.”
Attitudes About Readiness
“We have already seen, in the types of disasters that have happened, that the
people are not prepared and a lot of people have died. A lot of children have
died. So I think it’s much better if we prepare ourselves.”
“e wealthier areas are rst to receive the aid and the assistance decreases as
you get to those that are the poorest.”
“Another thing, they’re not going to give it to everyone. ere are many
people who have papers, and others who don’t have papers, and that is very
discriminatory, because in a disaster, everyone should be entitled to get help.
ere have been many cases like that, where there have been illegals, they had
to ee from Katrina, because they were getting them in the street.”
Disaster Supplies: Recommended Items
“And plus your medicines. Doctor’s already saying that you should you have a
supply of medicines so that in case something does happen and you can’t get
to the doc. So, but the thing is that rst o when you go to the doctor and say,
“Hey, I need enough medicine to carry me over.” and he’ll say, “What?” But
then if you nally do get it, then you have to do the same thing as . . . make
sure that you rotate it or something. It still has to be on your shoulder, your
mind to do that.”
“I have my medicine rst of all, and I have chocolates, I have food, papers, two
pants, two shirts, two sweaters, one pair of shoes, a radio, ashlight, and water.”
“e food is not there, but I have chocolates there, just in case, because you can
survive with chocolates and water.”
“. . . money in cash, passports, all those things and important documents—I
keep them in a small briefcase—the most important papers like cards.”
“Just a few cans that they have given me at the church in a small cabinet. Like
about ve.”
“Maybe like six cans of canned fruit. A bag of cookies, powdered milk, two
gallons of water.”
“e documents are to identify yourself, because in this country, if you don’t
identify yourself they’re not going to help you.”
(Continued on p. 336)
Box 2. (continued)
336 Developing a disaster preparedness campaign
Disaster Supplies: Quantities
“No, if there are 4 or 5 people, with one gallon it’s enough for several days.”
“About a case of 35 little bottles, for example for about 4 people.”
“Let’s say for a family of six, enough for about three days . . . it would be about
30 little bottles.”
Disaster Supplies: Purchase, Use, and Storage
“Every time I go to the market, if I’m going to buy one can, I try to buy two so I
can store one away.”
“Because some people use them but don’t replace them. at’s happened to me.
ey’ve nished the water, they go to the beach. Right now, I don’t think I have
any le.”
“Because you know, many buildings, there’s nowhere to put things.”
“Well, I think sometimes it’s lack of storage space.”
“My house is also small, but I try to put it where we can have space because we
live in a small apartment and there are three of us.”
Communication Plans
“Yes, the emergency kit is easy, you’ve just got to get the items though. A
communications plan, you got to sit down with your family and tell them where
to go. What phone to call in case of an emergency. What’s going to be the route?
Who’s going to grab what, you know, you actually need to sit the whole family
down and discuss the communication plan.”
“It’s a little hard because we come up with a lot of ideas. What if this happens,
or what if this happens?”
“e hardest part is to sit the whole family down because everybody has got
things to do.”
“Well, the same thing with youth. ey want to live in the moment. We have to
die from something. at’s they’re answer.”
“Teenagers, they don’t want to hear.”
Preferred Sources of Information
“Well, more classes like this one that would teach us, that would give us more
information. Because like on TV, you have to wait until the time they talk about
this and, well, you can’t be glued to the TV waiting to see how you need to get
prepared or how to do it. I think with more classes, more communication . . .
that there should be more workshops like this one.”
“Someone who has the knowledge either through school, or because they received
training, or because they work with the community because something happened
to them and they don’t want the same thing to happen to other people.”
Box 2. (continued)
337
Eisenman, Glik, Maranon, Gonzales, and Asch
Table 1.
DESCRIPTION OF FOCUS GROUP PARTICIPANTS N5100
Gender
Male 28
Female 72
Age (years)
Average 40
Marital status
Married or living with someone as married 61
Separated or divorced 11
Widowed 4
Never married 22
Missing 2
Employment status
Working 35 or more hours per week 17
Working less than 35 hours per week 15
Unemployed and looking for work 14
Unemployed and not looking for work 4
Student or retired 7
Disabled 9
Keeping house 21
Missing 13
Children 17 years of age or younger at home
Yes 62
No 38
Number of other adults in household
1 18
2 44
3 17
4 12
Missing 9
(Continued on p. 338)
Results
Participants reported signicant concerns about earthquakes and terrorism, especially
subway bombings. Gang violence (maras), school shootings, home robberies, home res,
murder attempts, kidnapping, car accidents, and riots were oen cited as examples of
disasters in their communities. Other disasters they worried about were hurricanes,
tsunamis, oods, wildres, and tornados. Participant characteristics are summarized
in Table 1.
Many participants had experienced disasters themselves, including earthquakes,
oods, war, and the Watts and Rodney King riots, experiences that had led them to
make some preparations for a disaster (Box 2).
338 Developing a disaster preparedness campaign
Consequences of disasters. Participants cited loss of life, property, jobs, and diculty
with family reunication as the consequences of a disaster. However, disruption of
essential services was rarely mentioned. Participants expressed considerable anxiety over
losing control of their emotions and spoke frequently about remaining calm (calma),
not panicking, (“stay calm, don’t get desperate or hysterical”) and having “presence of
mind” during an earthquake. e anxiety centered on events during an earthquake (“I
feel like everything is going to fall and at the moment what am I going to do?”) and
how they might respond (“You’re going to panic and go out running if a building falls”)
and less about the post-earthquake period. Participants oen stated that a person can
prepare best for an earthquake “if you know what to do in that moment.”
Parents frequently expressed anxiety over their children losing control and spoke of
teaching their children that “they shouldn’t panic.” Several recommended we “prepare
them so that they’re at school and not running around the street.”
Attitudes about readiness. Participants noted that preparation is useful and neces-
Table 1. (continued)
Home/apartment ownership or rental
Own your home 9
Rent 85
Other 4
Missing 2
Years living in the United States
Average 19
Country of origin
Mexico 50
El Salvador, Guatemala, Nicaragua, Honduras 46
Missing 4
Highest level of education
0–5 13
6–8 20
9–12 43
12 19
Missing 5
Annual family income ($)
Under 10,000 30
10,000–19,000 23
20,000–29,000 21
30,000–39,000 5
40,000–49,000 4
50,000 3
Missing 14
Note: Data not available on two participants
339
Eisenman, Glik, Maranon, Gonzales, and Asch
sary. ey frequently cited Hurricane Katrina as evidence that governments are oen
provide inadequate assistance (“e government does not worry about areas were
Latinos live”). ey also noted that government aid arrives “late” and may discriminate
against undocumented immigrants or use it as an opportunity to deport them.
Disaster supplies: recommended items. Less than half of participants recognized
the terms disaster kit or emergency kit though most heard of disaster supplies or emer-
gency supplies (“Sorry, a kit? A rst aid kit?” “What’s the dierence between a disaster
kit and a rst aid kit?”). Frequently-mentioned supplies were an water, extra money,
non-perishable foods, candles, ashlights, batteries, a battery-operated radio, a portable
radio, can openers, canned food, warm clothing, and rst aid materials (“A rst aid kit,
of course. We always have that”). Less frequently mentioned were blankets and medi-
cines. Occasionally credit cards were recommended (“Credit cards too. In a disaster
there’s no money”). Participants listed immigration-related papers commonly (“ey’ll
send you to Immigration!”) and “shot records.” Finally, several groups recommended
high calorie sweets (“like jelly, chocolate has a lot of vitamins, calories”) and vitamin
supplements (“extra vitamins”).
Disaster supplies: quantities. Most participants reported that “a few” or “several days”
worth of water was needed (“A least for 5 days,” “To be able to survive for a few days I
could imagine”). However, many reported insucient quantities of water (“Yes, I have,
for example, a gallon of water and I know that I have enough there for a month.”)
Disaster supplies: purchasing, use, and storage. Due to their limited incomes,
many participants purchased supplies one at a time:
When I go to the market and if I need ve bottles of water, I buy six and I say that
that is extra. It’s something extra for us just in case, like they say.
ough items were intended to be for disasters, circumstances oen led participants
to use their supplies:
ere are times when you’re unemployed and you get from [the emergency supplies]
to be able to eat.
When probed about how well-organized the supplies were, very few participants
stated that they were stored in one place. A typical response was:
I think we all have all those things, but many of us don’t have them . . . in one place,
like you said, a kit. ey’re scattered, like the Band-aids in a drawer, the water where
we use it every day, right?
Participants reported lack of space in crowded houses and apartments as an impor-
tant obstacle to storing disaster supplies in a single container:
Because we rent one room. I’m with my mother.
Communication plan. e idea of a communication plan was oen misunderstood
as having the supplies to receive communications such as walkie-talkies and cell phones
340 Developing a disaster preparedness campaign
(“Even if you have three or four telephones, you need a cell phone number, even if it’s
just for a family”). When the concept was explained, more participants understood it
though they noted that it was more dicult to accomplish than assembling supplies
(“It’s not that simple like saying here’s $200, let’s go buy it”). While purchasing and
assembling disaster supplies can be done by a single member of the family, developing
an emergency communication plan requires involvement, communication and agree-
ment among multiple family members:
I think the hardest part would be brainstorming, getting everyone to agree with the
same plan.
A communication plan requires discussion about possible disaster scenarios,
which some participants found dicult, especially for participants with adolescent
children.
I’ve mentioned it, but they all say don’t get dramatic. Like they don’t take me
seriously.
Preferred sources of disaster information. Many participants stated they enjoyed
the focus group format and discussing their experiences and knowledge with each
other. Several groups spontaneously suggested small group discussions and informal
meetings (platicas) to learn about disaster preparedness. One participant said,
But I think even now, just as a group, like I learned a lot from each and every person
here, so even that, you know, that’s even helpful.
Participants wanted specic help with building their family communication plans
and asked each other and the facilitator for recommendations for their specic circum-
stances. ey rated promotoras de salud highly as potential teachers.
Discussion
Focus groups provided insights into disaster preparedness among low-income Latino
immigrants in Los Angles. Participants highlighted remaining calm during an earth-
quake, but rarely mentioned disruption of services (e.g., gas, electric, water, telephone).
Individuals are advised to prepare to live without any services for three to seven days
following a major disaster. Disaster materials and programs for this community must
emphasize this and its concrete implications. e research team’s recommendations
based on this research are summarized in Box 3.
Disaster supply kits appear not to be acceptable in this community. Many partici-
pants lived in crowded apartments so that space limitations were an obstacle to storing
a kit; adding a receptacle holding such supplies was viewed as burdensome. Instead,
prioritizing the stocking of supplies generally instead of the creation of single “kit”
should be considered.28,29
Although participants understood the types of basic supplies needed, there was
confusion and misinformation about the exact quantities of water and about the cor-
341
Eisenman, Glik, Maranon, Gonzales, and Asch
Box 3.
RECOMMENDATIONS FOR DISASTER
PREPAREDNESS PROGRAMS THAT TARGET
LOWINCOME, IMMIGRANT LATINOS
Targeted Content
1. Emphasize the disruption of essential services and the concrete consequences
of this loss. Most focus groups did not mention loss of gas, electricity, water,
or phone among the consequences of a disaster. Some participants reported
stocking dried rice with the assumption that they could cook it. Others
suggested credit cards would be useful, though telecommunications, banking
and electricity may be down. Additional information is needed to link service
loss directly to the inability to cook, clean, ush toilets or other activities.
2. Use familiar terminology. Latinos may use dierent terms for disaster supplies
based on their countries of origin and educational levels. ey may not be
familiar with “disaster kit” and “communication plans.” It is important to
consistently use accepted terms.
3. Provide clear, concise, prioritized information about safety during an
earthquake. Participants were most concerned about panicking if they were in
a building during an earthquake. ey believed that learning how to protect
themselves would allow them to remain calm so they could help others and
reduce their risks of injury. Emphasizing “drop, cover and hold” may reduce
this anxiety and reduce injury (agachese, cubrase y detengase).
4. Disaster “kits” are unlikely to be adopted by urban-dwelling, low-income
Latinos. It is imperative that disaster preparedness programs address
stockpiling supplies within the context of the target audience’s resources,
environment and lifestyle. Specically, space considerations and the need to
use disaster supplies on a routine basis (e.g., important documents, extra food
when guests come over or money is short) preclude the building and storing
of a single container with all supplies. It is more important to prioritize the
stockpiling of extra supplies as the primary issue. A disaster kit available
for evacuating one’s home in a hurry does not reect the situation of this
population who are unlikely to have a private vehicle for rapid evacuation
anyway. Storage under a bed or in a closet is an alternative for some
households.
5. Be specic about appropriate types and quantities of supplies. Recommend
specic foods that are both nutritionally appropriate and culturally acceptable
to Latino immigrants. Recommend specic quantities of water per person
using liters not gallons (1 gallon53.78 liters) as the unit of measure,
emphasizing its use for hydration and hygiene. Seven days worth may be
too much to achieve in a low-income household so recommend a 3 to 7 day
supply.
(Continued on p. 342)
342 Developing a disaster preparedness campaign
Box 3. (continued)
6. Provide details on family communication plans. e barriers to obtaining
supplies are dierent from the barriers to developing a communication
plan. e concept of “communication plans” was oen misunderstood by
participants in this study. Use terminology that requires low literacy skills,
such as “Your family should have a plan for nding each other and knowing
everyone is safe aer a disaster.” Recommendations for constructing a family
communication plan need to be responsive to the lives of low-income Latinos,
including parents who hold multiple, part-time jobs and whose out-of-town
contacts may live in Mexico or Central America.
Targeted Methods
7. Use small-group discussions to deliver education. Participants enjoyed the
focus group format and oen suggested small group discussions and informal
meetings (platicas or charlas) as a method of learning.
8. Use promotoras to deliver educations. Participants viewed promotoras
as respected and credible sources of disaster information. Additionally,
promotoras are experienced with teaching in a small-group discussion format.
9. Provide a hands-on learning experience. Participants had questions about
lling out their communication plans. is could be addressed by having the
participants start lling their cards out in the group so that questions could be
identied, misinformation corrected, and locally-relevant solutions suggested.
10. Use targeted materials with prioritized information. Provide low-literacy
written materials that focus on a limited set of prioritized messages.
rect food. Most groups included participants who greatly under-estimated the amount
of water needed to be disaster prepared. Similarly, most groups had participants who
included chocolate, candy, and cookies among the foods one should stock. It is not
clear whether this lack of knowledge is a result of low literacy (e.g., FEMA’s website
recommendation to “stock canned foods, dry mixes, and other staples that do not
require refrigeration, cooking, water, or special preparation” is written at a higher level
of readability than many participants in our focus groups had attained),29 or exposure
to incorrect health and disaster information in their communities. Future preparedness
programs targeted to low-income Latino communities must provide clear instructions
about quantities of water and types of food.
Disaster preparedness programs targeting low-income Latino immigrants may
utilize social networks and informal gatherings to disseminate information. Partici-
pants were enthusiastic about small group gatherings to learn, oen citing the focus
groups themselves as a model. Engaging participants to share lessons with each other
is consistent with methods of adult learning theory, which recognizes that adult learn-
ers have experience (many participants had experienced disasters) and that learning
must be learner-centered.30,31 Disaster programs can leverage these experiences by
343
Eisenman, Glik, Maranon, Gonzales, and Asch
facilitating individuals’ contributions to the goals of teaching. Similar recommenda-
tions resulted from focus groups held for the National Heart Lung and Blood Institute
Latino Community Cardiovascular Disease Prevention and Outreach Initiative, Salud
para su Corazon.32
Small group gatherings may be particularly suitable since they provide an opportunity
for addressing participants’ anxiety over losing control and for clarifying uncertain-
ties and misunderstandings regarding communication plans. Promotoras appear to be
credible in this regard and may be eective because they use their cultural knowledge
and leadership role in the community to model behavior, overcome barriers, and
promote change.
Our results are consistent with the few studies of preparedness among Latinos.
Carter-Pokras and colleagues also found that Latino focus groups considered home res
and gangs (maras) to constitute emergency situations.33 Furthermore, concerns about
remaining calm (calma) were prevalent in their groups. In another study, low-income
Mexican Americans were more likely than Whites to report neighborhood meetings as
a preferred channel for preparedness information.34,35 Similarly, friends and families may
be more important sources of disaster preparedness information among Latinos than
among non-Latino Whites.36 ese results are consistent with our nding that platicas
(or charlas in Carter-Pokras’ study) could provide ecacious means of disseminating
preparedness programs.
We performed focus groups to understand disaster preparedness among Latino
immigrants living in low-income communities in Los Angeles County. Our results
are not meant to identify categorical distinctions attributable to ethnicity or socioeco-
nomic status or to suggest stereotyped programs on the basis of these characteristics.
e interaction of participants and the group dynamics within focus groups impose
limitations to the generalizability of the data. Additionally, participants were mostly
married women with children and not working full-time outside of the home. As
Project PREP was intended to target Latino immigrants living in low-income com-
munities, our sample included more married Latina women with children, who were
immigrants and living below the federal poverty line, than the general population of
Latino persons in Los Angeles.37 So, the results of our study are not representative of
Latinos in general.
Conclusion
ese data allow us to understand low-income Latino immigrants’ beliefs regarding
preparedness, barriers, preferences, and facilitators to adopting and sustaining pre-
paredness behaviors. Based on these results, future studies might examine the value of
utilizing social networks and informal gatherings, such as platicas, to improve disaster
preparedness in this community.
Notes
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