Communicating Risk to Motivate Individual Action

CRC2ndAnnualMeetingFeb.1-3,2017TheUniversityofNorthCarolinaatChapelHill

JamesO.Prochaska,Ph.D.,CPRC,UniversityofRhodeIslandAndreaL.Paiva,Ph.D.,CPRC,UniversityofRhodeIsland

PamRubinoff,CoastalExtensionSpecialist,CRC,UniversityofRhodeIslandJanetL.Johnson,Ph.D.,Pro-ChangeBehaviorSystems

NorbertMundorf,Ph.D.,Communications,UniversityofRhodeIslandColleenA.Redding,Ph.D.,CPRC,UniversityofRhodeIsland

CommunicatingRisktoMotivateIndividualAction

TheUniversityofNorthCarolinaatChapelHill

ProjectGoal:ApplytheTranstheoreticalModel(TTM)todevelopandtestcomputertailoredinterventions(CTIs)viatextmessagingdesignedtofacilitateandacceleratecoastalresidents(NEandFL)throughthestagesofchangetotakeactiontoprepareforandmitigateimpactsofcoastalstorms.

RelevancetoHomelandSecurity

RelevancetoHomelandSecurity.Thisresearchwillstrengthennationalpreparednessandimprovetheresilienceofcoastalcommunitiesinthefaceofcoastalstormhazards.• Coastalresidentswhoarenotreadyordonotseethebenefitsofbecomingpreparedwillbehitthehardestandwilleventuallycostthemostmoney.• Byengagingtheentirepopulation,weareabletomakelargerimpactsonthecommunityandconformtothecoreguidingprinciplesoftheDHSWholeCommunityApproach:1. understandandmeettheneedsoftheWholeCommunity2. engageandempowerallofthecommunity3. strengthenwhatworkswellincommunitiesonadailybasis.

CRC2ndAnnualMeetingFeb.1-3,2017


•Pre/PostInterventiontrialthatincludestextmessagingtoincreasedisasterpreparedness

•Tailoringinterventionandtextmessagestothemostimportantchangevariables

•3,043peoplefromNewEnglandandGulfCoastStatescollectedduringtheSpringof2017,althoughfundedforonly1000.

ThismaterialisbaseduponworksupportedbytheU.S.DepartmentofHomelandSecurityunderGrantAwardNumber2015-ST-061-ND0001-01.

THEPROJECTOverview

N %

Gender Female 1938 63.7

Male 1094 36

Transgender 9 0.3

Other 2 0.1

Race AmericanIndian/AlaskaNative 37 1.2

Asian 122 4

Black/AfricanAmerican 236 7.8

NativeHawaiian/PacificIslander 15 0.5

White 2633 86.5

Ethnicity Hispanic 332 10.9

NotHispanic 2711 89.1

DHSBaselineDataSummary(N+3043)

Education Highschoolgraduate 469 15.4

Somecollege 895 29.4

Bachelor’sdegree 942 31

Graduatedegree 611 20.1

Certificate 85 2.8Other 41 1.3

OwnHome Yes 2126 69.9

No 917 30.1

State Alabama 390 12.8

Connecticut 306 10.1

Florida 1787 58.8

Massachusetts 477 15.7

RhodeIsland 77 2.5

DHSBaselineDataSummary(N+3043)

n %

BaselineStage–Disaster Precontemplation 352 11.6

Contemplation 545 17.9Preparation 748 24.6Action 783 25.7Maintenance 615 20.2

StageofChangeOverall

NewEngland GulfStates(n=2,177)

N866 28% n 72%

BaselineStage–Disaster Precontemplation 164 19.1 187 8.6

Contemplation 213 24.8 332 15.3Preparation 206 24 541 24.9Action 145 16.9 636 29.2Maintenance 132 15.3 481 22.1

StageofChangebyRegion

StageofChangebyRegion(Pre-ActionStagesOnly)

Overall NewEngland GulfCoastPrecontemplation 21.4 28.1 17.6Contemplation 33.2 36.5 31.3Preparation 45.5 35.3 51.0

21.4

28.1

17.6

33.236.5

31.3

45.5

35.3

51.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Percent

AxisTitle


BaselineVariableComparison

•WedichotomizetheStageofChangevariableintoPre-Actionvs.A/Mtoexploredifferencesbetweenthosepeoplewhohavenotyettakenaction(PC,C,&Prep)andthosewhohavetakenaction(Action&Maintenance).

•Analysescomparethesegroupson:•Demographicvariables•TTMvariables


•Race,Ethnicity,andGender:•DifferenceswerenotfoundbetweenPre-ActionandA/Mindividualsonraceorethnicityhoweversignificantdifferencewerefoundongenderwithahigher%ofmenbeinginA/M.

•Education:•Nosignificantdifferences,butthepercentofpeopleinA/Mincreasesacrosslevelsofeducation(HighSchoolà Collegeà GraduateDegree).

•HomeOwnership:•Significantlymorehomeowners(50.6%)wereinA/Mcomparedto35.2%ofnonhomeowners.

DemographicVariables

44

46

48

50

52

54

56

PC Cont PR Action Maint

ProsCons

PCà Action


StageTransitions

TheprosandconsofchangingacrossstagesofchangefromPCtoAction

Hall,K.L.&Rossi,J.S.(2008).Meta-analyticexaminationofthestrongandweakprinciplesacross48healthbehaviors.PreventiveMedicine,46, 266-274.




TTMVariables

45464748495051525354

Pros Cons Confidence

Pre-Action A/M

SignificantdifferenceswerefoundonPros,Cons,andConfidence


Activities,findingsandoutcomestodate

ResearchWorkandAccomplishment

Expectedactivities,findings,andoutcomesforremainderofproject

1. Cross-sectionalModelforTailoringDisasterPreparednessCommunicationsBasedonover3,000participants

2. LongitudinalModelforTailoringDisasterPreparednessCommunicationsBasedonover3,000participants

3. InterventionImpactsofTailoredCommunicationsComparingInterventionandControlGroupsat12months.

4. Expectatleast10xgreaterpreparednessininterventiongroupcomparedtoseculartrends.

1. Fullyfunctioningprogramisnowavailable.Thisinvolvedincorporatingchangesbasedonadvicefromend-usersandwidenedthecontenttoincludeNewEngland,Alabama,andFloridaresidents,andnowincludestextmessagingthathasbeendeliveredtoover3,000participantsoverthenextyear.


EngagingEndUsersRIRedCross,RIEmergency

ManagementAgency• Interestinexpandingoutreach

programstoimprovepreparedness• Modelforotherstatechapters

FEMAIndividualandCommunityPreparednessDivision

• Researchdesign,evaluation,• Tooltoincreaseandmonitor

behaviorchangenation-wide

IBHS– InsuranceInstituteofBusinessandHomeSafety

• Research-orientedassociation,supportsnationwideinsuranceindustrypartners

SmartHomeAmerica• Toolforcitizenoutreachfor

preparedness.


TechnicalActivitiesandMilestones– 1/1/2016to6/30/18

ResearchActivity Start/CompletionUpdate/customizeInternetCTI;Developstatisticaldecisionrulesfortext-basedCTIs. Completed6/30/16

CreateTTM-basedtextmessages;Programandtesttextsystem. Completed12/31/16

CompleteupdatedCTIsystem,includingtextmessages,readytodisseminate. Completed12/31/16

Recruitcensus-basedsampleof3,000coastalresidents(NE,AL,andFL) Completed1/31/17

Analyzeandreportbaselinedataon3,000coastalresidentsrecruitedintothestudy. 2/15/17- 3/15/17

DeliverInternetCTIandfirst12monthsoftextmessagingwithfrequencytailoredtostage. 1/15/17– 12/31/17

Follow-upParticipants 1/15/18– 3/31/18

Analyzeandreportdataon12monthoutcomesofcoastalresidentsrecruitedintothestudy. 4/01/18– 6/30/18

ResearchWorkandAccomplishment


AnticipatedProjectImpact1. Evidence-basedtailoreddigitalcommunicationwillbereadyfor

disseminationbyend-users.2. Cross-sectionalresultswillbeamongstthehighestimpactstudiesofrisk

communicationsandbehaviorchangeforpopulationpreparedness.3. Longitudinalresultswillbeamongstthehighestimpactstudiesfor

populationpreparedness.4. Empiricalmodelfortailoringdigitalcommunicationswillbeamongst

thehighestimpactstudiesforpopulationpreparedness.5. Interventionpreparednessoutcomeswillbeamongstthehighest

impactstudiesforpopulationpreparedness.


ProposedFollow-onWork

ProposedProjectTitle:DigitalTechnologiesDeliveredinSchoolstoIncreaseHouseholdPreparednessBehaviorstoReduceRisksforNaturalDisasters

Objective:AdaptourCTIsandtextmessagestopreparehighschoolstudentstobecomechangeagentsinhelpingtheirhouseholdsmakebehaviorchangesneededtoreducerisks.

AnEducationalCommunityPartnershipusingevidence-basedhealthinterventionstohelpstudents becomeagentsof

changeinhelpingtheirhouseholdsreducerisksfromnaturaldisasters

Karin Oatley, M.A., C.A.G.S. Director of School-based Interventions

UniversityofRhodeIsland&

WesterlyHighSchool“Together…CreatingaPositiveChangeinOurCoastalCommunity”


BriefSummary&Timeline•Approximately400highschoolstudents(FreshmanandSophomoresonly)toparticipateinanonlinebriefassessmentfollowedbyanindividuallytailored computerizedinterventionhelpingthemtobeagentsofchangewithintheirhousehold intheareaofemergencypreparedness.

•Utilizationofapassiveparentalconsentprocess.

•Accesstoparticipantstwotimesduringthe2017-18schoolyear(February&May).

•Classroomtimeneeded- approximately25minutestotal- 5minutesforthebriefintroductionand18minutesfortheassessment&tailoredTTMfeedback.

•Betweenclassroomvisitsstudentparticipantswillbeaskedtoreceive1-4textmessagespermonthwhichalsoprovidestage-matchedfeedbackregardingemergencypreparedness.

Communicating Risk to Motivate Individual Action

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