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How can a method used to get smokers to quit be used to get people better prepared for hurricanes?

As much as building better levees, tracking storms more accurately and training future emergency professionals, changing the behavior of residents in storm-susceptible communities can have a major effect on resilience to natural hazards. Initiating changes in behavior – to faster, more substantive decision-making in the event of an oncoming hazard – is the focus of a Coastal Resilience Center of Excellence (CRC) project led by Dr. James Prochaska of the Cancer Prevention Research Center at the University of Rhode Island.

Dr. Prochaska’s project focuses on how individuals react to risk information. He says his well-established method of tailoring behavioral changes can be applied to all manner of behaviors, such as insurance purchases, buying supplies for long power outages and more.

The project team also includes researchers Dr. Andrea Paiva, Pam Rubinoff, Dr. Janet Johnson, Dr. Norman Mundorf and Dr. Colleen Redding.


Motivating action

Dr. James Prochaska
Dr. James Prochaska

Dr. Prochaska, whose project is titled “Communicating risk to motivate individual action,” focuses on the issue of preparedness for hazards. It operates on the understanding that efforts to communicate disaster preparedness and risk messages usually lead to increased public awareness. However, research shows that actual preparedness measures show relatively little improvement over time.

Researchers are tailoring risk-related communication to a diverse group of users, representing key populations in coastal areas. Based on responses to a wide-ranging survey, individuals receive online feedback and coaching to move them toward improved readiness to prepare and mitigate the impacts of coastal storms.

The project is based on theories of behavior change psychology, which state that behavior targeted for change must be clearly defined and include specific achievable goals. Theories hold that behavior change is a process composed of progress through a series of stages of change. While pairing behavior change methods and preparedness have been shown to be successful, they are not commonly employed in emergency and planning communication.

The project uses the Transtheoretical Model of Behavior Change (TTM), which has been tested on more than 50 risk behaviors that change over time. The model includes five stages: 1) Precontemplation (Not Ready); 2) Contemplation (Getting Ready; 3) Preparation (Ready); 4) Action; and 5) Maintenance. At each stage, different principals and processes need to be applied to result in effective action, continued over time.

“Leaders of FEMA’s Preparedness in America Program have expressed considerable enthusiasm about our project,” Dr. Prochaska said. “They have already been drawing heavily on TTM, so we have quickly begun to collaborate.”

The Transtheoretical Model of Behavior Change has five stages, divided into Pre-Action and Action elements.
The Transtheoretical Model of Behavior Change has five stages, divided into Pre-Action and Action elements.

Researchers will use computer tailored interventions (CTIs) – online, user-friendly programs that ask a series of questions and provide immediate feedback tailored to the users’ responses. Data from a pool of 1,000 research participants will be used to benefit local, state and federal emergency managers and coastal planners.

Dr. Paiva said that the response has already exceeded expectations.

“We have been able to recruit 3,000 instead of 1,000 individuals from four susceptible coastal communities to participate in our program to help us assess its impact,” Dr. Paiva said.

They hope these communications can produce models for interventions applied across entire populations that are fully tailored to each individual and in ways that drive the most change. Statistical decision-making rules determine the best messages that should be sent and provide feedback on where participants are making their best efforts, where they need to improve and where they are progressing. The secondary focus will be on mitigation behaviors designed to reduce damage from wind and flooding.

Digital technologies like texting can provide personalized communications tailored to each individual’s stage of change and their use of processes that can maximize progress to effective action.

To evaluate whether interventions are working, longitudinal studies are necessary over a period of time, including reassessing participants after one- and two-year periods to determine how behaviors change by movement through the five stages, and to adjust the individualized digital coaching accordingly.

Among those expected to be most impacted by the project are coastal residents who are not prepared but are likely to incur large costs during recovery. The project engages large populations, conforming to the core guiding principles of the Department of Homeland Security’s Whole Community Approach.

“Our innovations applying digital technologies like texting, can provide personalized communications tailored to each individual’s stage of change and their use of processes that can maximize progress to effective action,” Dr. Prochaska said. “These proven approaches to behavior change can complement FEMA’s use of mass media. Together we are likely to produce impacts that can dramatically increase preparedness in America.”

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