Regional Metrics Pertinent for Children and Families in Disaster Cycle

Background: Awareness of day to day situations that can effect children and families in disasters is an important component to mitigation in the disaster cycle through the development of standardized metrics to evaluate all types of events. Children make up 20% of the US population and are impacted physically and emotionally by disasters. Issues related to social and physical determinants of health emphasize the inequities between preparedness for the segments of the US population in different communities, as evidenced by the COVID pandemic. Tools have been created to assist communities to address hazards, such as the Hazard Vulnerability Analysis (HVA) and the Threat Hazard Identification and Risk Assessment (THIRA), but unique needs of children are not included or highlighted in these tools. The Assistant Secretary for Preparedness and Response (ASPR) created two Pediatric Disaster Centers of Excellence (COE) in 2019, Western Regional Alliance for Pediatric Emergency Management (WRAP- EM) and Eastern Great Lakes Pediatric Consortium for Disaster Response (EGLPCDR) and situational awareness around pediatrics and disasters was a important deliverable.

Methods: Along with the two pediatric COE, and Emergency Medical Services for Children (EMSC/EIIC) disaster domain experts, a group of pediatric disaster subject matter experts (SME) identified key infrastructures and support mechanisms that exist and could be important to healthcare coalitions or communities when considering children and families within a region.Through a modified delphi process, nine domains were recommended. The domains consisted of healthcare expertise available within a region, mental health considerations, community resiliency, early education and schools, transportation services, public health jurisdiction, shelters and sheltering in place, supply chain and patient tracking, reunification and evacuation.

Results: An extensive literature search was completed to review existing resources that could inform quality measures within the domains identified. Alignment of available measures that could inform the domains was completed and a scorecard was created to pilot among healthcare coalitions to better assess community level awareness for children and families that are important to the entire disaster cycle. This scorecard and preliminary evaluation will be used to create the first regional metrics scorecard for situational awareness to help inform the nine domains within communities or healthcare coalitions that can be important to consider when mitigating for disasters effecting children and families.

Conclusion: When used at least annually, this regional metrics scorecard can inform where improvement and where further attention is needed to better prepare for future disasters improving the resilience for children and families and the entire community.