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3. Capítulo 2: Marco de referencia

3.3 Fisioterapia

3.3.3 Rehabilitación

Educating individuals, especially children, about hazard risks and how to respond to them can save lives (e.g., Ronan & Johnston, 2005; UNICEF, 2011). The inclusion of

hazards education within the formal school system is seen as an effective mechanism for the dissemination of hazards information into the broader community to increase resilience (e.g., GADRRRES, 2017), as schools provide a link between children, families, and communities (e.g., Ronan & Johnston, 2005). Incorporating hazards education material in school curricula is an efficient means to empower children and increase their preparedness by: promoting more realistic risk perceptions; increasing hazard knowledge; reducing hazard related fears; and increasing home-based preparedness efforts (e.g., Peek, 2008; Ronan at al., 2016).

Two recent international reviews have provided the current understanding of hazards education programmes and their effectiveness. Johnson et al. (2014c), is a methodological review of 35 evaluations of school-based hazards education programmes. The study found major gaps in the evidence base used to evaluate the effectiveness of education programmes, due to significant methodological limitations (e.g., sample sizes, lack of baseline data and control groups). Ronan et al. (2015) provides a critical review of the international research on preparedness for children in disasters with a focus on education programmes. For the most part, the review findings were positive. However, it was noted that in spite of a dramatic increase in the child- centred disaster research available over the last 15 years more work needs to be done. For example, in addition to the issues related to methodological rigour recognised by Johnson et al. (2014c), Ronan and colleagues identify a need for programme content and delivery issues to be addressed, thereby ensuring physical and psychosocial preparedness components of programmes are evidence-based. Finally, the Ronan et al. review asks whether “programs actually do decrease risk and increase resilience when intended, including saving lives, reducing impacts (e.g., injuries, psychosocial consequences, property damage; DRR costs), and helping children and families get back on their feet and bounce back more resiliently when disaster strikes” (p. 58). It is not known how many school children have access to education programmes, as this is not often asked by researchers. Much of the information available is based upon research conducted with students asking about their preparedness knowledge (e.g., safety behaviours) and in some cases, what preparedness activities had been undertaken in their homes (see Johnson et al., 2014c for an overview of these studies). Two of the studies introduced in the previous section, provide some small insights. For example, the RiskRED (2009) survey of Californian schools found 20% of students were aware of some basic information such as how to turn off flames and isolate hazardous material in science laboratories, and 69% knew the ‘4 rules for building evacuations’ (i.e., don’t talk; don’t push; don’t run; and don’t turn back). In their survey

of schools in the Central US states, Petal et al. (2011) reported 25% of students had been provided with information about how communities can build and plan to reduce disaster impacts, and 22% of students had participated in projects or activities to learn how to reduce disaster impacts. What remains unclear is what proportion of schools provide their students with access to hazards education and home-based preparedness material that can increase their individual safety and family resilience to disasters and emergencies.

In addition to providing hazards education programmes and response training to students, school staff also require training. Staff are often first responders to emergency events occurring at school, and as such they require training to support their response efforts. School leaders and staff need the skills and resources to develop emergency response and preparedness plans (Alba & Gable, 2012; Burling & Hyle, 1997). To assist in ensuring the necessary skills and resources are available, schools are encouraged to establish crisis management teams (e.g., Chung et al., 2009; GADRRRES, 2017; Pitcher & Poland, 1992), with the responsibility of overseeing preparedness and response efforts in the school. In addition to school leaders, it is recommended that where available, crisis management teams include other school-based professionals, with the relevant skills and knowledge to contribute to school emergency management, such as: nurses (e.g., Rebmann, Elliott, Artman, VanNatta & Wakefield, 2015); social workers (e.g., Werner, 2014); and psychologists (e.g., Adamson & Peacock, 2007).

It is also recognised as beneficial (e.g., Chung et al., 2009; Kano & Bourque, 2007; Momani & Salmi, 2012) that school leaders (and staff) receive training in managing crisis situations, to help when making decisions in stressful situations where information, time and resources may be limited (MacNeil & Topping, 2007). Children look to significant adults to guide how they will respond during and after an emergency (Lazarus, Jimerson & Brock, 2003). Consequently, the need to prepare school staff to respond to the emotional and cognitive needs of their students and colleagues during and after an emergency has become a focus in school preparedness literature since the mid-2000s (e.g., Adamson & Peacock, 2007; American Academy of Pediatrics, 2008a; Heath et al. 2007). As a result, the emphasis has moved away from staff only responding to the physical requirements of students in emergencies, to a more inclusive approach which also considers students psychological needs, usually as a result of staff being trained in some form of psychological first aid or crisis management training (e.g., Elangovan & Kasi, 2015; Ramirez et al., 2013; Trethowan & Nursey,

being as important to response and recovery efforts as physical preparedness (Ronan & Johnston, 2005).

In sum, there is a consensus that providing students and staff with education and training ensures that they have the necessary knowledge and skills to respond appropriately during an emergency. However, there is little research available identifying current levels of students’ access to hazards education programmes, and students and staff training for emergency response.