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Research papers, University of Canterbury Library

One of the great challenges facing human systems today is how to prepare for, manage, and adapt successfully to the profound and rapid changes wreaked by disasters. Wellington, New Zealand, is a capital city at significant risk of devastating earthquake and tsunami, potentially requiring mass evacuations with little or short notice. Subsequent hardship and suffering due to widespread property damage and infrastructure failure could cause large areas of the Wellington Region to become uninhabitable for weeks to months. Previous research has shown that positive health and well-being are associated with disaster-resilient outcomes. Preventing adverse outcomes before disaster strikes, through developing strengths-based skill sets in health-protective attitudes and behaviours, is increasingly advocated in disaster research, practise, and management. This study hypothesised that well-being constructs involving an affective heuristic play vital roles in pathways to resilience as proximal determinants of health-protective behaviours. Specifically, this study examined the importance of health-related quality of life and subjective well-being in motivating evacuation preparedness, measured in a community sample (n=695) drawn from the general adult population of Wellington’s isolated eastern suburbs. Using a quantitative epidemiological approach, the study measured the prevalence of key quality of life indicators (physical and mental health, emotional well-being or “Sense of Coherence”, spiritual well-being, social well-being, and life satisfaction) using validated psychometric scales; analysed the strengths of association between these indicators and the level of evacuation preparedness at categorical and continuous levels of measurement; and tested the predictive power of the model to explain the variance in evacuation preparedness activity. This is the first study known to examine multi-dimensional positive health and global well-being as resilient processes for engaging in evacuation preparedness behaviour. A cross-sectional study design and quantitative survey were used to collect self-report data on the study variables; a postal questionnaire was fielded between November 2008 and March 2009 to a sampling frame developed through multi-stage cluster randomisation. The survey response rate was 28.5%, yielding a margin of error of +/- 3.8% with 95% confidence and 80% statistical power to detect a true correlation coefficient of 0.11 or greater. In addition to the primary study variables, data were collected on demographic and ancillary variables relating to contextual factors in the physical environment (risk perception of physical and personal vulnerability to disaster) and the social environment (through the construct of self-determination), and other measures of disaster preparedness. These data are reserved for future analyses. Results of correlational and regression analyses for the primary study variables show that Wellingtonians are highly individualistic in how their well-being influences their preparedness, and a majority are taking inadequate action to build their resilience to future disaster from earthquake- or tsunami-triggered evacuation. At a population level, the conceptual multi-dimensional model of health-related quality of life and global well-being tested in this study shows a positive association with evacuation preparedness at statistically significant levels. However, it must be emphasised that the strength of this relationship is weak, accounting for only 5-7% of the variability in evacuation preparedness. No single dimension of health-related quality of life or well-being stands out as a strong predictor of preparedness. The strongest associations for preparedness are in a positive direction for spiritual well-being, emotional well-being, and life satisfaction; all involve a sense of existential meaningfulness. Spiritual well-being is the only quality of life variable making a statistically significant unique contribution to explaining the variance observed in the regression models. Physical health status is weakly associated with preparedness in a negative direction at a continuous level of measurement. No association was found at statistically significant levels for mental health status and social well-being. These findings indicate that engaging in evacuation preparedness is a very complex, holistic, yet individualised decision-making process, and likely involves highly subjective considerations for what is personally relevant. Gender is not a factor. Those 18-24 years of age are least likely to prepare and evacuation preparedness increases with age. Multidimensional health and global well-being are important constructs to consider in disaster resilience for both pre-event and post-event timeframes. This work indicates a need for promoting self-management of risk and building resilience by incorporating a sense of personal meaning and importance into preparedness actions, and for future research into further understanding preparedness motivations.

Research papers, University of Canterbury Library

Abstract. Natural (e.g., earthquake, flood, wildfires) and human-made (e.g., terrorism, civil strife) disasters are inevitable, can cause extensive disruption, and produce chronic and disabling psychological injuries leading to formal diagnoses (e.g., post-traumatic stress disorder [PTSD]). Following natural disasters of earthquake (Christchurch, Aotearoa/New Zealand, 2010–11) and flood (Calgary, Canada, 2013), controlled research showed statistically and clinically significant reductions in psychological distress for survivors who consumed minerals and vitamins (micronutrients) in the following months. Following a mass shooting in Christchurch (March 15, 2019), where a gunman entered mosques during Friday prayers and killed and injured many people, micronutrients were offered to survivors as a clinical service based on translational science principles and adapted to be culturally appropriate. In this first translational science study in the area of nutrition and disasters, clinical results were reported for 24 clients who completed the Impact of Event Scale – Revised (IES-R), the Depression Anxiety Stress Scales (DASS), and the Modified-Clinical Global Impression (M-CGI-I). The findings clearly replicated prior controlled research. The IES-R Cohen’s d ESs were 1.1 (earthquake), 1.2 (flood), and 1.13 (massacre). Effect sizes (ESs) for the DASS subscales were also consistently positive across all three events. The M-CGI-I identified 58% of the survivors as “responders” (i.e., self-reported as “much” to “very much” improved), in line with those reported in the earthquake (42%) and flood (57%) randomized controlled trials, and PTSD risk reduced from 75% to 17%. Given ease of use and large ESs, this evidence supports the routine use of micronutrients by disaster survivors as part of governmental response.

Research papers, University of Canterbury Library

Abstract The original intention for the Partnership Community Worker (PCW) project in 2006 was for it to be an extension of the Pegasus Health General Practice and furthermore to be a bridge between the community and primary healthcare. It was believed that a close working relationship between the Practice Nurse and the PCW would help the target population of Māori, Pacifica and low income people to address and overcome their perceived barriers to healthcare which included: finance, transport, anxiety, cultural issues, communication, or lack of knowledge. Seven years later although the PCW project has been deemed a success in the Canterbury District Health Board annual reports (2013-14) and community and government agencies, including the Christchurch Resettlement Service (2012), many of the Pegasus Health General Practices have not utilised the project to its full extent, hence the need for this research. I was interested in finding out in the first instance if the model had changed and, if so why, and in the second instance if the promotional material currently distributed by Pegasus Health Primary Health Organisation reflected the daily practice of the PCW. A combination of methods were used including: surveys to the Pegasus Health General Practices, interviews with PCWs, interviews with managers of both the PCW host organisations and referring agencies to the PCW project. All the questions asked of all the participants in this research were focussed on their own perception of the role of the PCW. Results showed that the model has changed and although the publications were not reflecting the original intention of the project they did reflect the daily practice of the PCWs who are now struggling to meet much wider community expectations and needs. Key Results: Partnership Community Worker (PCW) interviews: Seventeen PCWs of the 19 employed were interviewed face to face. A number expressed interest in more culturally specific training and some are pursuing qualifications in social work; for many pay parity is an issue. In addition, many felt overwhelmed by the expectations around clients with mental health issues and housing issues now, post-earthquakes. Medical Practice surveys: Surveys were sent to eighty-two Pegasus Health medical practices and of these twenty five were completed. Results showed the full capacity of the PCW role was not clearly understood by all with many believing it was mostly a transport service. Those who did understand the full complexity of the role were very satisfied with the outcomes. PCW Host Community Manager Interviews: Of the ten out of twelve managers interviewed, some wished for more communication with Pegasus Health management because they felt aspects of both the PCW role and their own role as managers had become blurred over time. Referring organisations: Fifteen of the fifty referring community or government organisations participated. The overall satisfaction of the service was high and some acknowledged the continuing need for PCWs to be placed in communities where they were well known and trusted. Moreover results also showed that both the Canterbury earthquakes 2010-2011 and the amalgamation of Partnership Health PHO and Pegasus Health Charitable Limited in 2013 have contributed to the change of the model. Further future research may also be needed to examine the long term effects on the people of Canterbury involved in community work during the 2011-2014 years.  

Research papers, University of Canterbury Library

Worldwide, the numbers of people living with chronic conditions are rapidly on the rise. Chronic illnesses are enduring and often cannot be cured, requiring a strategy for long term management and intervention to prevent further exacerbation. Globally, there has been an increase in interventions using telecommunications technologies to aid patients in their home setting to manage chronic illnesses. Such interventions have often been delivered by nurses. The purpose of this research was to assess whether a particular intervention that had been successfully implemented in the United Kingdom could also be implemented in Canterbury. In particular, this research assessed the perspectives of Canterbury based practice nurses and district nurses. The findings suggest that a majority of both district and practice nurses did not view the service as compatible with their current work situation. Existing workload and concerns over funding of the proposed service were identified as potential barriers. However, the service was perceived as potentially beneficial for some, with the elderly based in rural areas, or patients with chronic mental health needs identified as more likely to benefit than others. Practice nurses expressed strong views on who should deliver such services. Given that it was identified that practice nurses already have in-depth knowledge of their patients’ health, while valuing the strong relationships established with their communities, it was suggested that patients would most benefit from locally based nurses to deliver any community based health services in the future. It was also found that teletriaging is currently widely used by practice nurses across Canterbury to meet a range of health needs, including chronic mental health needs. This suggests that the scope of teletriaging in community health and its potential and full implications are currently not well understood in New Zealand. Significant events, such as the Christchurch earthquakes indicate the potential role of teletriaging in addressing mental health issues, thereby reducing the chronic health burden in the community.

Audio, Radio New Zealand

The immediate aftermath of the devastating 2011 Christchurch earthquake and its ongoing impact on residents' mental health is being described as a recovery of two halves. The latest wellbeing survey from the Canterbury District Health Board shows that one in five people, predominantly those living in the eastern suburbs, say they experience stress most or all of the time.

Research papers, University of Canterbury Library

Rapid, accurate structural health monitoring (SHM) assesses damage to optimise decision-making. Many SHM methods are designed to track nonlinear stiffness changes as damage. However, highly nonlinear pinched hysteretic systems are problematic in SHM. Model-based SHM often fails as any mismatch between model and measured response dynamics leads to significant error. Thus, modelfree methods of hysteresis loop tracking methods have emerged. This study compares the robustness and accuracy in the presence of significant measurement noise of the proven hysteresis loop analysis (HLA) SHM method with 3 emerging model-free methods and 2 further novel adaptations of these methods using a highly nonlinear, 6-story numerical structure to provide a known ground-truth. Mean absolute errors in identifying a known nonlinear stiffness trajectory assessed at four points over two successive ground motion inputs from September 2010 and February 2011 in Christchurch range from 1.71-10.52%. However, the variability is far wider with maximum errors ranging from 3.90-49.72%, where the second largest maximum absolute error was still 19.74%. The lowest mean and maximum absolute errors were for the HLA method. The next best method had mean absolute error of 2.92% and a maximum of 10.51%. These results show the clear superiority of the HLA method over all current emerging model-free methods designed to manage the highly nonlinear pinching responses common in reinforced concrete structures. These results, combined with high robustness and accuracy in scaled and fullscale experimental studies, provide further validation for using HLA for practical implementation.

Research papers, University of Canterbury Library

Climate change and population growth will increase vulnerability to natural and human-made disasters or pandemics. Longitudinal research studies may be adversely impacted by a lack of access to study resources, inability to travel around the urban environment, reluctance of sample members to attend appointments, sample members moving residence and potentially also the destruction of research facilities. One of the key advantages of longitudinal research is the ability to assess associations between exposures and outcomes by limiting the influence of sample selection bias. However, ensuring the validity and reliability of findings in longitudinal research requires the recruitment and retention of respondents who are willing and able to be repeatedly assessed over an extended period of time. This study examined recruitment and retention strategies of 11 longitudinal cohort studies operating during the Christchurch, New Zealand earthquake sequence which began in September 2010, including staff perceptions of the major impediments to study operations during/after the earthquakes and respondents’ barriers to participation. Successful strategies to assist recruitment and retention after a natural disaster are discussed. With the current COVID-19 pandemic, longitudinal studies are potentially encountering some of the issues highlighted in this paper including: closure of facilities, restricted movement of research staff and sample members, and reluctance of sample members to attend appointments. It is possible that suggestions in this paper may be implemented so that longitudinal studies can protect the operation of their research programmes.<br /><br />Key messages<br /><ul><li>Recruitment and retention of longitudinal study participants is challenging following a natural disaster.</li><br /><li>The long-lasting, global effects of the Covid 19 pandemic will increase this problem.</li><br /><li>Longitudinal study researchers should develop protocols to support retention before a disaster occurs.</li><br /><li>Researchers need to be pragmatic and flexible in the design and implementation of their studies.</li></ul>

Research papers, University of Canterbury Library

Interagency Emergency Response Teams (IERTs) play acrucial role in times of disasters. Therefore it is crucial to understand more thoroughly the communication roles and responsibilities of interagency team members and to examine how individual members communicate within a complex, evolving, and unstable environment. It is also important to understand how different organisational identities and their spatial geographies contribute to the interactional dynamics. Earthquakes hit the Canterbury region on September, 2010 and then on February 2011 a more devastating shallow earthquake struck resulting in severe damage to the Aged Residential Care (ARC) sector. Over 600 ARC beds were lost and 500 elderly and disabled people were displaced. Canterbury District Health Board (CDHB) set up an interagency emergency response team to address the issues of vulnerable people with significant health and disability needs who were unable to access their normal supports due to the effects of the earthquake. The purpose of this qualitative interpretive study is to focus on the case study of the response and evacuation of vulnerable people by interagencies responding to the event. Staff within these agencies were interviewed with a focus on the critical incidents that either stabilised or negatively influenced the outcome of the response. The findings included the complexity of navigating multiple agencies communication channels; understanding the different hierarchies and communication methods within each agency; data communication challenges when infrastructures were severely damaged; the importance of having the right skills, personal attributes and understanding of the organisations in the response; and the significance of having a liaison in situ representing and communicating through to agencies geographically dispersed from Canterbury. It is hoped that this research will assist in determining a future framework for interagency communication best practice and policy.

Audio, Radio New Zealand

There's growing frustration over the government's work to match it's promise to tackle the country's suicide rates. A Mental Health Commission report describes frustration over the pace of change - and points to an urgent need for an overarching action plan. Mental health advocates are also criticising the lack of progress in helping people in Canterbury, with many still severely affected by ongoing trauma from earthquakes and the 2019 Mosque shootings. Eleisha Foon reports.

Research papers, University of Canterbury Library

People aged 65 years and older are the fastest growing age group in New Zealand. By the mid-2070s, there are predictions that this age group is likely to comprise approximately one third of the population. Older people are encouraged to stay in their own homes within their community for as long as possible with support to encourage the extension of ageing in place. Currently around 14% of those aged 75 years or older, make the move into retirement villages. This is expected to increase. Little is known by retirement villages about the wellbeing and health of those who decide to live independently in these facilities. Predicting the need for a continuum of care is challenging. This research measured the wellbeing and health of older adults. It was situated in a critical realist paradigm, overlaid with an empathetic axiology. A focused literature review considered the impact on wellbeing from the aspects of living place, age, gender, health status and the 2010/2011 Canterbury earthquakes. Longitudinal studies used the Enlightenment Scale and the interRAI Community Health Assessment (CHA) to measure the wellbeing and health of one group of residents (n=120) living independently in one retirement village in Canterbury, New Zealand. The research was extended to incorporate two cross-section studies when initial results for wellbeing were found to be higher than anticipated. These additional studies included participants living independently from other retirement villages (n=115) and those living independently within the community (n=354). A total of 589 participants, aged 65 – 97 years old, completed the Enlightenment Scale across the four studies. Across the living places, wellbeing continued to significantly improve with age. The Enlightenment Scale was a useful measure of wellbeing with older adults. Participants in the longitudinal studies largely maintained a relatively good health status, showing little change over the study period of 15 months. Predictions for the need for a move to supportive care were not able to be made using the CHA. The health status of participants did not influence their level of wellbeing. The key finding of note is that the wellbeing score of older adults increases by 1.27 points per year, using the Enlightenment Scale, irrespective of where they live.