Graduation Year

2008

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Community and Family Health

Major Professor

Elizabeth A. Gulitz, Ph.D.

Committee Member

Wayne W. Westhoff, Ph.D.

Committee Member

Howard N. Jacobson, M.D.

Committee Member

Larry J. Polivka, Ph.D.

Committee Member

Arron A. Smith, Ph.D.

Keywords

disability, evacuation, shelters, emergency management, grounded theory, social construction theory

Abstract

The overall purpose of this exploratory study was to comprehend how in the event of a hurricane Hillsborough County, Florida protected its elderly and disabled residents with special medical needs. This study used Social Constructionist Theory as a framework and Grounded Theory methodology in the collection of qualitative data.

To understand stakeholder knowledge and how they constructed the SpNP, three focus groups were conducted, with representatives from agencies on the Planning Committee. Through 30 in-depth, semi-structured interviews, clients of the SpNP, provided insight into their knowledge of the program and how society influenced evacuation decisions. Finally, 10 in-depth, semi-structured interviews were conducted with elites or directors of agencies in the SpNP (bosses of stakeholders), who functioned as key informants to verify results.

Examination of how SpNP stakeholders, perceived the meaning of community responsibility for people with special medical needs identified three themes: disaster experience, coalition building, and collective moral responsibility. Examination of how SpNP clients, constructed their meaning of the SpNP, identified five themes: registration barriers, SpNP knowledge, support systems, cultural expectations, and the media. Examination of societies influence on the evacuation decision of SpNP clients identified three themes: risk perception, evacuations barriers and the media.

The study highlighted the importance of forming community coalitions to address the needs of vulnerable populations. It is also obvious that the state legislation needs to specifically define special needs and standards of care that must be provided at public and special needs shelters. Implications for public health practitioners, suggest the need to be more involvement with the media, in efforts to promote policies and the perception of risks due to hurricanes. Public health nurses need to receive training on caring for chronic illnesses. Mandatory training for social workers, nurses, and physicians who provide health care to the general population should be considered.

There is a need for all agencies that provide services and advocate for individuals with special needs to participate in the SpNP, by registering and educating their clients. Many SpNP clients were confused as to the services provided, which could be partially solved by separating the programs transportation and SpNS components.

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