A Framework for Action: 

The Evidence Base for America’s PrepareAthon!

Spring 2015
Contents

THE CASE FOR PREPAREDNESS ...................................................................................................................2

AMERICA’S PREPAREATHON! OVERVIEW...................................................................................................2

EVIDENCE-BASE FOR AMERICA’S PREPAREATHON!...............................................................................3

FEMA National Household Survey Research ....................................................................................4

Extended Parallel Process Model..........................................................................................................5

The Social Ecological Model ....................................................................................................................5

Social Cognitive Theory.............................................................................................................................7

The Stages of Change Model and Segmentation of Audiences for America’s 

PrepareAthon! ..............................................................................................................................................7

Other Strategies Used in America’s PrepareAthon!.................................................................... 10

AMERICA’S PREPAREATHON! BEHAVIOR CHANGE MODEL ............................................................... 11

AMERICA’S PREPAREATHON! LOGIC MODEL ......................................................................................... 13

END NOTES....................................................................................................................................................... 15

1 A Framework for Action: The Evidence Base for America’s PrepareAthon!
THE CASE FOR PREPAREDNESS

Extreme weather events have increased in frequency in the past 50 years and are 

expected to become even more common, more intense, and more costly.1 Between 

1900 and 2014, the United States experienced 38 earthquakes, 166 floods, and 568

storms (including tropical cyclones).2 In 2013, there were more than 440 weatherrelated fatalities, and nearly 2800 injuries.3

Being unprepared is costly. In 2013, deadly weather caused nearly $9 billion in property 

damage.4 According to the Insurance Information Institute, an estimated 25 percent of 

all businesses affected by a major disaster never reopen.5 Failing to prepare for 

extreme weather events has cost the United States $1.15 trillion in economic losses 

from 1980 to 2010 and could cost another trillion in coming years.6

Findings from the 2012 FEMA National Survey reveal that, despite multiple efforts at the 

national, state, tribal, territorial, and local levels, many Americans are not prepared for 

disasters.7 As of 2012, less than half of Americans report having a household 

emergency plan, while just over half report having disaster supplies ready in their 

homes. The increasing number of disasters and insufficient levels of individual 

preparedness provide the impetus for a new approach to promote personal and 

organizational preparedness.

Presidential Policy Directive 8/PPD-8: National Preparedness was released on March 

30, 2011 with the goal of strengthening the security and resilience of the United States 

through systematic preparation for the threats that pose the greatest risk to the security 

of the Nation. At its core, PPD-8 requires the involvement of everyone—not just the 

government—in a systematic effort to keep the nation resilient and safe from harm 

when struck by hazards, such as natural disasters, acts of terrorism, and pandemics.

FEMA developed America’s PrepareAthon! to address these needs.

AMERICA’S PREPAREATHON! OVERVIEW

America’s PrepareAthon! is a grassroots campaign for action to increase community 

preparedness and resilience through hazard-specific drills, group discussions, and 

exercises. The campaign is coordinated by FEMA’s Individual and Community 

Preparedness Division (ICPD) in collaboration with Federal, state, tribal, territorial, and 

local governments, private sector, and non-governmental organizations at all levels.

America’s PrepareAthon! was designed to engage all levels of government, the public 

and private sectors, faith-based organizations, emergency management and response 

organizations, schools and institutions of higher education, and families and individuals.

2 A Framework for Action: The Evidence Base for America’s PrepareAthon!
The campaign provides resources for individuals, organizations, and communities to 

participate in activities that will increase their preparedness, including preparedness 

drills, group discussions, campaign promotion, and exercises to practice for local 

hazards.

Twice a year FEMA holds a National PrepareAthon! Day to bring national attention to 

the importance of creating a more resilient Nation by engaging with media and bringing 

stakeholders, communities, and individuals across the country together to take action 

and to join the national conversation on resilience.

The goal of the campaign is to increase the number of people who:

• Understand which disasters could happen in their community, 

• Know what to do to be safe and mitigate damage, 

• Take action to increase their preparedness, and 

• Participate in community resilience planning. 

EVIDENCE-BASE FOR AMERICA’S PREPAREATHON!

FEMA developed America’s PrepareAthon! as an evidence-based campaign, grounded 

in research, and supported by a behavior change model, and logic model. The sections 

below present how research findings and social science theory have been translated 

into America’s PrepareAthon! strategies and activities. Foundational research and 

modeling include FEMA’s Preparedness Profiles and the four social science 

theories/models that have guided social marketing and risk communication research: 

the Extended Parallel Process Model (EPPM),8 the Stages of Change Model (SoC),9

Social Cognitive Theory (SCT),10 and the Social Ecological Model (SEM).11 For more 

detailed information about the theories described here, please reference the National 

Institute of Health’s publication Theory at a Glance.12 Additional factors in disaster 

preparedness research related to these theories are drawn from ongoing literature 

reviews conducted by FEMA to inform its efforts.

3 A Framework for Action: The Evidence Base for America’s PrepareAthon!
FEMA National Household Survey Research

The 2013 report, Preparedness in America: Research Insights to Increase Individual, 

Organizational and Community Preparedness13 and the accompanying Personal 

Preparedness in America: Findings from the 2012 FEMA National Survey14 suggest that 

there are specific opportunities to better encourage individual preparedness. The 

analysis provided in these reports identified that the following beliefs and experiences 

were related to preparedness behaviors: 

• Beliefs

o Confidence in one’s ability to respond to all disasters

o Perception of risk of natural disaster

o Perception that a natural disaster could be severe

o Belief that preparing will help in a natural disaster

o Knowing how to prepare

o Willingness to consider preparing

o Having thought about preparedness

• Experiences

o Having talked about preparedness with others

o Having planning and training encouraged or required at work or 

school

o Having a personal disaster experience

Relevant America’s PrepareAthon! Strategies and Activities

• Community Engagement

o America’s PrepareAthon! is a grass-roots campaign designed to be 

implemented at the local level. Individuals are encouraged to take 

preparedness actions at workplaces, places of worship, and communitybased organizations.

o Individuals are provided tools and resources to encourage them to talk 

about and learn about preparing in social settings.

• Skills Building

o Individuals are provided opportunities to practice preparedness behaviors

increasing their confidence and efficacy so they have confidence in their 

ability to respond to a disaster.

o Individuals will learn about relevant specific disasters to increase their 

awareness of hazards their community faces and specific steps to prepare 

for those risks.

4 A Framework for Action: The Evidence Base for America’s PrepareAthon!
Extended Parallel Process Model

The Extended Parallel Process Model (EPPM) describes how individuals process risk 

information and decide to take action. Research has found that perceived susceptibility 

to and severity of a threat predict long-term hazard preparedness for hazards such as 

earthquakes, hurricanes, floods, volcanic eruptions, and hazardous materials 

disasters.

15 Fear of the threat alone does not promote preparedness actions; individuals 

must also perceive that they have enough personal efficacy to make preparations, and 

that their actions will make a difference in avoiding the threat.16 As such, messages 

should convey the ease and feasibility of preparing through a focus on simple, 

achievable tasks (self-efficacy) and the effect that preparing will have on reducing the 

potential severity of the threat (response efficacy).

17,18,19,20

Relevant America’s PrepareAthon! Strategies and Activities

• Perceived risk

o Individuals learn about the hazards for which they are at risk so they 

understand the need to prepare.

o Communities can choose the hazard(s) most relevant to their community 

members, since the campaign framework supports multiple hazards. 

• Perceived efficacy

o Individuals are provided with protective actions and mitigation measures 

for a range of specific hazards. Messaging will convey susceptibility to the 

risk integrated with messages of self and response efficacy. Messaging to 

individuals will include “simple steps you can take now.”

o Organizational partners will receive messages such as, “America’s 

PrepareAthon! supports your existing preparedness efforts with easy 

activities at low or no cost” to decrease barriers to participation.

o Individuals will experience increased self-efficacy through preparedness 

exercises and drills that demonstrate that they are able to engage in the 

recommended activities.

• Perceived risk and efficacy

o Individuals see creative materials that demonstrate that the danger of 

hazards is real, coupled with statements that build perceived efficacy.

The Social Ecological Model

The Social Ecological Model (SEM) stresses that behaviors both shape and are shaped 

by the social environment.21 A social ecological perspective highlights the importance 

of campaigns at multiple levels: individual (knowledge, attitudes, skills, self-concept), 

interpersonal (social networks, families, work groups, peers, friends, neighbors), 

organizational (incentives, organizational culture, organizational structure), community

(neighborhood organizations, non-profit organizations, informal and formal leadership 

practices), and society/policy level (legislation, taxes, regulatory agencies).

22,23 Multi5 A Framework for Action: The Evidence Base for America’s PrepareAthon!
level interventions are most effective because environments and individuals’ 

perceptions of those factors influence (preparedness) attitudes and behaviors.24,25

Since a number of factors influence behavior change, not only personal beliefs, it is also 

important to address community-level behavior change. To achieve behavior change for 

preparedness, neighbors, colleagues, and classmates need to engage in preparedness 

activities together. Workplaces, schools and religious communities should display their 

commitment to preparedness and show it is a priority. This way, the message is 

conveyed that one’s whole ecological system favors, prioritizes, and enables

preparedness.

Further, ecological approaches can be more effective in reaching underserved and 

marginalized populations that may not have the community resources in place to make 

the desired changes.26 Providing resources to organizational leaders provides a conduit 

to populations segments that may not take independent action. Using social networks 

to engage people in preparedness provides important shared experiences and builds 

social capital that supports greater resilience in actual events. 

Relevant America’s PrepareAthon! Strategies and Activities

• America’s PrepareAthon! reaches out to the whole community and allows 

flexibility for localized customization (e.g., Acme Inc.’s PrepareAthon!, Springdale 

PrepareAthon! for Tornado Safety).

• America’s PrepareAthon! aligns with other national and local awareness 

campaigns. Local awareness week campaigns will provide additional 

springboards to America’s PrepareAthon!

• Participation guides support implementation by workplaces, educational facilities, 

faith-based organizations, and nonprofit organizations. 

• Messages to individuals convey the importance of individual and community level 

participation.

• Workplaces, schools, houses of worship, and other community organizations are 

encouraged to participate in drills and activities both individually and together as 

part of a community-wide event.

• Workplaces and schools are encouraged to develop creative strategies to 

support employees and students to practice preparedness behaviors. 

• Neighborhood events are organized, including preparedness discussions.

• Local elected officials are encouraged to participate and promote drills and 

discussions as a critical element to increasing the resilience of their community.

6 A Framework for Action: The Evidence Base for America’s PrepareAthon!
Social Cognitive Theory

Social Cognitive Theory (SCT) is a learning theory that suggests that people learn by 

watching what others do and will not do (vicarious learning). In other words, it describes 

the process of knowledge acquisition through the observation of models. Effective 

modeling teaches general rules and strategies for dealing with different situations, 

whether the models are taken from interpersonal interactions or from media sources. 

When individuals observe others modeling preparedness behaviors through 

demonstrations and trainings, they are more likely to think about these behaviors and 

act on them. 27 Demonstrations can be especially effective when attempting to raise the 

perceived efficacy of audience members28 or highlight the perceived social norms of the 

preparedness behavior.29

Social norms regarding preparedness can influence individuals’ intentions to prepare.

30

Through observing preparedness behaviors of others, individuals learn more about 

preparedness behaviors they could take and which behaviors they are expected to 

take.

31 Individuals are more likely to perform emergency planning, gather supplies, and 

believe they should prepare for emergencies when they believe their family and friends

think they should prepare and they perceive others are well prepared.

32

Relevant America’s PrepareAthon! Strategies and Activities

• America’s PrepareAthon! reaches individuals through multiple, trusted social 

networks by working with communities, local organizations, and credible local 

sources demonstrating that we should all be prepared. 

• America’s PrepareAthon! provides an experiential format through hands-on drills 

and activities to increase learning and knowledge. This format also provides 

opportunities for individuals to observe others taking appropriate actions.

• Peer-to-peer discussions within and across community and national networks are 

promoted, increasing social norms and the perceived importance of preparing.

• America’s PrepareAthon! provides visible examples of social norms for preparing 

and responding through demonstrations and community events.

The Stages of Change Model and Segmentation of Audiences for America’s 

PrepareAthon! 

According to the Stages of Change Model (SoC), people demonstrate varying degrees 

of readiness to change or varying levels of actual activity, to which communication 

messages and activities should be tailored.33 Tailored campaigns, or campaigns that 

are “stage-matched,”34 have been proven especially effective at increasing awareness 

and adoption of disaster preparedness behaviors, especially when tied to individuals’ 

values and beliefs.35

7 A Framework for Action: The Evidence Base for America’s PrepareAthon!
Table 1: Overview of Stages of Change Model

Stage Description

Pre-contemplation

No awareness of problem, no intention to change or think about change 

in the near future

Contemplation

Awareness of problem, intending to take action in the future, but not 

prepared to take action at present

Preparation Actively considering changing his or her behavior in the immediate future

Action Overt behavior change, but the changes are not yet well established

Maintenance New behavior has been maintained for more than 6 months

Preparedness in America: Research Insights to Increase Individual, Organizational and 

Community Preparedness36 employed a Latent Class Analysis (LCA), and found that its 

participants could be categorized into four Preparedness Profiles, which resemble the 

stages of change. Each Profile is discussed below.

Part Of Life largely corresponds to the action and maintenance stages.

Comprising 14 percent of the American population, these individuals 

understand that they are at risk for natural disasters. They are confident in 

their ability to respond to disasters and believe that preparing for a disaster 

will make a difference. They are already preparing, participating in preparedness 

training, and engaging in behaviors related to preparedness, such as talking about 

preparing and volunteering for disaster preparedness or response. They were more 

likely to be encouraged by a job or school to have a disaster plan. 

Relevant America’s PrepareAthon! Activities: Individuals in the maintenance stage 

should be assisted through strategies encouraging them to maintain their behaviors.

37

• Give reinforcements and reminders that strengthen their existing beliefs and 

activities. 

• Encourage these individuals to serve as advocates of change by talking with 

others, showing others the preparedness actions they have taken, and activating 

community networks for preparedness.

On Their Mind most closely resembles the contemplation stage. Nearly onefifth of the American population (18 percent) believes that they are at risk for 

disasters but has not engaged in many activities to prepare. These individuals

believe their communities are at high risk of a disaster, especially terrorism, 

hazardous materials accidents, and disease outbreaks, and that disasters will be 

severe. They are not aware of their local risks. They do not believe preparedness will 

18%

14%

8 A Framework for Action: The Evidence Base for America’s PrepareAthon!
help and expect to rely on the government and nonprofit organizations for support after 

a disaster. 

Relevant America’s PrepareAthon! Activities: Individuals who are contemplating change 

should be motivated and encouraged to make a plan for change.38

• Clarify risks and severity through relevant, community-based hazards information 

and skill-building activities. 

• Provide messages with simple, easy-to-do actions.

• Show the positive impact these actions can have during and after disasters.

Working On It is comprised of multiple stages. Many individuals in this Profile 

are preparing, but aren’t sure why they are doing it. These individuals, 

representing 21 percent of the American population, know how to prepare, 

and about half have conducted three or more preparedness behaviors, but

they tend not to believe they are at risk for natural disasters or that preparedness will 

help them handle a natural disaster, creating a conflict between awareness and 

preparedness. 

Relevant America’s PrepareAthon! Activities: Individuals who are preparing to make a 

change or in early stages of action should be assisted with setting goals and concrete 

action plans and supported through feedback, problem solving, social support, and 

reinforcement.39

• Clarify risks and severity through media and trusted local sources.

• Show the positive impact simple preparedness actions can have during and after 

disasters to increase their perception that preparing now will make a difference in 

the event of a disaster.

Not On Their Radar is the Preparedness Profile that corresponds most 

closely to the pre-contemplation stage. This profile, which is roughly half of 

the U.S. population, is the least likely to be prepared. Individuals in this group 

are more likely to be young (18 to 34 years old). They do not believe their 

community is likely to experience disasters and are not prepared. They expect to rely on 

government and nonprofit organizations for support after a disaster. 

Relevant America’s PrepareAthon! Activities: Individuals in this stage need increased 

awareness of the problem. 

• Provide information about the risks of local hazards and the severity of those 

hazards.

• Increase their exposure to messaging from media, and multiple local sources that 

the risks are real and that there are simple steps they can take that will make a 

difference.

21%

46%

9 A Framework for Action: The Evidence Base for America’s PrepareAthon!
Priority Preparedness Profiles

America’s PrepareAthon! focuses primarily on the two audience Profiles whose 

members are more likely to increase their preparedness behaviors: “Working On It” and 

“On Their Mind.” With better understanding of local risks, enhanced community-based 

outreach and support, and opportunities to improve their confidence in the effectiveness 

of preparedness measures, these individuals are more likely to take additional steps to 

become prepared.

Secondary Audience Profiles

The other two Profiles are included as secondary audiences and will be reached 

through messages and promotional activities conducted on a national scale. 

• Expose individuals in the “Not On Their Radar” Profile to preparedness 

messages that might change their attitudes and make them more open to future 

initiatives. 

• Sustain the behaviors of individuals in the “Part Of Life” Profile by providing 

additional opportunities to take preparedness steps and also encouraging these 

individuals to promote preparing to others through their personal networks.

Other Strategies Used in America’s PrepareAthon!

While the following strategies are not directly related to the above theories, they are 

distilled from individual preparedness research and the results of the Great ShakeOut

Earthquake Drill.

• America’s PrepareAthon! messages will reach audiences through multiple 

credible sources of information, including social media and printed materials

through media and interpersonal sources. 

• The whole community, including schools, faith-based organizations, employers, 

community interpersonal networks and community media, will disseminate 

preparedness messages and provide opportunities to practice preparedness 

actions since local and community-based preparedness messaging is superior to 

broad-based communication.40

• America’s PrepareAthon! encourages engagement in preparedness actions. 

Individuals are more likely to take preparedness actions when learning through 

interactive activities.41,42,43

• Community-based programs have led to changes in knowledge, attitudes, and 

preparedness.

10 A Framework for Action: The Evidence Base for America’s PrepareAthon!
AMERICA’S PREPAREATHON! BEHAVIOR CHANGE MODEL 

FEMA developed the America’s PrepareAthon! Behavior Change Model (Figure 1) 

based on over a decade of FEMA’s individual preparedness research, the risk 

communication and social marketing theories presented above, the expanding success 

of the Great ShakeOut Earthquake Drill, and published literature.

11 A Framework for Action: The Evidence Base for America’s PrepareAthon!
Figure 1: America’s PrepareAthon! Behavior Change Model

12 A Framework for Action: The Evidence Base for America’s PrepareAthon!
AMERICA’S PREPAREATHON! LOGIC MODEL

FEMA developed the America’s PrepareAthon! Logic Model (See Figure 2) to illustrate 

the campaign’s outputs and intended outcomes. The America’s PrepareAthon! Logic 

Model identifies outcomes related to learning, action, and condition. 

Logic models identify the outcomes a campaign is trying to achieve and the 

intermediate steps in the pathway to those outcomes. By articulating these goals, logic 

models can guide decisions about many aspects of evaluation, including the variables 

to measure and the optimal evaluation design for measuring those variables and their 

relationships. Logic models can also provide a framework for identifying alternative 

causal relationships, ensuring that these relationships are incorporated into the 

evaluation, and data collection plans. Finally, logic models assist in developing realistic 

expectations about the relationship between outputs and expected outcomes.

13 A Framework for Action: The Evidence Base for America’s PrepareAthon!
Figure 2: America’s PrepareAthon! Logic Model

14 A Framework for Action: The Evidence Base for America’s PrepareAthon!
END NOTES

1 Global Climate Change Impacts in the United States. Cambridge University Press, August 24, 2009. 2 Number of National Disaster in the United States from 1900 to 2014 by Type. Statista.

http://www.statista.com/statistics/236504/number-of-natural-disasters-in-the-us-by-type/ 3 National Weather Service (2014, July 22). Summary of Natural Hazard Statistics for 2013 in the United States. 

http://www.nws.noaa.gov/om/hazstats/sum13.pdf. 4 National Weather Service (2014, July 22). Summary of Natural Hazard Statistics for 2013 in the United States. 

http://www.nws.noaa.gov/om/hazstats/sum13.pdf. 5 Insurance Information Institute. (2013, October 3). Insurance lessons learned from Sandy: Steps to keep your business 

running following a disaster. Retrieved from www.iii.org/press_releases/insurance-lessons-learned-from-sandy-stepsto-keep-your-business-running-following-a-disaster.html. 6 U.S. Department of Homeland Security (2014, February 12). Extreme weather events: The costs of not being prepared. 

Testimony before the Senate Committee on Homeland Security and Governmental Affairs, February 12, 2014. 7 FEMA. (2013). Preparedness in America: Research insights to increase individual, organizational, and community 

action. Retrieved March 3, 2014, from http://www.fema.gov/media-library/assets/documents/94717. 8 Witte, K. (1992). Putting the fear back into fear appeals: The extended parallel process model. Communication 

Monographs, 59, 329-346. 9 Prochaska, J. O., Redding, C. A., & Evers, K. E. (2008). The Transtheoretical model and stages of change. In K. Glanz, B. K. 

Rimer, & K. Viswanath (Eds.), Health behavior and health education: Theory, research, and practice (pp. 67-96). San 

Francisco, CA: Jossey-Bass. 10 Bandura, A. (2002). Social cognitive theory in cultural context. Applied Psychology, 51(2), 269-290; Baranowski, T., 

Perry, C. L., & Parcel, G. S. (2002). How individuals, environments, and health behavior interact: Social cognitive theory. 

In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (pp. 

165-184). San Francisco, CA: Jossey Bass. 11 McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. 

Health Education Quarterly, 15, 351-377; Sallis, J. F., & Owen, N. (2004). Ecological models of health behavior. In K. 

Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (pp. 462-

484). San Francisco, CA: Jossey-Bass; Stokols, D. (1992). Establishing and maintaining healthy environments: Toward a 

social ecology of health promotion. American Psychologist, 47(1), 6-22; Stokols, D. (1996). Translating social ecological 

theory into guidelines for health promotion. American Journal of Health Promotion, 10, 282-298. 12 National Cancer Institute. (2005). Theory at a Glance. A Guide for Health Promotion Practice. U.S. Department of Health 

and Human Services. National Institutes of Health. National Institute of Health Publication No. 05-3896. 13 FEMA. (2013). Preparedness in America: Research insights to increase individual, organizational, and community 

action. Retrieved March 3, 2014, from http://www.fema.gov/media-library/assets/documents/94717. 14 FEMA. (2013). Personal Preparedness in America: Findings from the 2012 FEMA National Survey. Retrieved March 3, 

2014, from http://www.fema.gov/media-library/assets/documents/83190. 15 Lindell, M. K., & Perry, R. W. (2012). The Protective Action Decision Model: Theoretical modifications and additional 

evidence. Risk Analysis: An International Journal, 32(4), 616-632. 16 National Cancer Institute. (2005). Theory at a Glance. A Guide for Health Promotion Practice. U.S. Department of Health 

and Human Services. National Institutes of Health. National Institute of Health Publication No. 05-3896. 17 Maloney, E. K., Lapinski, M. K., & Witte, K. (2011). Fear appeals and persuasion: A review and update of the Extended 

Parallel Process Model. Social And Personality Psychology Compass, 5(4), 206-219. 18 Witte, K. (1992). Putting the fear back into fear appeals: The extended parallel process model. Communication 

Monographs, 59, 329-346. 19 Witte, K. (1992). Message and conceptual confounds in fear appeals: The role of threat, fear and efficacy. Southern 

Communication Journal, 58, 147-155. 20 Wood, M. M., Mileti, D. S., Kano, M., Kelley, M. M., Regan, R., & Bourque, L. B. (2012). Communicating actionable risk for 

terrorism and other hazards. Risk Analysis: An International Journal, 32(4), 601-615. 21 Glanz, K., & Bishop, D. (2010). The role of behavioral science theory in development and implementation of public 

health interventions. Annual Review of Public Health, 31, 399-418. 22 McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. 

Health Education Quarterly, 15, 351-377; Sallis, J. F., & Owen, N. (2004). Ecological models of health behavior. In K. 

15 A Framework for Action: The Evidence Base for America’s PrepareAthon!

 
Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (pp. 462-

484). San Francisco, CA: Jossey-Bass; Stokols, D. (1992). Establishing and maintaining healthy environments: Toward a 

social ecology of health promotion. American Psychologist, 47(1), 6-22; Stokols, D. (1996). Translating social ecological 

theory into guidelines for health promotion. American Journal of Health Promotion, 10, 282-298. 23 Abroms, L., & Maibach, E. (2008). The effectiveness of mass communication to change public behavior. Annual Review of 

Public Health, 29, 219-234; Snyder, L. B., Hamilton, M. A., Mitchell, E. W., Kiwanuka-Tondo, J., Fleming-Milici, F., & 

Proctor, D. (2004). A meta-analysis of the effect of mediated health communication campaigns on behavior change in 

the United States. Journal of Health Communication, 9, 71–96. 24 Glanz, K., & Bishop, D. (2010). The role of behavioral science theory in development and implementation of public 

health interventions. Annual Review of Public Health, 31, 399-418. 25 Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Health Behavior and Health Education, 4th ed. San Francisco: John Wiley 

& Sons. 26 Fahrenwald, N., & Stabnow, W. (2005). Sociocultural perspective on organ and tissue donation among reservationdwelling American Indian adults. Ethnicity & Health, 10(4), 341-354. 27 McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. 

Health Education Quarterly, 15, 351-377; Sallis, J. F., & Owen, N. (2004). Ecological models of health behavior. In K. 

Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (pp. 462-

484). San Francisco, CA: Jossey-Bass; Stokols, D. (1992). Establishing and maintaining healthy environments: Toward a 

social ecology of health promotion. American Psychologist, 47(1), 6-22; Stokols, D. (1996). Translating social ecological 

theory into guidelines for health promotion. American Journal of Health Promotion, 10, 282-298. 28 Bandura, A. (2002). Social cognitive theory in cultural context. Applied Psychology, 51(2), 269-290; Baranowski, T., 

Perry, C. L., & Parcel, G. S. (2002). How individuals, environments, and health behavior interact: Social cognitive theory. 

In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (pp. 

165-184). San Francisco, CA: Jossey Bass. 29 Lindell, M. K., & Perry, R. W. (2012). The Protective Action Decision Model: Theoretical modifications and additional 

evidence. Risk Analysis: An International Journal, 32(4), 616-632. 30 Paton, D., & Johnson, D., M., Eds. (2006). Disaster Resilience: An Integrated Approach. Springfield, IL: Charles C. Thomas 

Publisher. 31 Lindell, M. K., & Perry, R. W. (2012). The Protective Action Decision Model: Theoretical modifications and additional 

evidence. Risk Analysis: An International Journal, 32(4), 616-632. 32 Paek, H., Hilyard, K., Freimuth, V., Barge, J. K., & Mindlin, M. (2010): Theory-based approaches to understanding public 

emergency preparedness: Implications for effective health and risk communication. Journal of Health Communication, 

15, 428-444. 33 Prochaska, J. O., and C. C. DiClemente. (1982). Transtheoretical therapy: Toward a more integrative model of change. 

Psychotherapy: Theory, Research and Practice, 20, 161–173. 34 Prochaska, J.O., & Velicer, W.F. (1997). The transtheoretical model of health behavior change. American Journal of 

Health Promotion (1):38–48. 35 Rimer, B.K., & Kreuter, M.W. (2006). Advancing tailored health communication: A persuasion and message effects 

perspective. Journal of Communication, 56S, 184-S201. 36 FEMA. (2013). Preparedness in America: Research insights to increase individual, organizational, and community 

action. Retrieved March 3, 2014, from http://www.fema.gov/media-library/assets/documents/94717. 37National Cancer Institute. (2005). Theory at a Glance. A Guide for Health Promotion Practice. U.S. Department of Health 

and Human Services. National Institutes of Health. National Institute of Health Publication No. 05-3896. 38 Prochaska, J. O., Redding, C. A., & Evers, K. E. (2008). The Transtheoretical model and stages of change. In K. Glanz, B. K. 

Rimer, & K. Viswanath (Eds.), Health behavior and health education: Theory, research, and practice (pp. 67-96). San 

Francisco, CA: Jossey-Bass. 39 Ibid. 40 Kim, Y.C., K., & Jinae, K. (2010). Communication, neighborhood belonging and household hurricane preparedness. 

Disasters, 34(2), 470-488. 41 Koichi, S., & Rajib, S. (2008). Proactive Co-Learning: A new paradigm in disaster education. Disaster Prevention & 

Management, 17(2), 183-198.

16 A Framework for Action: The Evidence Base for America’s PrepareAthon!

 
42 Mileti, D.S., Nathe, S., Gori, P., Greene, M., & Lemersal, E. (2004). Public Hazards Communication and Education: the State 

of the Art. Update of Informer, 2, Public education for earthquake hazards. Retrieved February 23, 2012, from 

http://www.colorado.edu/hazards/publications/informer/informer.html. 43 Peek, L. (2008). Children and disasters: Understanding vulnerability, developing capacities, and promoting resilience—

An introduction. Children, Youth and Environments, 18(1), 1–29.

17 A Framework for Action: The Evidence Base for America’s PrepareAthon!