Predictors of community preparedness for flood in Dire-Dawa town, Eastern Ethiopia: Applying adapted version of Health Belief Model

A cross-sectional study was conducted in June and July 2015, aiming at investigating the cross cultural utility of adapted version of Health Belief Model (HBM) in predicting disaster preparedness for flood hazards at household levels in Dire Dawa town, Ethiopia. To accommodate the fact that this work was undertaken in a collectivistic culture in which social processes play more prominent roles in interpretation and action selection, a structured questionnaire was developed by adding community participation to the prominent constructs of HBM and modifying self-efficacy to collective-efficacy. Households (660) were selected by stratified systematic random sampling technique. From each household, an individual aged 18 or above was selected by random and participated in the study. Structural Equation Modeling (SEM) and Generalized Structural Equation Modeling (GSEM) analyses were done using STATA version-13.0. SEM analysis showed that the total effects of perceived threat (path coefficient (β)=−0.002, 95% Confidence Interval (CI): [−0.003, −0.001]), perceived benefits minus perceived barriers (β=−0.048, 95% CI: [−0.080, −0.015]), and cues to actions (β=−0.18, 95% CI: [−0.25, −0.11]) on preparedness were significant. The total effects of collective efficacy (β=0.011, 95% CI: [−0.027, 0.049]), perceived susceptibility (β=−0.0007, 95% CI: [−0.003, 0.002]), perceived severity (β=−0.002, 95% CI: [−0.007, 0.004]), and community participation (β=−0.0001, 95% CI: [−0.0003, 0.0001]) on preparedness were non-significant. In GSEM factor analysis, ethnicity, religion and residential duration were significantly associated with preparedness. Intervention is needed on barriers and perceived threat to enhance collective efficacy and preparedness.