Behavioral theories and leadership networks in emergency management preparedness

Emergency management refers to the exploration of how people and their organizations cope and interact with liabilities, threats, and resulting events (ex. Catastrophes, disasters, and multifaceted humanitarian crises), specifically via activities associated with response, preparedness, mitigation, and recovery. Although preparedness for emergency and disasters occurs at the individual level, it also happens at the organizational level via understanding and implementation of behavioral theory. Numerous behavioral theories have been used for disaster risk reduction (DRR). These theories are Health Belief Model, Theory of Planned Behavior, Social Cognitive Theory, and Extended Parallel Process Model.

These four areas of theory allow a synthesis of literature concerning emergency preparedness for common emergency situations such as influenza, earthquakes, and floods. The five disaster types: climatological, meteorological, hydrological, geophysical, and biological encompass 30 sub-types across 12 disaster types. The literature review briefly explores each theory and identifies which one has the best overall application over most emergency situations. In relation to selected situation, management and leadership will be used to explore the topic even further by understanding how effective management and leadership play a role in execution of theory and practical measure of efficacy.

Manages/leaders play an important role in how emergency situations are handled in several ways. Leadership is often managed through horizontal and vertical networks with communication as a base for various processes. Networks have become a commonly used means for dealing with disasters and emergencies. By using recent research to understand the use of networks and placing a theoretical lens over it for information synthesis, a deeper meaning will be derived. The last section will focus on application of theory and management/leadership. The chosen theory is Theory of Planned Behavior, which explores motivation and subjective norms.

Introduction

Emergency management is an integral part of any major and minor crisis. With more disasters occurring at a higher frequency, it is important to have in place a sound leadership strategy that will provide stability and focus during high pressure situations. Such strategies involve use of theory to understand what processes are valid or invalid in any given circumstance. The literature review in this paper will focus on four theories: Health Belief Model, Theory of Planned Behavior, Social Cognitive Theory, and Extended Parallel Process Model. The four theories provide a foundation from which to build a management and leadership model that will offer an exploration and analysis of leadership in emergency management, culminating in application of theory and analysis in the third section.

Literature Review

In emergency situations, networks have become a broadly used way to handle unexpected problems. "Researching this aspect of the emergency management process can effectively contribute to the outcome of disaster response and recovery by providing insight into the operations and processes of disaster management and ways to better utilize network resources and relationships" (Kapucu & Garayev, 2014, p. 931). The article by Kapucu & Garayev (2014), details how networks can provide a means of achieving specific processes in emergency situations. For example, vertical networks aim for delivery of resources to a specific group. They are specialized and non-generalized. They offer less, however their reach is specific, dedicating resources to specific processes. Horizontal networks are the opposite, offering resources to a wide group. Although their resources are more, it is aimed towards general needs rather than tailored to particular actions.

In emergency management, it is important to incorporate resources for a specific and general purpose. For example, if there is an earthquake, a horizontal network would be used like medical services where everyone can be treated for injuries resultant from the disaster. Vertical networks can come in like the Red Cross, to help people find shelter. This is a specific task that requires dedication to certain resources. This is what the researchers explain in their article.

By management having access to both vertical and horizontal networks, they are enabling the ability to collect resources for specific and generalized purposes. People require a variety of resources to ensure adequate care and service during emergency situations. For leaders to provide these resources through such networks, the ability to meet the needs of the affected population is increased. Networks are an important aspect of emergency management. However, there are other aspects that must be addressed.

One such aspect is training. Leaders need to be trained to handle the different roles required for effective emergency management. Coper et al. (2016), offered evaluation of a Team Emergency Assessment Measure (TEAM) that was used in two Australian Emergency Departments. Through a quasi-experimental design, researchers observed the non-technical skills of two teams. The overall effects of TEAM were positive and required minimal or no training. "The TEAM is a feasible, valid and reliable non-technical assessment measure in simulated and real clinical settings. Emergency teams need to develop leadership skills through training and reflective debriefing" (Cooper et al., 2016, p. 97).

Such assessment tools can be used to identify weaknesses or strengths in a team or team leader. Emergency management often requires the use and implementation of teams. Such teams allow for information to be dispersed efficiently and rapidly and allow for processes to be distributed and executed. With an assessment tool that requires little to no training, it allows for easy assessment and validation of processes, strategies, and measures.

The Health Belief Model refers to a psychological model used to predict and explain health behaviors (Ejeta, Ardalan, Paton, & Yaseri, 2016). To do so involves focus on beliefs and attitudes of people. First developed in the 1950s by Rosenstock, Hochbaum, and Kegels, some researchers have begun incorporating into strategies for emergency management. One such article discusses use of the Health Belief Model (HBM) for community preparedness for flood emergencies. An adapted version of the HBM was investigated to see if such a theory can help predict disaster preparedness in flood emergencies in Ethiopia.

HMB essentially was used to understand the level of preparedness in populations with the most potential of being affected by floods. The results demonstrated that those that viewed the floods as a major threat were more prepared versus those that did not. Community participation did not increase preparedness nor did collective efficacy.

The effects of community participation and collective efficacy on household preparedness for flood disaster were non-significant. Individuals' perception of flood disaster as threat, perceived benefits minus perceived barriers and cues to actions were inversely and significantly associated with household preparedness. Higher perception of barriers to household preparedness coupled with higher perception of flood disaster threat might have created fear on individuals, negatively affecting household preparedness for flood disaster (Ejeta, Ardalan, Paton, & Yaseri, 2016, p. 350).

If applied to emergency management, specifically prevention or evacuation, strategies should be aimed at detailing how hazardous the emergency is to increase preparedness or increase desire to perform the processes necessary for evacuation. According to the applied HBM framework, this is necessary to ensure cooperation.

Theory of Planned Behavior allows for a linking of beliefs and behavior. In emergency management scenarios, leaders may act according to their own set of principles and ethics. Therefore, understanding the potential framework for such actions could lead to improved overall functioning in such scenarios. Researchers of a 2015 study examine communication during a crisis situation through the Theory of Planned Behavior, identifying possible inclusion of other theories to increase the explanatory power of the theory. Results demonstrated Situational Crisis Communication Theory offers a better explanation of how previous experience with crisis impacts the social norms/attitudes associated with crisis behavior. Bandura's concept of self-efficacy provides a more direct interpretation of the availability of resources as "contributing factors to perceived behavioral control in a crisis. As such, the incorporation of these well-developed notions into the broader framework of the Theory of Planned Behavior affords greater understanding of the relationship between communication and behavior during a crisis" (McConnell JD & Crudo, PhD, 2015, p. 248).

The article shows how a theoretical framework can be used for analysis of processes during a crisis, allowing for potential of improvement. The theory helps management and leadership understand not only the important of communication during an emergency, but also how communication is affected. Communication can be improved through assessment of available resources and identification of past crisis experience. If for example, a city like Los Angeles has not experienced a flood, but unexpectedly is struck by one, the level of past experience with floods for rescue workers would be little to none.

Therefore, communication methods must include how to perform necessary functions that could include training and education to show individuals what to do.

Social Cognitive Theory is a concept positing that parts of a person's knowledge acquisition can be directly associated to observation of others in the context of outside media influences and social experiences and interactions (Sherman et al., 2016). When applied to emergencies, it can help explain the trauma experienced by survivors of a disaster. The aftermath of an emergency is just as important from the perspective of emergency management as is the other aspects. One article by Sherman et al. (2016) examined the psychological results of evacuees from the World Trade Center.

By using social cognitive theory as a basis, they identified risk factors for psychological injury to allow for future improvements in alleviating influences related with emergency high-rise evacuation. "Other variables associated with increased risk of psychological disorder outcome included gender (female), lower levels of education, preexisting physical disability, preexisting psychological disorder, greater distance to final exit, and more information sources during egress" (Sherman et al., 2016, p. 1). High-rise evacuations are rare, but can occur especially during fires. Emergency preparedness, especially for certain at-risk populations can prevent unnecessary trauma resultant from such emergencies.

The article notes the need for improvement in these areas to minimize challenges. "Improving the "emergency preparedness safety climate" of high-rise business occupancies and reducing the number of egress challenges are potential strategies for reducing the risk of adverse psychological outcomes of high-rise evacuations" (Sherman et al., 2016, p. 1). Leaders in emergency management must use such theories to identify and apply strategies to reduce potential problems for those affected by emergency situations.

The Extended Parallel Process Model is a theoretical framework that tries to predict how people will react when facing fear inducing stimuli. Developed by Kim Witte, researchers use it to understand the motivations of people. In a recent article, the model was used to understand the emergency response willingness of public health workers. Those using the model provided participants with a modified curriculum that could help them tackle emergency situations. "the curriculum focused on modifying perceptions of self-efficacy, response efficacy, and threat related to specific hazards in the all hazards spectrum among participants" (Von Gottberg, Krumm, Porzsolt, & Kilian, 2016, p. 1).

The results demonstrated the use of the model enabled the combination of various management levels as well as disciplines. The modified curriculum also improved self-efficacy. "participants reported despite challenges in administration, the curriculum was well designed and appropriate for combining multiple management levels and disciplines. The qualitative findings support quantitative findings of the curriculum's benefit in improving self-efficacy and willingness to respond among participants" (Von Gottberg, Krumm, Porzsolt, & Kilian, 2016, p. 1). Such a model can be used to identify willingness of emergency response workers as well as promote self-efficacy to those trained with the model incorporated into the curriculum.

This model also promotes the incorporation of multiple management levels leading to increased potential for effectiveness in emergency management. Researchers must dedicate

More effort into establishing theoretical frameworks for training purposes to allow for better emergency management. These theories demonstrated how they can be used to understand, create and implement sound strategy for emergency situations. Furthermore, they allow for a varied perspective in the ways in which emergency situations can be tackled, despite perceived challenges or obstacles.

The final article deals with leadership styles that emergency management staff may adopt during a crisis. Close loop communication is mentioned extensively and serves as the basis of communication for crisis resource management which incorporates certain leadership styles for proper execution of processes. "development of Crisis Resource Management (CRM), systematic educational program designed to improve team performance based on knowledge from the aviation context to ensure the quality of teamwork . . . a standardized scheme of communication has become a core component of CRM" leaders (Hargestam, Lindkvist, Jacobsson, Brulin, & Hultin, 2016, p. e009912). Two leadership styles were seen within Crisis Resource Management (CRM), egalitarian and authoritarian.

Experience in trauma courses, ethnicity, and CLC both team and leader were variables in which leadership style was most effective. CLC was a component in the shift of leadership styles with short answers and directive belonging to the authoritative style and long, open-ended answers to the egalitarian. Researchers founds CLC allowed for assessment of variables and improved overall communication between team and leader. The article suggests that although CLC is not a natural component to communication, it should be implemented.

CLC may not come naturally to the professionals in the trauma team. The reasons for this might include time pressure and workload, as well as hierarchical and interpersonal factors. Establishing a routine helps to normalize the practice of closed-loop communication during emergencies, as does role modelling by team leaders (Hargestam, Lindkvist, Jacobsson, Brulin, & Hultin, 2016, p. e009920).

In conclusion, this literature review highlighted several working theories for emergency management. It also provided recognition of distinct leadership styles. Communication in the form of CLC was found to be most conducive to emergency management. A theoretical framework also helped establish comprehension of the processes in emergency management.

Selected Situation

Management and Leadership (M&L) exists plays a vital role in emergency management. The various roles managers hold along with steps towards development and implementation of change, structure, and the selection process all have to do with M&L. Without these important aspects of emergency management, little would be done in case of an emergency. Briefly covered in the previous section, assessment can be a critical factor for emergency management.

M&L is the section of emergency management where most assessment is performed. Literature that provides a framework to enable assessment can lead to effective evaluation of several things like critical success factors, areas of weakness, and potential improvements.

One article shares a potentially new method for identifying critical success factors. "In this method, the evaluations of influencing factors in the form of intuitionistic fuzzy numbers (IFNs) are converted into basic probability assignments (BPAs). Then Dempster -- Shafer theory is adopted to combine group decision" (Li, Hu, Zhang, Deng, & Mahadevan, 2014, p. 504). Although this method is complex, involving computation, it shows how theory and analysis can lead to improved practice, especially concerning assessment. In a situation like flooding, critical success factors can be identified beforehand and then applied at the time of the crisis.

Researchers in the article stated that once the critical success factors were identified, they were optimized to improve efficacy, promoting success in emergency management. "By optimizing the five CSFs, the effectiveness and efficiency of the whole emergency management could be greatly promoted" (Li, Hu, Zhang, Deng, & Mahadevan, 2014, p. 504). So, if the role of M&L is examined through the perspective of evaluators, they are a key step in improving the overall process of emergency management.

Networks were also briefly mentioned in the previous section. Networks offer resources for emergency management. It can come in the form of general needs or specific needs. A 2013 study examined emergency management networks and their impact on emergency management. They go into detail about the increasing need for involvement of close interactions among a wide assortment of parties across fields. These fields can include emergency management, law enforcement, and public health along with sectors like the government; and levels of government.

Results revealed the importance of having a two-tiered network to better handle crises. "Analysis of data reveals a contrast between a core set of consistent (mostly governmental) actors and a peripheral set of rapidly turning over (mostly non-governmental) actors -- though the account depends on the mode of data on which one focuses" (Robinson, Eller, Gall, & Gerber, 2013, p. 344). Management and leadership promotes cohesion and fluidity among multiple groups and sectors. Without M&L there would lack of communication and confusion concerning tasks and responsibilities.

The role of M&L then become crucial for successful implementation of emergency management because they take on the role of mediator. They enable the continuation of communication through multiple streams. They also provide the kind of stability needed for emergency situations. Emergency situations can change depending on the nature of the disaster. For instance, a flood could cause water damage and loss of property and life. These are different factors that need to be analyzed and communicated accordingly. If it is not communicated properly, snags and higher losses can be incurred.

Finally, when looking at M&L regarding roles, they play a part in the interpersonal aspect of emergency management. There are several roles regarding interpersonal behavior within organizations. For example, there is the the leader, the figurehead, and the liason, to name some. These are some of the roles published in Mintzberg on Management Inside our Strange World of Organizations by Mintzberg in 1990 that fit into the category of interpersonal. The interpersonal category proves ideas and information, allowing coworkers to understand and communicate with each other (Mintzberg, 2007).

The figurehead is the one with the social, legal, and ceremonial responsibilities. They are typically expected to be a source of inspiration. People within the organization look up to them and admire their authority. They are an important part to creating motivation and respect in an emergency management situation (Mintzberg, 2007).

The next role is the leader. They offer leadership to the team or organization. They manage the responsibilities and performance of each person within the team (Mintzberg, 2007). Without them, there is no one to be held accountable for the actions of subordinates. There is also no clear order that may lead to chaos especially in crises.

The third role is liaison. Managers are liaisons and should communicate with external and internal contacts. They are the ones that network on behalf of the team or organization. Liaisons offers direct communication to other teams or organizations and helps avoid some of the confusion that comes from lack of clear distinction. (Mintzberg, 2007). These roles all makeup the integral part of M&L showing the need for this part of emergency management to exist. This is why research is dedicated to M&L because they represent the brains and thought behind the operation. Lack of proper M&L can lead to lack of overall effectiveness for emergency management.

Application of M&L Theory

Theory of Planned Behavior explores motivation and subjective norms. This is the chosen theory that will be used when discussing M&L theory and subsequent application. The Theory of Planned Behavior (TPB), has been used in research to help with outbreak preparedness. One qualitative study found research using this theory concentrated on the behavior of blood donors. " . . . that used the TPB to investigate the beliefs of blood donors during the low and high-risk phases of avian influenza outbreak" (Ejeta, Ardalan, & Paton, 2015, p. 3). Imagine a scenario where there is a deadly disease outbreak and there are patients in need of blood transfusions. Emergency management teams must predict which groups may be more willing than other to donate blood and coordinate with nursing staff and hospitals to collect blood from specific segments of the population accordingly.

This theory allows for an understanding of attitude and subjective norm. It allows for assessment o intention as well as perceived power and control. In a variety of emergency situations, people automatically try to either control the situation or want someone else to take charge. Another key construct of TPB is self-efficacy and understanding how it plays a role in crises.

When it comes to overcoming obstacles and/or objections within the TPB model, the framework asks to break down the task to simplify it. Simplifying tasks allows for ease of communication in any M&L situation. A common theme amidst disaster scenarios is the lack of understanding of what to do. Emergency teams may not have past experience or may have multiple processes to undergo. For instance, during the earthquake that occurred in Japan in 2011 (Tohoku earthquake), there was a subsequent tsunami that created problems for the Fukushima Daiichi Nuclear Power Plant leading to a nuclear disaster.

The three disasters one after the other left emergency crews scrambling. They needed to rescue people in the flooded areas, keep people away from nuclear waste, and assess injured people from the earthquake as well as relay property damage. If TPB would have been applied in that scenario, all the complex problems would have been broken down into simpler ones allowing for faster and more effective execution of strategies and objectives. It would also allow for continued assessment of areas where people would be more cooperative in terms of getting to safety and seeking medical assistance.

Another part of overcoming obstacles within the TPB theoretical framework is emphasizing positive outcomes/preparedness. When the public endures a stressful and tragic time as a crisis, people lose hope and feel overwhelmed with the fear and loss. However, by focusing on the positive results such as number of survivors, ability to rescue and avert dangers, it allows for a relay of hope and uplifting emotion for those affected by such tragic events. People that endure natural disasters like earthquakes and tsunamis often lose their homes and most, if not all of their personal belongings. They need M&L that can show them positivity.

A way to promote and encourage positivity is by emphasizing the role every person in the community has and their possible participation. Here is where M&L is key. As described in Section II, interpersonal skills are part of the M&L aspect of emergency management. The figurehead, the liaison, and the leader act out necessary processes to promote communication and understanding. Leaders can play a key role in getting everyone to perform allotted tasks and the inspiration can come from the figurehead. The liaison can parlay the objectives and aims identified by the leader to the people part of emergency and management and outside of it.

By showing the public they can and have a role in bettering the situation, it is empowering them, motivating them to persevere. Another key aspect of overcoming obstacles according to TPB is emphasis of likelihood of success is such preparations are executed. For example, going back to the tragedy in Japan, if emergency crews did not notify people near the nuclear power plant to evacuate, they would have faced deadly contamination. It was the job of emergency management to warn people and let them know of the dangers should they stay.

People all over require assurance and positivity to help them commit to actions necessary for improved outcomes during emergencies. The final aspect of overcoming obstacles according to the TPB is encouragement of family plans/intimate conversations. It is all about motivating people and changing their attitudes so they can perform the necessary actions for a positive outcome. Without acknowledging the need to socialize and communicate emergency crews will not be able to increase morale among survivors of a disaster. People need each other in order to survive and rely on each other for almost everything, including relief and positive emotions.

TPB promotes such communication and allows emergency management to pinpoint the processes needed to achieve positive outcomes. Obstacles will continue to exist when it comes to managing crises. However, theoretical frameworks like TPB aiding in managing negative situations and turning them into positives by improving outlook, increasing motivation, and emphasizing positivity and proactive behaviors. This is what is needed in disaster scenarios and this is what M&L can provide and have provided in various situations involving crises.

M&L enables successful formation of relationships and collaboration through effective and varied communication. It allows this through assessment and identification of behaviors, obstacles, and outcomes. It is important to understand preparedness should be people-focused and aiming for work and planning with not for the public. Active participation from the public promotes proactive resolutions and reduces the stress and negative emotions that can come from an emergency situation. Motivation does not come from knowledge, information, and education. At least not fully.

It comes from community, and understanding of process, and communication on all levels through corresponding positions and those in key roles administering effective strategies to mitigate the negative emotional impact that disasters can bring. All of which stand to benefit from an understanding of TPB. TPB when broken down is about norms and not just social norms, but also subjective, descriptive, and injunctive norms. Subjective norms denote "a person's perception of what others who are important to the person expect him or her to do" (Coppola & Maloney, 2017). A man may be expected to save a woman who is drowning in a flood. This is because men are considered the physically stronger sex and are often less important than the woman due to the nature of reproduction and the womb. An emergency preparedness campaign may include messages to avoid risking one's life to save a trapped person and instead notify rescue workers of their location. That way casualties will be kept at a minimum.

The next one is injunctive norms. "Rather than just considering what important others expect, injunctive norms involve the types of behaviors of which important others approve or disapprove" (Coppola & Maloney, 2017). An example of this is looting stores after an earthquake. Authority figures or other people of importance may disapprove of looting and thus some will act accordingly. Descriptive norms follow roughly the same framework except according to what society thinks in general should be done.

All of these allow for thorough and adequate examination of the complexities of attitudes and motivations in people during crisis situations. Such information is invaluable to emergency management. It shows how information and knowledge in certain areas can improve outcomes. Furthermore, it can allow for improved overall function concerning emergency task processes.

In conclusion, it takes great effort to orchestrate action in lieu of an emergency. Emergency management has a complex and difficult task of helping the public and minimizing loss of life and loss of property. Sometimes disasters occur one after the other and require a deeper understanding of complex processes to effectively lead everyone to a positive outcome. TPB allows for a better synthesis of information and allows for a systematic and detailed means of overcoming the many obstacles that come with emergencies.

Although TPB and other theories have been used within the lens of disease outbreaks, it can be used for other disasters, especially complex ones where several things occur. Theoretical framework sets up not only improved preparedness and response to emergencies, but also allows emphasis on the effectiveness of M&L. M&L are crucial for several aspects of emergency management, namely communication and allotment of responsibilities to not just emergency teams, but also the public at large. TPB allows for understanding of motivation and why people may or may not perform certain actions.

While other theories were reviewed briefly in the literature review, this theory shows more of the motivation behind things versus beliefs or possible interconnected pathways. Lastly, M&L is a key aspect of emergency management because it serves as the brains to any operation performed by emergency management. There always needs to be some central power or authority to oversee the processes performed during an emergency.

This central power understand acknowledges what is needed and what will work best. Without the central power, chaos will ensure. Thus proving the need for effective M&L in emergencies.

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