How Can We Improve Initial Public Response During Emergencies? Recommendations from a Systematic Review of Pre-Incident Information

This systematic review examines the effect of pre-incident information on public preparedness prior to an emergency or disaster. Preparing members of the public for adverse events can improve self-sufficiency and improve health outcomes, particularly during periods when emergency responders are not immediately available. Twenty-three studies were identified, addressing both natural and human-influenced events. All the studies investigated pre-incident training targeting members of the public rather than specialist responders. The synthesis considered training content, delivery approaches and evaluation methods. The studies included preparation, personal safety, triage, first aid and evacuation in scenarios involving terrorism, fire, earthquake, flood and CBRN events. Pre-incident education generally improves knowledge and intention to act, with higher-intensity and interactive training yielding greater engagement and response. Due to the difficulty of simulating emergencies and disasters, several studies used self-reporting and hypothetical testing, while others attempted to create real-life scenarios. The immediate effects of pre-incident education were generally positive, although many studies tested outcomes theoretically or within a classroom environment. It was also noted that few studies considered retention over the medium to long term; this is a concern as temporal decay may reduce preparedness. This review provides a basis for continued development of public-facing pre-incident education to increase resilience to both terrorist attacks and natural disasters.