Android-based Mobile Rapid Health Assessment in the Disaster Emergency Response Phase

Abstract


INTRODUCTION
Major disasters and emergencies debilitate individuals' security, well-being, and welfare worldwide.Each year, millions of individuals are influenced by disasters with numerous passings, wounds, and vagrancy.As a result, these disasters and emergencies have a critical effect on people's lives [1].
Within the past ten years, several disasters have caused numerous casualties which affected the welfare and safety of individuals worldwide.Indonesia is one of the foremost disaster-prone nations since it is geologically found within the assembly zone of the world's significant plates, namely the Eurasian, Indo-Australian, Pacific, and Philippine plates which have a series of volcanoes throughout the Asia-Pacific or called "Ring of Fire."The zone or region between the plate meeting and the volcano series (forearc) has active faults that make Indonesia a country prone to natural disasters such as earthquakes, tsunamis, volcanic eruptions, and landslides [2].and evacuated by recent disasters in Indonesia [3], [4].In East Java, throughout 2022, there were 212 disasters, and up to August 2023, 127 disasters had occurred.In Lamongan Regency, from 2017 to 2022, there have been 34 disasters [3].

Many disasters have happened in
Ideally, the rapid health assessment response provides organizations with the information they need to coordinate disaster relief quickly, reliably, and without bias, covering all types of standard and unique needs experienced by disaster survivors [1].
Rapid assessment response aims to understand better the needs and problems of people influenced by a disaster within one to two weeks.It may be a doable and fast elective to conduct a point-by-point evaluation of the issues and needs of each influenced person.
Rapid needs assessment should be distinct from post-disaster health research.[5].When disasters occur, a quick and effective response is essential to help communities, reduce casualties, and mitigate economic impacts [6].
Properly evaluating and tending to the wellbeing needs of influenced population conveniently is necessary, as community versatility depends on mental working [7].In addition, rapid assessments can be valuable in deciding behavioral well-being needs in case local health and medical systems are overpowered or disturbed by the catastrophe and cannot give this data [8].
Disaster needs assessments are often ineffective and slow after a major natural disaster, leading to inefficient and uncoordinated responses [9].Conducting a rapid assessment response in a disaster can cause several challenges for health workers and disaster volunteers, including identifying and reaching target populations, collecting field groups, and securing funding and ethics review board approval [10].Another critical challenge that can ruin fast arrangement of assessment teams is the need for existing assessment tools to assess influenced individuals [8].Although it is recommended that health workers or disaster volunteers develop questions used in pre-disaster activities [11], this is only sometimes possible.
In 2015, research on creating a websitebased RHA application was conducted in Aceh Province [12].However, this application was still not widely used nor downloaded because it was a website, not an Android application.
In this study, the researchers sought to create an information system to accelerate and improve the accuracy of disaster data in the rapid health assessment (RHA) response phase using android mobile.On the other hand, Information and Communication Technology (ICT) has proven to have strong prospects in advancing the field of disaster access services [13].Mobile technology seems promising in improving access and efficiency of healthcare services [14].Shan [15]

Design
This research used a research and development approach to produce and test certain products [17].The application is acceptable when the I-CVI score equals 1.00 (for categories 3-5 experts).
In addition, the reliability test was tested using Cronbach's alpha.
The application trial questionnaire used

Data Analysis
Research data obtained from questionnaires filled out by disaster experts were then analyzed using Microsoft Excel to determine the I-CVI score on each question item.At the same time, the data from the questionnaire filled out by the users were analyzed using the SOS formula in the form of percentages and descriptive statistics.
The formula for the SU5S score [18]

DISCUSSION
The RHA application is proven to be valid and reliable for use in conducting rapid health assessments in the disaster emergency response phase.This application is specifically designed for disaster volunteers in Indonesia to assess health quickly to accelerate decision-making about the type of assistance needed by disaster victims.Mobile phone is the primary tool victims require during a disaster while evacuating to a safe place [19].

Previous research has been conducted
by creating a website-based RHA application and using different forms [12].The androidbased RHA application makes it easier for volunteers to conduct rapid health assessments during disasters compared to website and paper-based types.Previous research conducted an RHA assessment of the flood disaster in Gresik Regency, East Java, which used paper-based forms [20].However, the effectiveness needed to be analysed.
The use of android-based RHA applications is still relatively new.Several mobile/android-based applications have been created to monitor elderly patients with atrial fibrillation [21], oncology patients [22], and post-natal patient care [23].The androidbased RHA application can be used to assess the impact of disasters and the existence of potential threats in the health sector, prove the existence of a disaster emergency, assess capacity in existing emergency response, determine the type of immediate needs, and make recommendations for priority actions in the process of implementing emergency response [24].Rapid assessment is critical to take the right policy in disaster management and to fulfill the needs of affected communities in disaster areas in terms of quality and quantity [25].

Limitation
This application can only be used when there is internet (cannot be used offline).In addition, this application is still partly in Indonesian, especially in the form-filling section, and cannot be used for cellphones other than Android.Users and passwords are not made independently by the users to avoid pranks.Therefore, volunteers who want to complete the application must contact the administrator to create a username and password.

Nursing Implication
The results of this study can be used as a reference in the process of rapid health assessment in the disaster emergency response phase as one of the materials studied in disaster nursing.The existence of this application is expected to facilitate the assessment process and data recapitulation so that damage, casualties, and urgent needs can be identified as soon as possible.

CONCLUSION
The RHA application is valid, has good internal consistency, and is usable for rapid health assessment in the disaster emergency response phase.It is proven to be valid and reliable to be used in the broader community, especially disaster agencies and disaster volunteers in Indonesia.The RHA application can also be downloaded through the Play Store and used through an android cellphone.
Further researchers can improve the quality of applications accessed offline or without an internet connection.

ACKNOWLEDGEMENT
We want to express our gratitude to all parties Indonesia over the past four years.From 2016 to 2019, there were 2,302 occasions with 3,161,231 individuals affected and uprooted, 2,853 events with 3,674,168 individuals affected and uprooted; 2,572 occasions with 10,333,309 individuals affected and uprooted; and 721 occasions with 186,204 individuals affected and evacuated.As of August 2023, there have been 996 disaster events in Indonesia.These statistics show that there are a large number of people affected

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This exploratory research aims to determine or open new areas by designing an information system [12].This research was conducted in two stages.Stage 1 was the application of RHA development and testing of internal consistency and Individual Content Validity Index (I-CVI) of the application.The second stage was socialization, followed by a test for usability for the user application.Samples Stage 1 is application development.Then, the application was reviewed by five experts who have experience in disaster response for more than five years to measure the internal consistency and content validity index of the application.Stage 2 was socialization, followed by a test for usability on 30 disaster volunteers from various disaster agencies in Lamongan Regency recruited by purposive sampling technique.Inclusion criteria for respondents in the application trial were disaster volunteers in Lamongan Regency who had received disaster education and training, had responded to local or national disasters, and had an android cellphone.Exclusion criteria were disaster volunteers who had never responded to a disaster even though they had received training and or could not operate an android cellphone.Stage I: Application RHA development The RHA application development was carried out in June-August 2023.The application development involved IT (information technology), while the RHA application content was reviewed by the researchers together with a team of disaster experts in Lamongan.The RHA form was adopted from the disaster emergency response assessment form by Muhammadiyah Disaster Management Center (MDMC) and modified by the researchers which included general disaster data (type of disaster, location, time of occurrence, affected area), victims and damage, community conditions (temporary shelter, clothing, food, clean water, sanitation, public facilities, major protection issues in the community, education, and health), information sources, recommendations for emergency response assistance locations.The application content was general so that it could be used in all types of disasters.The validity tests were carried out with the Individual Content Validity Index (I-CVI) scores.The reliability was tested using internal consistency reliability (Cronbach's alpha).The CVI assessment was carried out by five disaster experts in Lamongan, including one disaster consultant doctor from the Indonesian Ministry of Health and four senior nurses specialized in disaster and HPCRED facilitators.They have also been involved in disaster management for more than five years.The focus Group discussion was done in August 2023 at Universitas Muhammadiyah Lamongan.Stage II: Socialization and application trials Application socialization and measuring the effectiveness of the application on users (Disaster institutions in Lamongan) were carried out in September 2023.Disaster volunteers who met the criteria were given informed consent and an invitation to attend the socialization if they wished to become the respondents.Those who agreed to participate in the socialization were included in the Whatsapp group to communicate and remind them of the schedule.The offline socialization and testing of the application were carried out at Muhammadiyah Lamongan University.The respondents were provided with a username and password and were then asked to log in and fill out the application.After all the features and contents of the application were tested, respondents were asked to fill out a questionnaire.Research InstrumentsThe instruments used in this research were the RHA application and a questionnaire prepared by the researchers.There are two kinds of questionnaires in this research.The first questionnaire was distributed to five experts to measure the Content Validity Index (CVI) and Individual Content Validity Index (I-CVI) scores.In contrast, the second questionnaire was used for the users.The questionnaire for experts consists of 19 items about application content.The measurement scale was 1 (Not relevant), 2 (somewhat pertinent and requires many changes), 3 (entirely appropriate, but needs a little modification/change), and 4 (very relevant).In addition, to perceive the extent to which the instrument is understood, a measurement scale of 4 (good/very good),

Fig. 1 .
Fig. 1.The mean score of personal user application who have contributed to this research, especially Dr. Corona Sp.E.M. as the disaster consultant of the Indonesian Ministry of Health, the Disaster Management Committee of Lamongan Muhammadiyah Hospital, Muhammadiyah Disaster Management Center of Lamongan, Regional Disaster Management

Table 1
Validity of RHA Application by Disaster Expert is as follows: Ethical Clearance This research proposal was declared ethically feasible by the Ethics Committee of the University of Muhammadiyah Lamongan No.