Vulnerability to natural disasters is increasing globally1,2,3. In parallel, the responsibility for natural hazard preparedness has shifted to communities and individuals4. It is therefore crucial that households increase their preparedness, yet adoption of household preparedness measures continues to be low, even in high-risk regions5,6,7,8. In addition, few hazard-preparedness interventions have been evaluated longitudinally using observational measures. Therefore, we conducted a controlled intervention with a 12-month follow-up on adults in communities in the United States and Turkey that focused on improving household earthquake and fire preparedness. We show that this Fix-it intervention, involving evidence-based, face-to-face workshops, increased multihazard preparedness in both cultures longitudinally. Compared to baseline, the primary outcome—overall preparedness—increased significantly in the intervention groups, with more improvement in earthquake preparedness in the Turkish participants and more improvements in fire preparedness in the US participants. High baseline outcome expectancy and home ownership predicted overall preparedness change in both intervention groups longitudinally, implying that a sense of agency influences preparedness. An unintended consequence of observation is that it may increase preparedness, as even the control groups changed their behaviour. Therefore, observation of home preparatory behaviours by an external source may be a way to extend multihazard preparedness across a population.

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This study was funded by the EPSRC grant Challenging Risk: Achieving Resilience by Integrating Societal and Technical Knowledge (EP/F012179/1). The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. The authors thank R. West for his help in the original design of the study, M. Haklay, P. Rickles and E. Verrucci for their help using geographic information systems to scope which areas to choose for the study, C. Molina-Hutt for co-running the Seattle intervention and all of the study’s participants.

Author information


  1. Department of Clinical, Educational and Health Psychology, University College London, London, UK

    • Helene Joffe
    •  & Gabriela Perez-Fuentes
  2. Institute of Health Informatics, University College London, London, UK

    • Henry W. W. Potts
  3. Department of Civil, Environmental and Geomatic Engineering, University College London, London, UK

    • Tiziana Rossetto
  4. Department of Psychology, Başkent University, Ankara, Turkey

    • Canay Doğulu
  5. Department of Psychology, Gediz University, Izmir, Turkey

    • Ervin Gul


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H.J. had overall responsibility for devising the study, project planning, training researchers, data analysis and writing up the data. H.W.W.P. directed the data analysis and played a major role in the project write-up. T.R. played an advisory role in project planning. C.D. and E.G. played a major role in the data collection and running the intervention in Izmir. G.P.-F. was the key postdoctoral researcher for the duration of the project and played a key role in project planning, running the intervention in Seattle, the data analysis and the write-up.

Competing interests

The authors declare no competing interests.

Corresponding author

Correspondence to Helene Joffe.

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