The Hurricane Exposure, Adversity, and Recovery Tool (HEART): Developing and Validating a Risk Screening Instrument for Youth Exposed to Hurricane Harvey
Given the increasing regularity with which severe (named) hurricanes arise, there is a need for valid, practically useful measures that facilitate child-centered post-hurricane situation analysis and needs assessment. Measures that accurately assess the most potent hurricane-related risk factors are essential to identifying youth at risk for developing posttraumatic stress reactions and providing them with effective post-disaster support. With feedback from community stakeholders (e.g., school personnel, physicians and hospital staff, community clinicians), we developed the Hurricane Exposure, Adversity, and Recovery Tool (HEART), a 29-item self-report measure of hurricane risk factors. Test development procedures included: (1) Reviewing the literature regarding hurricane exposure-related risk factors in youth; (2) Generating a developmentally-informed test item pool; (3) Conducting interviews with clinicians, as well as youth impacted by Hurricane Harvey, to evaluate the comprehensibility and acceptability of candidate items; and (4) evaluating endorsement rates for hurricane exposure-related risk factors among (N = 107) youth in an outpatient clinic specializing in the treatment of childhood trauma and loss. Disaster-related exposure, pre-existing indicators of risk, and ongoing post-disaster adversities were correlated with posttraumatic stress and depressive symptoms. These results provide support for an integrative approach to post-hurricane screening for both hurricane-specific (e.g., witnessing injuries) and non-specific (e.g., prior trauma) factors
