{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:29:03Z","timestamp":1789147743461,"version":"build-2803163510"},"reference-count":59,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T00:00:00Z","timestamp":1644796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Center for Student Research &amp; Department of Public Health at California State University, East Bay","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In Puerto Rico, a host of factors makes the role of community-based organizations (CBOs) critically important in emergency preparedness and response (EPR) and disability-inclusive disaster risk reduction (DiDRR) addressing the needs of people with disabilities and older adults. The territory has been the site of recurring hurricanes, earthquakes, medical crises, and human-made disasters. Political, social, and economic problems unique to the archipelago have historically limited the preparedness and response capacity of governmental authorities, especially for its most at-risk populations. In a context of severe constraints on government resources, CBOs are positioned to play an outsized role in providing services for disabled and older adults before, during, and after emergencies. This study assesses the emergency preparedness and response capacity of CBOs (n = 22) for addressing the needs of people with disabilities and the elderly. Semi-structured, largely closed-ended interviews were conducted in Spanish with key informants at Puerto Rican CBOs. The interviews included questions about emergency preparedness and response training, as well as organizational capacity during COVID-19 and post-Hurricane Mar\u00eda. This study posits that conditions in Puerto Rico place CBOs at the forefront of critical responsibilities including emergency preparedness and response, warranting assessment of their practices and resources to assist them in fulfilling their mission.<\/jats:p>","DOI":"10.3390\/ijerph19042156","type":"journal-article","created":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T20:26:42Z","timestamp":1644870402000},"page":"2156","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Assessing the Emergency Response Role of Community-Based Organizations (CBOs) Serving People with Disabilities and Older Adults in Puerto Rico Post-Hurricane Mar\u00eda and during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"19","author":[{"given":"Alina","family":"Engelman","sequence":"first","affiliation":[{"name":"Department of Public Health, California State University, East Bay, Hayward, CA 94542, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3716-7336","authenticated-orcid":false,"given":"Mariana T.","family":"Guzzardo","sequence":"additional","affiliation":[{"name":"Department of Human Development and Women\u2019s Studies, California State University, East Bay, Hayward, CA 94542, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marley","family":"Antolin Mu\u00f1iz","sequence":"additional","affiliation":[{"name":"Department of Public Health, California State University, East Bay, Hayward, CA 94542, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Arenas","sequence":"additional","affiliation":[{"name":"Department of Public Health, California State University, East Bay, Hayward, CA 94542, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aracely","family":"Gomez","sequence":"additional","affiliation":[{"name":"Department of Public Health, California State University, East Bay, Hayward, CA 94542, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,14]]},"reference":[{"key":"ref_1","first-page":"67","article-title":"Impact of Hurricane Maria to the Civic Sector: A Profile of Non-Profits in Puerto Rico","volume":"32","author":"Garcia","year":"2020","journal-title":"CENTRO: J. Cent. Puerto Rican Stud."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"30","DOI":"10.2105\/AJPH.2017.304198","article-title":"Maria in Puerto Rico: Natural Disaster in a Colonial Archipelago","volume":"108","year":"2018","journal-title":"Am. J. Public Health"},{"key":"ref_3","unstructured":"Klein, N. (2018). The Battle for Paradise: Puerto Rico Takes on the Disaster Capitalists, Haymarket Books."},{"key":"ref_4","first-page":"157","article-title":"Corporations and Reconstruction Policy in Puerto Rico","volume":"32","year":"2020","journal-title":"Cent. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1177\/003335491412900208","article-title":"Assessment of State- and Territorial-Level Preparedness Capacity for Serving Deaf and Hard-of-Hearing Populations in Disasters","volume":"129","author":"Ivey","year":"2014","journal-title":"Public Health Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1177\/0899764010362115","article-title":"Complexity and Instability: The Response of Nongovernmental Organizations to the Recovery of Hurricane Katrina Survivors in a Host Community","volume":"40","author":"Gajewski","year":"2010","journal-title":"Nonprofit Volunt. Sect. Q."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Frimpong, L.K., Okyere, S.A., Diko, S.K., Abunyewah, M., Erdiaw-Kwasie, M.O., Commodore, T.S., Hernandez, D.O., and Kita, M. (2021). Actor-Network Analysis of Community-Based Organisations in Health Pandemics: Evidence from COVID-19 Response in Freetown, Sierra Leone. Disasters, in print.","DOI":"10.1111\/disa.12508"},{"key":"ref_8","unstructured":"Center for Puerto Rican Studies (2020). Enduring Disasters: Puerto Rico, Three Years After Hurricane Mar\u00eda, Center for Puerto Rican Studies, Hunter College. Available online: https:\/\/centropr.hunter.cuny.edu\/sites\/default\/files\/data_briefs\/centro_3year_maria_9-2020.pdf."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1056\/NEJMsa1803972","article-title":"Mortality in Puerto Rico after Hurricane Maria","volume":"379","author":"Kishore","year":"2018","journal-title":"New Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1002\/rhc3.12187","article-title":"The Role of Social Capital in Resiliency: Disaster Recovery in Puerto Rico","volume":"11","author":"Roque","year":"2020","journal-title":"Risk Hazards Crisis Public Policy"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"4177","DOI":"10.1017\/S1368980020003134","article-title":"The association between purchasing locally produced food and diet quality among adults in Puerto Rico","volume":"24","author":"Marrero","year":"2020","journal-title":"Public Health Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10455752.2018.1505233","article-title":"Puerto Rico: Hurricane Maria and the Promise of Disposability","volume":"29","year":"2018","journal-title":"Capital. Nat. Social."},{"key":"ref_13","first-page":"367","article-title":"The Perfect Storm: Puerto Rico\u2019s Evolving. Debt Crisis under PROMESA","volume":"1","author":"Meng","year":"2019","journal-title":"Columbia Bus. Law Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1177\/0898264317714144","article-title":"Aging in Puerto Rico: A Comparison of Health Status Among Island Puerto Rican and Mainland U.S. Older Adults","volume":"29","author":"Ailshire","year":"2017","journal-title":"J. Aging Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1353\/hpu.2019.0043","article-title":"Disaster Care and Socioeconomic Vulnerability in Puerto Rico","volume":"30","author":"Rudner","year":"2019","journal-title":"J. Health Care Poor Underserved"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1093\/geroni\/igy031.3688","article-title":"Social Determinants Of Late-Life Disability In Puerto Rico","volume":"2","year":"2018","journal-title":"Innov. Aging"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.24966\/GGM-8662\/100041","article-title":"Elderly People with Disabilities and Natural Disasters: Vulnerability of Seniors and Post Trauma","volume":"5","author":"Maltais","year":"2019","journal-title":"Gerontol. Geriatr. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S50","DOI":"10.1093\/geront\/gnz018","article-title":"Impact of Natural Disasters on Health Outcomes and Cancer Among Older Adults","volume":"59","author":"Prohaska","year":"2019","journal-title":"Gerontol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1001\/jama.2018.10929","article-title":"Use of Death Counts from Vital Statistics to Calculate Excess Deaths in Puerto Rico Following Hurricane Maria","volume":"320","author":"Howard","year":"2018","journal-title":"JAMA"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1089\/env.2017.0043","article-title":"The Political Determinants of Disaster Risk: Assessing the Unfolding Aftermath of Hurricane Maria for People with Disabilities in Puerto Rico","volume":"11","author":"Morris","year":"2018","journal-title":"Environ. Justice"},{"key":"ref_21","first-page":"10","article-title":"Health and social services in Puerto Rico before and after Hurricane Maria: Predisaster conditions, hurricane damage, and themes for recovery","volume":"9","author":"Chandra","year":"2021","journal-title":"Rand Health Q."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1080\/01488376.2017.1321081","article-title":"Disaster Preparedness among Older Adults: Social Support, Community Participation, and Demographic Characteristics","volume":"43","author":"Kim","year":"2017","journal-title":"J. Soc. Serv. Res."},{"key":"ref_23","unstructured":"Alexander, D., Gaillard, J.C., and Wisner, B. (2012). Disability and disaster. Handbook of Hazards and Disaster Risk Reduction, Routledge."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1037\/0003-066X.62.2.118","article-title":"The dirty dozen: Twelve failures of the Hurricane Katrina response and how psychology can help","volume":"62","author":"Gheytanchi","year":"2007","journal-title":"Am. Psychol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1007\/s10597-011-9446-1","article-title":"A Qualitative Analysis of Barriers, Challenges, and Successes in Meeting the Needs of Hurricane Katrina Evacuee Families","volume":"48","author":"Legerski","year":"2011","journal-title":"Community Ment. Health J."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Engelman, A., Ivey, S.L., Tseng, W., Dahrouge, D., Brune, J., and Neuhauser, L. (2013). Responding to the deaf in disasters: Establishing the need for systematic training for state-level emergency management agencies and community organizations. BMC Health Serv. Res., 13.","DOI":"10.1186\/1472-6963-13-84"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e104","DOI":"10.2196\/jmir.2007","article-title":"Socioeconomic and Geographic Disparities in Health Information Seeking and Internet Use in Puerto Rico","volume":"14","author":"Rutten","year":"2012","journal-title":"J. Med Internet Res."},{"key":"ref_29","first-page":"1","article-title":"Erasure and resistance: The state of public education in Puerto Rico","volume":"34","author":"Brusi","year":"2021","journal-title":"Int. J. Qual. Stud. Educ."},{"key":"ref_30","first-page":"288","article-title":"Impact of the COVID-19 Pandemic on Resilience to Climate Change in Underserved Communities","volume":"14","author":"Palinkas","year":"2021","journal-title":"Sustain. Clim. Chang."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"100943","DOI":"10.1016\/j.dhjo.2020.100943","article-title":"The public health response to the COVID-19 pandemic for people with disabilities","volume":"13","author":"Boyle","year":"2020","journal-title":"Disabil. Health J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1111\/jgs.16472","article-title":"COVID-19 and Older Adults: What We Know","volume":"68","author":"Shahid","year":"2020","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1080\/14461242.2020.1784020","article-title":"Disability, communication, and life itself in the COVID-19 pandemic","volume":"29","author":"Goggin","year":"2020","journal-title":"Health Sociol. Rev."},{"key":"ref_34","unstructured":"Amirhosseini, Z. (2021, October 25). COVID-19\u2019s impact on people with disabilities. Massachusetts General Hospital. Available online: https:\/\/www.massgeneral.org\/news\/coronavirus\/Covid-19s-impact-on-people-with-disabilities."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"101161","DOI":"10.1016\/j.dhjo.2021.101161","article-title":"Impacts of the COVID-19 pandemic on health, financial worries, and perceived organizational support among people living with disabilities in Canada","volume":"14","author":"Gignac","year":"2021","journal-title":"Disabil. Health J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"100944","DOI":"10.1016\/j.dhjo.2020.100944","article-title":"The COVID-19 pandemic and people with disability","volume":"13","author":"Turk","year":"2020","journal-title":"Disabil. Health J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1108\/EOR-02-2023-0004","article-title":"COVID-19 and employees\u2019 mental health: Stressors, moderators and agenda for organizational actions","volume":"2","author":"Hamouche","year":"2020","journal-title":"Emerald Open Res."},{"key":"ref_38","unstructured":"Guzzardo, M., Engelman, A., Todorova, I., Polidoro-Lima, M.M., Dean-Olmsted, E., and Guzzardo-Tamargo, R. The perceived experiences of older adults with functional diversity after Hurricane Mar\u00eda in Puerto Rico. Soc. Sci. Med., in preparation."},{"key":"ref_39","unstructured":"Murray, Y.M. (2018). FEMA has been a nightmare: Epistemic injustice in Puerto Rico. Williamette Law Rev., 55, Available online: https:\/\/papers.ssrn.com\/sol3\/papers.cfm?abstract_id=3249220."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e001191","DOI":"10.1136\/bmjgh-2018-001191","article-title":"Quantifying inequities in US federal response to hurricane disaster in Texas and Florida compared with Puerto Rico","volume":"4","author":"Willison","year":"2019","journal-title":"BMJ Glob. Health"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1177\/1049732320968791","article-title":"Feelings, Thoughts, and Behaviors During Disaster","volume":"31","author":"Massazza","year":"2020","journal-title":"Qual. Health Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"112610","DOI":"10.1016\/j.socscimed.2019.112610","article-title":"Twelve years later: The long-term mental health consequences of Hurricane Katrina","volume":"242","author":"Raker","year":"2019","journal-title":"Soc. Sci. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1111\/j.1939-0025.2010.01027.x","article-title":"The impact of Hurricane Katrina on the mental and physical health of low-income parents in New Orleans","volume":"80","author":"Rhodes","year":"2010","journal-title":"Am. J. Orthopsychiatry"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.5993\/AJHB.43.6.15","article-title":"Impact of Hurricane Katrina on Mental Health among US Adults","volume":"43","author":"An","year":"2019","journal-title":"Am. J. Health Behav."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1017\/dmp.2018.151","article-title":"The Mental Health Impact of Hurricane Maria on Puerto Ricans in Puerto Rico and Florida","volume":"13","author":"Scaramutti","year":"2019","journal-title":"Disaster Med. Public Health Prep."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1017\/S1041610220000848","article-title":"The impact of COVID-19 on mental health in the Hispanic Caribbean region","volume":"32","author":"Acosta","year":"2020","journal-title":"Int. Psychogeriatr."},{"key":"ref_47","unstructured":"Agosto-Maldonado, L.E. (2021, October 25). Puerto Rico: Nonprofits Recalibrate after Hurricane Maria. Spotlight on Poverty and Opportunity. Available online: https:\/\/spotlightonpoverty.org\/spotlight-exclusives\/puerto-rico-nonprofits-recalibrate-after-hurricane-maria\/."},{"key":"ref_48","unstructured":"Herrera, K. (2021, October 25). Tres A\u00f1os. Cuatro Desastres. Los Trabajadores Sociales en Puerto Rico Quieren un Cambio. The Center for Public Integrity. Available online: https:\/\/publicintegrity.org\/environment\/hidden-epidemics\/tres-anos-cuatro-desastres-los-trabajadores-sociales-en-puerto-rico-quieren-un-cambio\/."},{"key":"ref_49","first-page":"71","article-title":"For peer review only for community mobilization: A model for preparedness for Puerto Rico after Hurricane Maria","volume":"4","author":"Diaz","year":"2019","journal-title":"Int. J. Public Health Systems"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1037\/a0019784","article-title":"Shared traumatic reality in communal disasters: Toward a conceptualization","volume":"47","author":"Baum","year":"2010","journal-title":"Psychotherapy"},{"key":"ref_51","first-page":"2020070451","article-title":"Burnout in the clinical personnel of Puerto Rico during the COVID-19 pandemic","volume":"1","author":"Afanador","year":"2020","journal-title":"Preprints"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/ppc.12351","article-title":"Disaster awareness and coping: Impact on stress, anxiety, and depression","volume":"55","author":"Lee","year":"2018","journal-title":"Perspect. Psychiatr. Care"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1037\/trm0000228","article-title":"In the aftermath: The effects of hurricanes Harvey and Maria on the well-being of health-care and social service providers","volume":"26","author":"Powell","year":"2020","journal-title":"Traumatology"},{"key":"ref_54","first-page":"123","article-title":"Building collaborative partnerships across professions to implement trauma-focused cognitive behavioral interventions after Hurricane Maria in Puerto Rico","volume":"42","author":"Stewart","year":"2019","journal-title":"Behav. Ther."},{"key":"ref_55","unstructured":"Capacity Building Toolkit (2021, November 19). Announcements\u2014New Resource Available: Emergency Planning Toolkit for the Aging and Disability Networks. Administration for Community Living, Available online: https:\/\/acl.gov\/news-and-events\/announcements\/new-resource-available-emergency-planning-toolkit-aging-and-0."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/j.1467-7717.2007.00339.x","article-title":"Natural disasters and older US adults with disabilities: Implications for evacuation","volume":"31","author":"McGuire","year":"2007","journal-title":"Disasters"},{"key":"ref_57","unstructured":"Borges-M\u00e9ndez, R. (2021, October 25). Community Development Corporations and Reconstruction Policy in Puerto Rico. Available online: https:\/\/www.researchgate.net\/publication\/350499676_Community_Development_Corporations_and_Reconstruction_Policy_in_Puerto_Rico."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1080\/09540261.2020.1761776","article-title":"Decoloniality and community-psychology practice in Puerto Rico: Autonomous organising (autogesti\u00f3n) and self-determination","volume":"32","author":"Torres","year":"2020","journal-title":"Int. Rev. Psychiatry"},{"key":"ref_59","unstructured":"Taylor, A., and Taylor, S. (2021, October 25). Solidarity Across Species. Available online: https:\/\/www.dissentmagazine.org\/article\/solidarity-across-species."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/4\/2156\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:19:24Z","timestamp":1760134764000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/4\/2156"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,14]]},"references-count":59,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["ijerph19042156"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19042156","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,14]]}}}