Enhancing household disaster preparedness among older adults using the N-TORM intervention: A quasi-experimental study in rural Indonesia

Diki Ardiansyah (Emergency and Critical Care Department, Faculty of Health Sciences and Technology, Universitas Jenderal Achmad Yani, Bandung)
Roviatul Imaniah (Emergency and Critical Care Department, Faculty of Health Sciences and Technology, Universitas Jenderal Achmad Yani, Bandung)
Rita Fitri Yulita (Emergency and Critical Care Department, Faculty of Health Sciences and Technology, Universitas Jenderal Achmad Yani, Bandung)
Susilawati Susilawati (Emergency and Critical Care Department, Faculty of Health Sciences and Technology, Universitas Jenderal Achmad Yani, Bandung)
Asep Badrujamaludin (Emergency and Critical Care Department, Faculty of Health Sciences and Technology, Universitas Jenderal Achmad Yani, Bandung)
Khrisna Wisnusakti (Emergency and Critical Care Department, Faculty of Health Sciences and Technology, Universitas Jenderal Achmad Yani, Bandung)
Firman Sugiharto (Doctoral Program, Faculty of Nursing, Universitas Padjadjaran)

Nursing and Health Sciences Journal (NHSJ)
Vol. 6 No. 3 (2026): September 2026

Older adults in earthquake-prone low- and middle-income countries (LMICs) face disproportionate disaster-related morbidity and mortality. Culturally adapted, nurse-led preparedness programs for this demographic in seismically active LMIC settings remain largely unexplored. This study evaluated the effectiveness of the Nurses Taking on Readiness Measures (N-TORM) intervention on household emergency preparedness (HEP) among older adults (≥ 60 years) residing near Indonesia’s Lembang Fault. A quasi-experimental, non-equivalent control-group pre-post design was implemented in April 2025 in Suntenjaya Village, West Java. Forty participants were allocated to intervention (n = 20) or control (n = 20) groups based on residential clusters to minimize contamination. The six-day N-TORM intervention comprised disaster education, booklet-guided planning, and home-visit monitoring. HEP was measured using the 32-item Household Emergency Preparedness Instrument (HEPI; score range 32–160; ≥ 112 indicates preparedness). Data were analyzed using the Wilcoxon signed-rank and Mann-Whitney U tests. Baseline assessments categorized both groups as unprepared (median HEPI score: 57). Post-intervention, the intervention group showed a significant increase in score (median: 126, p < 0.001), successfully achieving the prepared threshold. The control group exhibited no significant change. Between-group comparisons at post-test revealed a highly significant difference (Mann-Whitney U = 0.00, p < 0.001). The culturally adapted N-TORM intervention significantly enhances household emergency preparedness among older adults in earthquake-prone LMICs. Integrating such nurse-led programs into existing community health infrastructure, particularly integrated health posts, offers a scalable strategy to strengthen disaster risk reduction for vulnerable aging populations.