The Red Cross traditional method of Disaster Health System (DHS) response is ' boots on the ground.' Texas, the 2nd largest state by population and land mass, has only 15 DHS volunteer nurses who were not able to meet the needs of disaster victims in Texas with the traditional response method. The Texas Red Cross DHS volunteer nurses began piloting a virtual DHS model in 2014. The research question was how Texas Red Cross nurses designed, developed, implemented, and evaluated the Texas Red Cross virtual DHS Model. The purpose of this case study was to provide this information in a case study. The research approach followed a single investigator case study design that utilized Roger's diffusion of innovations theory and Lewin's change theory to identify how this virtual pilot was created and implemented in Texas. The processes developed and utilized are provided in detail in this case study. Data maintained by the Texas DHS team from March, 2016 to March, 2017 provided evidence that all 1,724 cases assigned to the DHS team were worked and closed by a Texas DHS volunteer. A qualitative summary of nurses' satisfaction with this model was uniformly positive. This provided support for the use of the virtual model for communication to meet the disaster-related health needs of disaster victims in Texas. The use of a virtual model for disaster management supports positive social change in addressing the disaster-related health needs of disaster victims in Texas and for possible use by other Red Cross DHS stakeholders.

Disasters occur all over the world, and affect a rising number of people. The health effects of natural disasters depend on several factors present before, during, and after a disaster event. However, there is only limited knowledge of survivors experiences, needs, and health after natural disasters. Disaster radio means a temporary radio station that broadcasts information, music, and support to the affected population. Disaster radio has the potential to function even in a severely affected area, but its effects need to be further evaluated from a health perspective. The context of this thesis was the Haiyan supertyphoon that hit parts of the Philippines in November 2013. The overall aim was to describe survivors’ and health professionals’ experiences during and in the immediate aftermath of a natural disaster, the health effects from such a disaster, and how disaster radio as a disaster response intervention can be used and evaluated from a health perspective. The thesis includes four studies using qualitative research methods, including content analysis and a phenomenological hermeneutic method, and quantitative methods with statistical analysis. The results show that the Haiyan typhoon affected physical, psychological, and social dimensions of health. Disaster radio was used to broadcast health-related information and psychosocial support, and made a positive contribution to recovery from the perspective of the survivors. Being a health professional deployed during the disaster was an experience of being both a helper and a victim. The use of a self-selected internetbased sample recruited via Facebook for a web-based survey mitigated several practical challenges related to disaster research, but also raised questions about the generalizability of the results. Based on the findings, the importance of an integrated physical, psychological, and social health response to natural disasters is emphazized. Also, the health care system should prepare to use disaster radio as disaster response. In addition, the results suggest that disaster training for health professionals should include personal preparation and coping strategies. Internet-based methods in disaster research need to be further evaluated.