Background and Objective: Natural disasters are among the most significant public health threats, particularly in disaster-prone countries such as Iran. Community preparedness plays a critical role in reducing disaster-related mortality and economic losses. Health Ambassadors, as a bridge between the health system and the community, can contribute substantially to improving disaster preparedness. This study aimed to assess disaster preparedness among Health Ambassadors in Sabzevar, Iran, based on the Extended Parallel Process Model (EPPM).

Materiah and Methods: This cross-sectional analytical study was conducted in 2017 among 120 Health Ambassadors in Sabzevar, Iran, who were selected through random sampling. Data were collected using a three-part questionnaire comprising demographic characteristics, EPPM constructs (knowledge, perceived susceptibility, perceived severity, perceived response efficacy, self-efficacy, enabling factors, and behavioral intention), and the standardized Disaster Assessment of Readiness and Training (DART) questionnaire. Data were analyzed using descriptive statistics and linear regression analysis in SPSS version 16.

Results: The mean age of participants was 37.8 ± 9.11 years. Most participants were married (88.3%) and had a secondary level of education (67%). The mean knowledge score was 11.78 ± 2.01 out of 14, whereas the mean disaster preparedness score was 4.85 ± 4.16 out of 15. Regression analysis revealed that EPPM constructs explained 39.9% of the variance in behavioral intention. Among these constructs, self-efficacy (β=0.534, P<0.001) and perceived response efficacy (β=0.174, P=0.033) were significant predictors of behavioral intention. Furthermore, enabling factors emerged as the only significant predictor of disaster preparedness (β=0.351, P<0.001) and, together with behavioral intention, explained 21.8% of the variance in preparedness.

Conclusion: Despite relatively adequate knowledge levels, disaster preparedness among Health Ambassadors was low. Self-efficacy and perceived response efficacy were the strongest predictors of behavioral intention, whereas enabling factors played the most important role in explaining disaster preparedness. These findings suggest that improving preparedness requires more than educational interventions alone. Providing enabling resources, practical skills, equipment, organizational support, and appropriate infrastructure is essential for translating behavioral intention into actual preparedness. Therefore, theory-based interventions that simultaneously strengthen self-efficacy and enabling factors may enhance community disaster preparedness and mitigate the adverse consequences of disasters.

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