Introduction
The frequency and magnitude of flood disasters are increasing globally due to climate change, with Japan showing similar trends.Reference Yoshida, Ozaki and Morita 1 While appropriate evacuation planning is essential during flood events, children represent one of the populations requiring consideration. Elementary school children have developing knowledge and capacities for ensuring their own safety, necessitating appropriate support from caregivers and communities.Reference Chiu, Goodman and Palacios 2 However, research on flood evacuation among families with children remains limited, and the specific challenges faced by elementary school children and their families, as well as the support they require, have not been adequately investigated.
A cross-sectional study found that maternal anxiety during disasters was associated with inadequate preparation of emergency supplies for children with food allergies and concerns about the psychological impact of evacuation on children under three years of age.Reference Yamazaki and Nakai 3 Given that maternal anxiety and stress affect children’s psychological well-being, the study emphasized the importance of routine emergency preparedness, evacuation drills, and community mutual assistance.Reference Yamazaki and Nakai 3 , Reference Seddighi, Yousefzadeh and López López 4 These findings underscore the need for support systems for children and their families to ensure safety during natural disasters.
Children’s disaster-related responses include fear, anxiety, and hostility toward siblings.Reference Peek 5 Conversely, children can actively participate in decision-making processes and disaster preparedness activities in schools, homes, and communities.Reference Anderson 6 , Reference Bodoque, Díez-Herrero and Amérigo 7 Flood preparedness education implemented in elementary schools in China has been shown to effectively enhance disaster resilience and adaptive capacity.Reference Zhong, Cheng and Zhang 8 Comprehensive research is needed to examine challenges unique to families with children, including managing multiple children and addressing children’s psychological stress.
This study aimed to identify the challenges faced by elementary school children and their families during flood evacuation and to elucidate the support required. A qualitative investigation was conducted focusing on the process from flood onset to arrival at evacuation shelters, examining factors that serve as barriers to evacuation behavior and the support needed to overcome these barriers. This study aimed to contribute to the development of effective disaster preparedness strategies for elementary school children and their families.
Methods
Design, Setting, and Participants
A qualitative research design was employed to gain an in-depth understanding of participants’ subjective experiences and to capture the issues from multiple perspectives. This study was conducted inductively, without an a priori theoretical framework, and therefore took an exploratory, hypothesis-generating stance. Specifically, interviews were conducted in accordance with the Consolidated criteria for reporting qualitative research (COREQ) guidelines, focusing on the process from flood onset to arrival at evacuation shelters, examining factors that serve as barriers to evacuation behavior and the support needed to overcome these barriers (Supplemental Table 1).Reference Tong, Sainsbury and Craig 9
Participant recruitment was conducted from July 2022 to March 2023 using snowball sampling, initially through the professional network of one of the authors, Ozaki. Participants were selected using maximum variation sampling based on background characteristics including family composition and residential circumstances. Several sources included Orange Home Care Clinic (Fukui City), associated daycare facilities, and Orange Kids’ Care Lab. Recruitment was continued until thematic saturation was reached; as a result, eight families comprising nine elementary school children were included in the interviews. The participating families had different family structures (2-parent households, single-mother households, and 3-generation households) and living environments, the latter referring to residential location and region, housing situation, and prior exposure to disasters such as the 2011 Great East Japan Earthquake and the 2019 Typhoon Hagibis. In families with more than one child, all children of elementary school age who were willing to participate and for whom parental consent and child assent were obtained took part in the interviews; in 1 family, 2 siblings participated.
Interview Guide
The interviews were conducted by Japanese medical students who had been trained in interviewing, following methods used in previous studies.Reference Yoshida, Ozaki and Morita 1 , Reference Miyatake, Yoshida and Kaneda 10 –Reference Kosaka, Murata and Kaneda 12 There was no prior relationship between the interviewers and participants. The interviews focused on the challenges faced by elementary school children and their families during flood evacuation and the support required. By selecting participants with characteristics aligned with the research objectives and comparing different experiences, information diversity and depth were ensured despite the relatively small sample size.
Data Collection
Online semi-structured interviews lasting 30 to 60 minutes were conducted with 9 children and 8 caregivers, all of whom were mothers; fathers did not participate in the interviews. Children often struggled to answer questions, and caregivers sometimes responded on their behalf. Semi-structured interviews were conducted focusing on 3 main domains: challenges during flood evacuation, support needed to overcome evacuation-related problems, and challenges and support required for safe shelter stays. These questions were explored from multiple perspectives, including material resources, human resources, policies and legislation, information accessibility, economic resources, communication, infrastructure, community measures, and medical services.
Data Analysis
The collected data were analyzed using inductive thematic analysis based on Braun and Clarke’s 6-phase approach.Reference Braun and Clarke 13 , Reference Braun and Clarke 14 The specific procedures were as follows: In Phase I, audio recordings were transcribed verbatim and read multiple times to gain overall understanding. In Phase II, meaningful patterns were identified from the data, and coding was conducted across the entire dataset. In Phase III, themes were constructed based on these codes. In Phase IV, the research team reviewed and refined themes to ensure alignment with the entire dataset. In Phase V, themes were repeatedly analyzed in detail and given clear names. In Phase VI, the manuscript was written based on the analytical findings. To ensure the reliability and validity of the analysis, multiple researchers verified the coding process, and member checking with participants was conducted. To ensure information power, refined questions and interview guides were employed. Analyses were performed manually, and no software was used. Consistent with the inductive design, the analysis aimed to generate hypotheses and themes to be examined in future research rather than to test predefined theories.
Ethical Considerations
This study was conducted in accordance with the Declaration of Helsinki, as revised in 2013. Ethical approval was obtained from the Ethics Committee of the Medical Governance Institute, Japan (approval number MG2022-01-R1). All participants gave informed consent following a detailed explanation of the study objectives and methods. Participants were also informed of their right to withdraw at any time without adverse consequences. Anonymity and confidentiality were assured, and data were stored and handled securely.
Results
Participant Characteristics
Eight parents and nine children participated in the study. All participating parents were mothers, at least one of whom accompanied each child during the interviews. Four of the 8 households were single-mother households, one of which included cohabiting grandparents. Many of the participating families resided in areas affected by the 2011 Great East Japan Earthquake and/or the 2019 Typhoon Hagibis; however, not all families had experienced actual flood evacuation, and some interview responses were based on anticipated rather than experienced evacuation. Participant characteristics are presented in Table 1. The gender of one participating child (participant C) and the number of years one family (participant D) had lived in the region were not obtained during the interviews and are therefore indicated as unknown in Table 1.
Participant characteristics
Table 1. Long description
The table consists of nine columns. The first column lists the categories, and the subsequent eight columns represent participants A through H.
* Participant A: 11 years old, Female, accompanied by Mother. Household of 5 (Father, mother, two sons, and participant). 11 years in the region.
* Participant B: 10 years old, Male, accompanied by Mother. Household of 5 (Mother, two daughters, participant, and one other son). 10 years in the region.
* Participant C: 12 years old, Gender Unknown, accompanied by Mother. Household of 3 (Mother, participant, sibling). 10 years in the region.
* Participant D: Ages 7 and 9, both Female, accompanied by Mother. Household of 5 (Mother, grandmother, grandfather, and two participant daughters). Years in region unknown.
* Participant E: 9 years old, Male, accompanied by Mother. Household of 5 (Father, mother, three sons including participant). 6 years in the region.
* Participant F: 9 years old, Male, accompanied by Mother. Household of 2 (Mother and participant). 9 years in the region.
* Participant G: 11 years old, Male, accompanied by Mother. Household of 4 (Father, mother, participant, and one daughter). 11 years in the region.
* Participant H: 10 years old, Male, accompanied by Mother. Household of 8 (Grandmother, grandfather, father, mother, three sons including participant, and aunt). 10 years in the region.
Note. Unknown: This information was not obtained during the interviews.
Participant Responses
A total of 111 codes were extracted and consolidated into 17 subthemes, which were subsequently grouped into 5 major themes: (T1) disaster preparedness (22.5% of codes); (T2) evacuation support (16.2%); (T3) material support at evacuation sites (22.5%); (T4) environmental support at evacuation sites (22.5%); and (T5) disaster response (16.2%). Table 2 presents the themes, subthemes, and their relative frequencies. Each theme and subtheme is described below (Table 2). Direct quotations from participants are presented in italics to distinguish them from the main text. Table 2 also presents the number of families that contributed codes to each subtheme; the major subthemes were derived from multiple families rather than from 1 or 2 specific families.
Themes and subthemes identified from thematic analysis
Table 2. Long description
The table is organized into five main themes with associated subthemes and frequency data.
* T 1 Disaster preparedness (N = 25, 22.5%): Includes challenges in flood risk awareness (N = 9, 36%, 4/8 families), need for evacuation planning (N = 9, 36%, 4/8 families), and importance of disaster education (N = 7, 28%, 3/8 families).
* T 2 Evacuation support (N = 18, 16.2%): Includes need for child evacuation assistance (N = 9, 50%, 5/8 families), challenges in evacuating with children (N = 4, 22.2%, 2/8 families), difficulties in mutual support among residents (N = 3, 16.7%, 2/8 families), and shortage of manpower (N = 2, 11.1%, 2/8 families).
* T 3 Material support at evacuation sites (N = 25, 22.5%): Includes challenges with relief supplies (N = 18, 72%, 7/8 families), challenges in medical provision (N = 3, 12%, 3/8 families), cash shortage (N = 3, 12%, 3/8 families), and challenges of long-term evacuation (N = 1, 4%, 1/8 families).
* T 4 Environmental support at evacuation sites (N = 25, 22.5%): Includes support for children (N = 11, 44%, 5/8 families), challenges with shelter environment (N = 4, 16%, 2/8 families), stress from evacuation life (N = 5, 20%, 4/8 families), and infection control challenges (N = 5, 20%, 5/8 families).
* T 5 Disaster response (N = 18, 16.2%): Includes information gathering during disasters (N = 14, 77.8%, 7/8 families) and infrastructure challenges (N = 4, 22.2%, 3/8 families).
Most of the coded statements were provided by mothers rather than children. Many of the children had little or no memory of the 2011 Great East Japan Earthquake, and few had experienced actual evacuation during the 2019 Typhoon Hagibis; accordingly, some children had difficulty perceiving flood disasters as personally relevant, and caregivers occasionally responded on their behalf. Mothers’ statements mainly concerned evacuation logistics, preparedness, relief supplies, caregiving burdens, and information needs, whereas children’s statements mainly concerned fear and anxiety, disaster education, and play and learning at evacuation sites. Because caregivers sometimes answered on behalf of their children, some codes could not be definitively attributed to either parents or children; therefore, codes were not quantitatively separated by speaker in Table 2.
Theme 1: Disaster Preparedness (N = 25, 22.5%)
This theme encompasses challenges related to disaster preparedness. While some participants expressed difficulty in imagining the impact of flooding, others recognized the importance of evacuation planning and disaster education. These challenges were categorized into 3 subthemes: (1) challenges in flood risk awareness (n = 9, 36%), (2) need for evacuation planning (n = 9, 36%), and (3) importance of disaster education (n = 7, 28%).
Multiple participants demonstrated limited understanding and an inability to envision flood disasters, indicating that these limitations could affect their preparedness and response capabilities. This lack of awareness highlights the need for more targeted education about region-specific flood risks (T1-1: Challenges in flood risk awareness, n = 9, 36%).
I don’t know [about the hazard map]. (2_16)
I wasn’t really clear about what flooding actually means. (4_18)
Participants emphasized the importance of discussing evacuation plans with family members and others in the community before disasters occur. This subtheme underscores the importance of disaster preparedness planning through connections not only within families but also among community residents (T1-2: Need for evacuation planning, n = 9, 36%).
Not just with our family of three, but with people close to us—we need to discuss in advance what to do when such situations occur. Otherwise, it’s difficult to cooperate. Considering my occupation as well, there’s anxiety about not knowing when it might happen, and yes, there are some difficulties. (5_1)
Participants recognized the importance of disaster education in promoting self-protective behaviors. They expressed the need for better awareness, advance planning, and educational initiatives. This reflects that appropriate disaster education and preparatory learning can empower even elementary school children to take proactive action during disasters (T1-3: Importance of disaster education, n = 7, 28%).
I learned that I need to protect my own life, so I want to research various things to be able to handle it myself when the time comes. (3_1)
I want to learn about government support during disasters in social studies class. (6_35)
Theme 2: Evacuation Support (N = 18, 16.2%)
This theme addresses challenges related to evacuation support, particularly focusing on children’s support needs, difficulties in evacuating with children, lack of community support, and manpower shortage. These challenges were categorized into 4 subthemes: (1) need for child evacuation assistance (n = 9, 50%), (2) challenges in evacuating with children (n = 4, 22.2%), (3) difficulties in mutual support among residents (n = 3, 16.7%), and (4) shortage of manpower (n = 2, 11.1%).
Participants expressed concerns about children evacuating alone and emphasized the need for community support. This included elementary school children’s expressions of anxiety during disaster evacuation (T2-1: Need for child evacuation assistance, n = 9, 50%).
I’m anxious thinking that evacuation would be difficult for elementary school children alone or by themselves, unless there’s community awareness like “I don’t know whose child this is, but they’re alone, let’s help them.” (11_1)
This subtheme revealed that restricted access to transportation during disasters makes it difficult to move elementary school children and infants. It also highlights the challenges of evacuating with children while carrying emergency supplies, particularly for those with multiple children (T2-2: Challenges in evacuating with children, n = 4, 22.2%).
If cars become unavailable, like in a flood situation, I worry that it would be difficult to evacuate the children by myself. (3_3)
When evacuating with children, I think it would be difficult to carry emergency supplies while taking the children along. It would be good if there were supplies available at the evacuation sites. (4_1)
Some participants mentioned that limited interaction with neighbors could hinder mutual assistance during disasters. The lack of existing social connections serves as a barrier to community-based support during emergencies (T2-3: Difficulties in mutual support among residents, n = 3, 16.7%).
We have almost no interaction with residents in this area. (5_26)
Participants identified practical challenges related to staffing shortages at evacuation shelters. This subtheme emphasizes the difficulty in accessing basic necessities during disasters, particularly for evacuee households facing a manpower shortage (T2-4: Shortage of manpower, n = 2, 11.1%).
When the water supply was cut off, there were water distribution points, but it was difficult for households with only children, women, or without male members to carry the water. (5_3)
Theme 3: Material Support at Evacuation Sites (N = 25, 22.5%)
This theme focuses on challenges related to material support at evacuation shelters, including concerns about relief supplies, medical services, cash shortage, and long-term evacuation. These challenges were categorized into 4 subthemes: (1) challenges with relief supplies (n = 18, 72%), (2) challenges in medical provision at evacuation sites (n = 3, 12%), (3) cash shortage (n = 3, 12%), and (4) challenges of long-term evacuation (n = 1, 4%).
Many participants mentioned difficulties in accessing necessary supplies during disasters. Required supplies included resources and clothing items. The shortage of infant care products was also raised as a concern (T3-1: Challenges with relief supplies, n = 18, 72%).
Baby diapers and such items were probably the most difficult to obtain. (5_9)
It would be good if there were clothes in the right sizes for children, but when evacuating without bringing anything, there might not be clothes or shoes in matching sizes. (8_1)
Participants expressed concerns about access to medical care during emergencies. This emphasizes the need for basic medical supplies and trained personnel at evacuation shelters (T3-2: Challenges in medical provision at evacuation sites, n = 3, 12%).
When there are urgent injuries or illnesses at evacuation shelters and ambulances cannot reach them, some level of first aid would be necessary on-site. Having medical supplies—even something like a stethoscope—would allow for some basic examination and expand what can be assessed. (6_2)
Some participants highlighted financial challenges during disasters when electronic systems fail. This subtheme emphasizes the continued importance of physical currency during disasters when electronic payment systems are compromised (T3-3: Cash shortage, n = 3, 12%).
Money would help. If we evacuated without any money, it would be helpful if we could borrow a certain amount of cash. (9_2)
Concerns about long-term evacuation and economic challenges were also expressed. This reveals the financial burden on families during prolonged evacuation, extending beyond immediate emergency needs (T3-4: Challenges of long-term evacuation, n = 1, 4%).
During the earthquake disaster with the nuclear power plant issue, my family evacuated to Tochigi instead of staying in Iwaki. We rented an apartment there and stayed for one to two months, but there were costs involved—buying futons, dishes, and other daily necessities. (16_1)
Theme 4: Environmental Support at Evacuation Sites (N = 25, 22.5%)
This theme addresses challenges related to the evacuation environment, focusing on support for children, shelter conditions, stress during evacuation, and infection control concerns. These challenges were categorized into 4 subthemes: (1) support for children at evacuation sites (n = 11, 44%), (2) challenges with the shelter environment (n = 4, 16%), (3) stress from evacuation life (n = 5, 20%), and (4) infection control challenges during evacuation (n = 5, 20%).
Participants emphasized the need for dedicated support for children at evacuation shelters. This reflects the need for caregivers for children during the period between evacuation and family reunification, as well as concerns about educational continuity and psychological burden at evacuation sites (T4-1: Support for children at evacuation sites, n = 11, 44%).
It’s important, and at evacuation sites, we need someone to properly look after children until they reunite with their parents. (7_11)
If there were teachers at the evacuation site, they could teach lessons. (20_2)
Concerns about privacy were expressed as part of stress mitigation at evacuation shelters. This reflects the psychological importance of securing private spaces for individuals and family units, even in emergency shelters (T4-2: Challenges with shelter environment, n = 4, 16%).
When evacuating, it would be good to have spaces that can be separated for individuals or families. (3_2)
As stress gradually builds up, people become irritated with each other, so we need to create some private spaces for better communication. (9_3)
Participants highlighted the psychological stress experienced during evacuation and communal living. This subtheme emphasizes addressing the psychological impact of evacuation life on children and the challenges of maintaining children’s patience (T4-3: Stress from evacuation life, n = 5, 20%).
Adults might be able to endure it mentally, but the burden on children is significant—the psychological burden. (11_31)
Stress gradually builds up. Adults can manage staying home for days, but children want to play and be active. Having them constantly under stress seemed pitiful. (6_1)
Concerns about disease transmission in evacuation shelters were also expressed. This subtheme reveals awareness of public health considerations in shelters, particularly for children and elderly individuals (T4-4: Infection control challenges during evacuation, n = 5, 20%).
I worry about spreading illness to others, and if we’re coughing, elderly people nearby might be wary of us. Children often don’t keep their masks on properly, so it would be best if families with children could be separated from elderly evacuees. (21_35)
Theme 5: Disaster Response (N = 18, 16.2%)
This theme focuses on disaster response challenges, particularly related to information gathering and infrastructure issues. These challenges were categorized into 2 subthemes: (1) information gathering during disasters (n = 14, 77.8%), and (2) infrastructure challenges during disasters (n = 4, 22.2%).
Many participants reported difficulties in gathering information during disasters. This included concerns about communication methods with children, lack of devices, and safety confirmation. These findings indicate critical challenges in emergency information systems, including how to collect information and the need for information provision after evacuation (T5-1: Information gathering during disasters, n = 14, 77.8%).
Not being able to see what lies ahead during evacuation causes the most anxiety. Getting daily updates about how long this situation will last, when flooding might occur, when we can move to new housing—having this information regularly updated would be very positive for evacuees. (5_1)
Information is crucial. As a parent, knowing immediately whether my child has evacuated safely would provide reassurance. I worry whether this can be done under such circumstances. (17_1)
Participants mentioned critical infrastructure failures that severely impacted daily life. This subtheme emphasizes the psychological impact on evacuees caused by infrastructure deficiencies and damage (T5-2: Infrastructure challenges during disasters, n = 4, 22.2%).
When the water pipes broke, I felt nothing but despair. (21_4)
Infrastructure is critical—without electricity, we can’t charge our phones, and even backup chargers need to be charged. Electricity would be the biggest problem. We have water and supplies stored, but they often expire because we forget to check them regularly. We need to develop a habit of checking them periodically, or everything might be expired when a disaster strikes. (7_2)
Discussion
This study investigated the challenges and support needs of elementary school children and their families during flood evacuation. The analysis identified 5 major themes: disaster preparedness (Theme 1), evacuation support (Theme 2), material support at evacuation sites (Theme 3), environmental support at evacuation sites (Theme 4), and disaster response (Theme 5). Given the qualitative, inductive design and the limited number of participating families, these themes should be interpreted as hypothesis-generating insights that require further investigation in larger and more diverse populations.
Challenges During Flood Evacuation
The challenges related to flood evacuation for elementary school children and their families can be examined from 5 main aspects. First, as revealed in the “disaster preparedness” theme, challenges existed regarding flood risk awareness. Participants had difficulty recognizing hazard maps and forming concrete images of flooding. However, some elementary school children emphasized the importance of specific response methods and education. It was noted that advance disaster preparedness is a challenge not only for families but for entire communities.
Second, the “evacuation support” theme revealed elementary school children’s inherent vulnerability and the challenges faced by their parents who must fulfill multiple roles during evacuation. Previous research indicates that children’s disaster responses vary by developmental stage, with elementary school children aged 5–12 showing pronounced reactions of fear and anxiety.Reference Peek 5 This aligns with participants’ statements such as “evacuation would be difficult for elementary school children alone,” demonstrating the limitations of elementary school children’s capacity for independent evacuation behavior during disasters. Although hostility toward siblings has also been reported as a disaster-related response in children, sibling-related statements were limited in the present data and did not form an independent theme. Studies have reported that parents of infants face heavy burdens during evacuation, such as carrying supplies and providing care, highlighting the difficulty of evacuating multiple children.Reference Gribble, Hamrosi and Tawia 15
Third, “material support at evacuation sites” revealed specific needs according to life stages, constraints in medical access, and vulnerabilities in economic systems. During disasters, age-appropriate supplies and safe living environments are essential.Reference Onyejesi, Alsabri and Del Castillo Miranda 16 , Reference Reid and Hillman 17 Securing basic medical supplies (ambulances, stethoscopes, etc.) and medical functions is important not only for children requiring special medical care but also for general elementary school children.Reference Reid and Hillman 17 , Reference Orenstein, Boenning and Engh 18
Fourth, as revealed in “environmental support at evacuation sites,” challenges emerged regarding the need for shelters to function as spaces that promote children’s development, in addition to strengthening health and infection control measures. While evacuation shelter operations often focus primarily on ensuring adult survival, consideration for developmental needs such as educational continuity, play, and social interaction for children remains insufficient. Disasters impose greater psychological stress on children, potentially affecting their development.Reference Onyejesi, Alsabri and Del Castillo Miranda 16 , Reference Reid and Hillman 17 , Reference Flynn and Nelson 19 The need for temporary alternative care also emerged when family separation occurs during disasters.
Finally, “disaster response” highlighted concerns about information systems during disasters and the psychological burden associated with infrastructure failure. For families with elementary school children, evacuation decisions are not individual actions but choices that affect the entire family’s safety. Information uncertainty and lack of future prospects increase psychological burden.Reference Afifi, Felix and Afifi 20 , Reference Makwana 21 This is important as information provision supports both communication and psychological stability.Reference Sezgin, Karaaslan and Ersoy 22
Implications
Education and support were considered important frameworks for disaster preparedness. Children are recognized as a high-risk group during disasters due to their developmental stages and physical limitations in behavioral and psychological aspects.Reference Chiu, Goodman and Palacios 2 However, developmentally appropriate education enhances children’s disaster response and understanding of flood risks.Reference Peek 5 , Reference Yildiz, Dickinson and Priego-Hernández 23 Furthermore, experiential learning such as risk assessment and evacuation planning based on regional characteristics can foster children’s autonomy and provide practical disaster prevention knowledge. Child participation in disaster planning mitigates impacts on families and communities.Reference Haynes and Tanner 24 , Reference Ronan, Alisic and Towers 25 This has significance for community disaster preparedness as well. In the present study, most accounts were provided by mothers, and children’s direct statements were relatively limited; creating opportunities for children to articulate their own needs is therefore an important component of such education. In addition, life skills such as swimming ability, which were not specifically explored in the present interviews, may warrant attention as a component of flood disaster preparedness education for children and represent a topic for future research (Theme 1).
There is a need for age-specific support systems and mechanisms to shift support structures from family-based to community-based units. Children exhibit different disaster responses and vulnerabilities at each developmental stage, and require additional support due to their immature judgment and skills in seeking help independently.Reference Peek 5 The reality that parents face evacuation difficulties when fulfilling multiple roles simultaneously has been revealed. Family-based support alone is insufficient, and a community-based framework is essential to safeguard children during disasters.Reference Gribble, Hamrosi and Tawia 15 Building community connections through resident networks can alleviate roles such as evacuation, transportation, and caregiving, representing an important policy for ensuring children’s safety during disasters (Themes 1 and 2).
Regarding material support, stockpiling in preparation for disasters is essential. Age-specific stockpiling plans for necessary supplies according to age groups and developmental stages, such as elementary school children, are important for evacuation shelter operations. Given the limited medical access, stockpiling pediatric medical equipment, medications, and devices for disasters is crucial. 26 As electronic payment systems become unavailable during disasters, having cash on hand is essential. For prolonged evacuation, stockpiling bedding and daily necessities is also necessary. Building support systems to reduce economic vulnerability, including timely fund allocation, remains a challengeReference Natarajan and Swaminathan 27 , Reference Ma, Yan and Ye 28 (Theme 3).
In evacuation environments, the importance of shelter design and support systems that consider children’s developmental stages and psychosocial characteristics emerged as a challenge. Studies have reported the need for alternative caregiver arrangements and family reunification support during disasters. 29 Spatial considerations are also considered important for securing privacy and family-unit spaces, as these maintain children’s psychological stability and family relationships.Reference Onyejesi, Alsabri and Del Castillo Miranda 16 Support measures such as deploying psychological care specialists for mental health care and educators to secure play and learning spaces for children at evacuation shelters may be desirable (Theme 4).
Disaster information systems require mechanisms for phased information delivery and practical safety confirmation. Technologies such as remote sensing, satellite communication, and ad hoc networks can enable safety confirmation even when traditional infrastructure fails.Reference Zhao, Xu and Cui 30 , 31 Visualizing infrastructure recovery progress and livelihood reconstruction status after functional failure, and clearly presenting the reconstruction timeline to disaster victims, contributes to psychological support (Theme 5).
Limitations
This study has several limitations. First, the number of participants was limited to 8 families. Although thematic saturation was reached and information power was considered, caution is needed when generalizing the findings, and the findings should be regarded as hypothesis-generating rather than confirmatory; future studies should examine whether similar findings are observed beyond the present families, for example by developing standardized questions based on the hypotheses and themes generated here. In particular, regions with different geographical conditions and socioeconomic backgrounds may experience different flood impacts and evacuation challenges. Second, this study primarily collected data from parents’ perspectives, and elementary school children’s own perspectives and experiences may not be fully reflected. Moreover, all participating caregivers were mothers; fathers’ perspectives were not obtained, and potential differences between maternal and paternal perspectives remain to be examined in future research. Furthermore, some participants lacked actual flood evacuation experience, meaning some findings are based on hypothetical situations, and the type and extent of flood exposure—such as rescue from an already inundated area versus precautionary evacuation before inundation—could not be systematically distinguished, although these contexts may involve substantially different psychological impacts on children and practical challenges for parents. Finally, this study is based on data collection at a specific point in time and does not capture changes in perceptions or situations over time. A longitudinal research approach could provide insights from a longer-term perspective.
Conclusions
This study qualitatively investigated the challenges and support needs of elementary school children and their families during flood evacuation, identifying 5 major themes: disaster preparedness, evacuation support, material support at evacuation sites, environmental support at evacuation sites, and disaster response. The findings suggest that ensuring the safety of elementary school children and their families during floods may require enhanced community awareness, development of family-based evacuation plans, establishment of child-friendly evacuation shelter environments, construction of effective information dissemination systems, and strengthened collaboration among schools, families, and communities. These findings emphasize the importance of considering the unique needs of elementary school children and their families in disaster planning, evacuation shelter management, and disaster support system development. Future research with more diverse samples and the development and evaluation of practical intervention programs are expected to contribute to enhancing the resilience of elementary school children and their families.
Supplementary material
The supplementary material for this article can be found at http://doi.org/10.1017/dmp.2026.10448.
Acknowledgments
The authors utilized Claude Sonnet 4.5 (Anthropic) for English proofreading and editing during manuscript preparation. All content was subsequently reviewed, revised as necessary, and remains the authors’ full responsibility.
Author contribution
Conceptualization: Shota Inoue, Asumi Yamamoto, Naomi Komori, Yasuhiro Kotera, Hirotomo Miyatake, Makoto Kosaka, Akihiko Ozaki, Masaharu Tsubokura, Hiroaki Shimmura, Hiroyuki Beniya.
Writing—original draft: Shota Inoue, Akihiko Ozaki, Yasuhiro Kotera.
Writing—review and editing: Shota Inoue, Asumi Yamamoto, Naomi Komori, Yasuhiro Kotera, Hirotomo Miyatake, Makoto Kosaka, Akihiko Ozaki, Masaharu Tsubokura, Hiroaki Shimmura, Hiroyuki Beniya.
Funding statement
This work was supported by grants from the Institute of Seizon and Life Sciences.
Competing interests
Dr. Ozaki has received payments from MNES, Kyowa Kirin Inc., Becton, Dickinson and Company, Pfizer, Daiichi Sankyo Inc and Taiho Pharmaceutical Co., Ltd., outside of this study. No other authors have conflicts of interest to declare.
