Participatory development of a disaster preparedness checklist for health systems to address the impacts of extreme weather events: methodology and pilot testing of the tool in four mountainous European areas

Abstract As climate change-related Extreme Weather Events increasingly threaten population health and the functioning of health systems, there is a growing need for adaptive, context-specific preparedness tools developed collaboratively with relevant local stakeholders. This study presents the participatory development and piloting processes of a Disaster Preparedness Checklist for health systems, designed to strengthen preparedness for Extreme Weather Events across diverse mountainous European contexts. The tool was developed and pilot-tested with health system representatives from four European countries. Its development followed a multi-step participatory process that combined expert and experiential knowledge, beginning with local needs assessment and continuing through the development, validation, testing, and evaluation of the tool. The process itself contributed to shared learning among participants and stimulated internal discussion around disaster preparedness. These findings highlight the value of participatory approaches in the disaster preparedness field and underscore their potential to enhance the effectiveness and uptake of adaptation tools in the context of climate change-related Extreme Weather Events.