Extending Emergency Response Skills to Limited English Proficiency Communities

描述（由申请人提供）： 本提案的目的是通过调查向英语水平有限的社区有效传播旁观者CPR（心肺复苏）技能的策略，将应急响应技能扩展到英语水平有限的社区。旁观者心肺复苏术已被证明可以降低心脏骤停的死亡率。不幸的是，来自不同种族社区的个人不太可能接受旁观者心肺复苏术，可能是由于对这些人群的心肺复苏术培训传播不足。最近的一项调查显示，在一个大都市社区，拉丁裔和亚裔参与者报告心肺复苏术培训的可能性低于其他族裔。此外，研究表明，与非LEP呼叫者相比，在心脏紧急情况期间由9-1-1调度操作员提供的CPR指令不太可能被LEP呼叫者接受和执行。在旁观者进行CPR的情况下，LEP呼叫者的紧急呼叫开始和旁观者CPR开始之间的时间间隔比非LEP呼叫者长一分钟以上。电话辅助的CPR已被证明可以降低心脏骤停的死亡率，因此，缺乏对CPR指令的理解或指令传达的显著延迟可能会对健康结果产生负面影响。建议的主要研究活动包括：1）针对亚洲和拉丁裔LEP个体的焦点小组研究，以调查旁观者CPR的意识和可接受性以及传播基本CPR技能培训的首选渠道，2）实验研究，以测试语言适应的9-1-1操作员辅助CPR指令，以了解LEP和非LEP个体在模拟心脏骤停期间的CPR理解和表现，和3）观察性研究活动，包括9-1-1磁带提取，以评估在太平洋西北部的两个大型呼叫中心在9个月期间内实施语言适应的调度辅助CPR指令。第二个目标是调查的可行性视频为基础的传播战略，达到亚洲和拉丁美洲社区与基本的心肺复苏术培训和研究成果传播到其他社区。所有研究活动的目的是让社区合作伙伴以及亚洲和拉丁美洲社区的LEP人群代表参与。虽然CPR只是许多应急准备和响应技术之一，但从旁观者CPR中获益的证据以及旁观者CPR率中存在的健康差异都证明了这一重点。拟议的研究活动的结果将导致“系统一级”的立即变化，因为新的调度电话指令将在评估后成为参与呼叫中心的标准政策。此外，研究结果将阐明潜在的沟通和传播战略，以达到LEP社区与其他类型的应急准备和响应信息。 公共卫生相关性： 将应急技能扩展到英语水平有限的社区。本提案的目的是调查有效的沟通策略，以便向英语水平有限的（LEP）社区传播心肺复苏术培训和指导，方法是：1）评估语言适应的9-1-1派遣辅助心肺复苏术指导（T-CPR）在LEP社区中对心肺复苏术的理解和执行情况，2）调查视频-为亚洲和拉丁美洲社区提供基本的心肺复苏术培训。拟议研究活动的结果将导致“系统一级”的立即变化（即，新的调度电话指示，在评估后将成为标准政策），并将阐明潜在的沟通和传播战略，以达到LEP社区与其他类型的应急准备和反应信息。

DESCRIPTION (provided by applicant): The objective of this proposal is to extend emergency response skills to communities with limited English proficiency (LEP) by investigating strategies for effective dissemination of bystander CPR (Cardio- pulmonary resuscitation) skills to LEP communities. Bystander CPR has been proven to reduce mortality from cardiac arrest. Unfortunately, individuals from different ethnic communities are less likely to receive bystander CPR, possibly due to insufficient dissemination of CPR training to these populations. A recent survey showed that Latino and Asian participants were less likely to report CPR training than other ethnic groups in one large metropolitan community. In addition, research shows that CPR instructions provided by 9-1-1 dispatch operators during a cardiac emergency are less likely to be accepted and performed by LEP callers compared to non-LEP callers. Where bystanders do perform CPR, the time-interval between onset of the emergency call and onset of bystander CPR is more than a minute longer for LEP callers than non-LEP callers. Telephone- assisted CPR has been shown to reduce mortality from cardiac arrest and as such the lack of understanding of CPR instructions or significant delays in communication of instructions may negatively affect health outcomes. Proposed primary research activities include 1) focus group research with Asian and Latino LEP individuals to investigate awareness and acceptability of bystander CPR and preferred channels for dissemination of basic CPR skills training, 2) experimental research to test linguistically adapted 9-1-1 operator-assisted CPR instructions on understanding and performance of CPR among LEP and non-LEP individuals during a simulated cardiac arrest, and 3) observational research activities including 9-1-1 tape abstraction to evaluate the implementation of linguistically adapted dispatch-assisted CPR instructions in two large call centers in the Pacific Northwest over a 9-month period. Secondary aims are to investigate the feasibility of video-based dissemination strategies for reaching Asian and Latino communities with basic CPR training and dissemination of research results to other communities. All study activities are designed to involve community partners as well as representatives of LEP populations in Asian and Latino communities. Although CPR is only one of many emergency preparedness and response techniques, both the evidence for benefit from bystander CPR as well as the health disparities that exist in rates of bystander CPR justify this focus. The results of the proposed research activities will lead to immediate changes at the "system- level" as new dispatch telephone instructions will become standard policy at the participating call centers after evaluation. In addition, the results will illuminate potential communication and dissemination strategies for reaching LEP communities with other types of emergency preparedness and response information. PUBLIC HEALTH RELEVANCE: Extending Emergency Response Skills to Limited English Proficiency Communities. The objective of this proposal is to investigate effective communication strategies for dissemination of CPR training and instructions to limited English proficiency (LEP) communities by 1) evaluating linguistically adapted 9-1-1 dispatch-assisted CPR instructions (T-CPR) on understanding and performance of CPR among LEP communities and 2) investigating the feasibility of video-based dissemination strategies for reaching Asian and Latino communities with basic CPR training. The results of the proposed research activities will lead to immediate changes at the "system-level" (i.e., new dispatch telephone instructions that will become standard policy after evaluation)and will shed light on potential communication and dissemination strategies for reaching LEP communities with other types of emergency preparedness and response information.