Improving Community-level Bystander Cardiopulmonary Resuscitation in Underserved Populations

改善服务不足人群的社区级旁观者心肺复苏

• 批准号: 10738902
• 负责人: Ryan Andrew Coute
• 金额: $ 17.39万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-23 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10738902
• 关键词: Address; Alabama; American Heart Association; Automated External Defibrillator; Award; Awareness; Blood flow; Brain; Cardiopulmonary Resuscitation; Caring; Cause of Death; Censuses; Communities; Complement; Data; Deep South; Development Plans; Education; Emergency medical service; Emergency response; Event; Feedback; Focus Groups; Funding; Future; Goals; Grant; Group Interviews; Health; Heart; Heart Arrest; Human Resources; Incidence; Institute of Medicine (U.S.); Interruption; Intervention; Interview; Knowledge; Lead; Learning; Life; Literature; Location; Maps; Mentored Patient-Oriented Research Career Development Award; Mentorship; Minority Groups; Neighborhoods; Organ; Outcome; Patient Self-Report; Population Heterogeneity; Qualitative Methods; Qualitative Research; Race; Reporting; Research; Research Personnel; Resuscitation; Risk; Science; Self Assessment; Socioeconomic Status; Structure; Survival Rate; Testing; Therapeutic; Time; Training; Underserved Population; United States; Variant; career development; community intervention; demographics; design; disability; effective therapy; experience; first responder; high risk; implementation science; improved; innovation; insight; low socioeconomic status; member; mortality; multi-site trial; multidisciplinary; novel; out-of-hospital cardiac arrest; outcome disparities; patient oriented; prototype; social health determinants; socioeconomic disparity; socioeconomics; support network; survivorship; therapy design; treatment and outcome; usability; willingness

PROJECT SUMMARY Survival of out-of-hospital cardiac arrest (OHCA) depends on the prompt delivery of bystander cardiopulmonary resuscitation (B-CPR), which is often administered by layperson community members until the arrival of emergency medical services personnel. There is wide variability in both B-CPR participation rates and survival of OHCA throughout the United States, particularly in neighborhoods of low socioeconomic status. Our central hypothesis is that unique modifiable barriers to B-CPR participation exist in high-risk neighborhoods in Birmingham, Alabama, which can be used to inform a targeted community B-CPR intervention to increase B- CPR rates and ultimately improve OHCA survival. We will test our hypothesis through the following specific aims: In Aim 1 we will utilize geospatial mapping of local cardiac arrest and census tract data to identify and characterize high-risk OHCA neighborhoods in Birmingham, AL. For our study, high-risk neighborhoods are defined as those with a high incidence of OHCA and low B-CPR participation rates. In Aim 2 we will utilize qualitative methods to understand barriers to B-CPR participation in high-risk neighborhoods and elicit community feedback on the current American Heart Association CPR Anytimeâ training kit. Focus group interviews with members of the Bystander Support Network will provide critical insights into the real-life bystander experience, which will help inform local focus group discussions. Stakeholder interviews and focus group discussions with community members residing in a high-risk Birmingham neighborhood will identify neighborhood-specific barriers to B-CPR participation and provide feedback regarding the usability of the CPR Anytimeâ training kit. Finally, in Aim 3 we will adapt the CPR Anytimeâ training kit using the feedback received from community focus groups; and then pilot a prototype targeted community intervention specifically designed to overcome modifiable barriers to B-CPR with the goal of increasing layperson OHCA awareness, CPR education, and willingness to perform B-CPR in at-risk neighborhoods. This project is complemented by a structured career development plan that has been designed with the input of an expert multidisciplinary mentorship team that is committed to provide guidance throughout this award. During the 5 years of this award, Dr. Ryan Coute, an early investigator committed to reducing OHCA treatment and outcome disparities, will learn geospatial mapping, multimethod qualitative research, community intervention design, and implementation science. This K23 award will ultimately support Dr. Coute’s transition to lead an independent research portfolio and will provide the training and preliminary data needed for future R-level proposals; such as (1) evaluating the impact of a targeted community-level B-CPR intervention on OHCA survival, (2) a multi-site trial to determine the impact of the intervention on other communities, or (3) exploring the dynamics of neighborhood make-up and social determinants of health on cardiac arrest survivorship for residents of at-risk communities.

项目摘要 院外心脏骤停（OHCA）的生存取决于旁观者的及时交付 心肺复苏术（B-CPR），通常由外行社区成员管理，直到 紧急医疗服务人员的到来。B-CPR参与率和 OHCA的生存在整个美国，特别是在低社会经济地位的社区。我们 中心假设是，在高风险社区， 伯明翰，亚拉巴马，它可以用来通知有针对性的社区B-CPR干预，以增加B- 心肺复苏率，并最终提高OHCA生存率。我们将通过以下具体目标来检验我们的假设： 在目标1中，我们将利用当地心脏骤停和人口普查区域数据的地理空间映射来识别和 描述伯明翰的高风险OHCA社区，AL。对于我们的研究，高风险社区是 定义为OHCA发生率高且B-CPR参与率低的人群。在目标2中，我们将利用 定性方法，以了解在高风险社区参与B-CPR的障碍， 社区对当前美国心脏协会CPR Anytime培训套件的反馈。焦点小组 对旁观者支持网络成员的采访将提供对现实生活中旁观者的重要见解 经验，这将有助于为当地重点小组的讨论提供信息。利益相关者访谈和焦点小组 与居住在伯明翰高风险社区的社区成员进行讨论， 社区参与B-CPR的特定障碍，并提供有关CPR可用性的反馈 随时随地训练包。最后，在目标3中，我们将根据收到的反馈调整CPR AnytimeTM培训套件 社区焦点小组;然后试点一个原型有针对性的社区干预， 克服B-CPR的可修改障碍，以提高外行OHCA意识，CPR 教育，并愿意在危险社区进行B-CPR。该项目由一个 在多学科专家的投入下设计的结构化职业发展计划 导师团队致力于在整个奖项中提供指导。在这个奖项的五年里， 博士Ryan Coute是一位致力于减少OHCA治疗和结果差异的早期研究者，他将学习 地理空间制图，多方法定性研究，社区干预设计和实施 科学这个K23奖项将最终支持Coute博士领导独立研究组合的过渡 并将为未来的R级提案提供所需的培训和初步数据;例如（1）评估 有针对性的社区水平B-CPR干预对OHCA生存率的影响，（2）一项多中心试验，以确定 干预对其他社区的影响，或（3）探索邻里构成的动态， 健康的社会决定因素对高危社区居民心脏骤停存活率的影响。