Improving Community-level Bystander Cardiopulmonary Resuscitation in Underserved Populations

项目总结 院外心脏骤停的存活依赖于旁观者的及时接生 心肺复苏术(B-CPR)，通常由非专业社区成员实施，直到 紧急医疗服务人员的到达。B-CPR参与率和B-CPR参与率之间差异很大 在整个美国，特别是在社会经济地位较低的社区，uchA的生存。我们的 中心假设是参与B-CPR的独特的可改变的障碍存在于 阿拉巴马州伯明翰，可用于向有针对性的社区提供B-CPR干预，以增加B- 心肺复苏率，并最终提高肝细胞癌的存活率。我们将通过以下具体目标来验证我们的假设： 在目标1中，我们将利用局部心脏骤停和人口普查区域数据的地理空间图来识别和 描述亚拉巴马州伯明翰的高危HCA社区的特征。在我们的研究中，高危社区是 定义为有高发生率和低B-CPR参与率的人。在目标2中，我们将利用 定性方法了解高危社区参与B-CPR的障碍并引出 社区对当前美国心脏协会CPR Anytime？培训包的反馈。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的旁观者的批判性见解 经验，这将有助于为当地焦点小组讨论提供信息。利益相关者访谈和焦点小组 与居住在伯明翰高危社区的社区成员讨论将发现 社区特定的参与B-CPR的障碍，并就CPR的可用性提供反馈 随时随地-培训工具包。最后，在目标3中，我们将使用收到的反馈来调整CPR Anytime培训套件 来自社区焦点小组；然后试点专门设计的有针对性的社区干预原型 为了克服B-CPR的可修改障碍，目标是提高非专业人员的uchA意识，CPR 教育，以及在高危社区进行B-CPR的意愿。这个项目得到了一个 根据多学科专家的意见设计的结构化职业发展计划 致力于在整个颁奖过程中提供指导的导师团队。在该奖项的5年时间里， 瑞安·考特博士是一位致力于减少ol A治疗和结果差异的早期研究员，他将了解到 地理空间制图、多方法定性研究、社区干预设计和实施 科学。这项K23奖项最终将支持考特博士过渡到领导独立研究组合 并将提供未来R级提案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uchA存活率的影响，(2)一项多点试验，以确定 干预对其他社区的影响，或(3)探索邻里组成和动态 高危社区居民心脏骤停存活率的健康社会决定因素。

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.