FirstCPR: A pragmatic community organisation-based cluster randomised trial to increase community training and preparedness to respond to out-of-hospital cardiac arrest

TL;DR

This study tested a community-based approach to improve CPR training and found that participants in the intervention group were more likely to be trained and confident in using CPR and AEDs.

Contribution

A novel community organization-targeted approach to increase BLS training and preparedness for out-of-hospital cardiac arrest.

Findings

Intervention clusters showed higher rates of CPR training and willingness to perform CPR on a stranger.

Participants in the intervention reported greater confidence in using automated external defibrillators.

Survey respondents in the intervention group were more willing to use AEDs on strangers compared to the control group.

Abstract

Bystander cardiopulmonary resuscitation (CPR) and defibrillation improve out-of-hospital cardiac arrest survival. However, basic life support (BLS) skills are low.

The FirstCPR cluster randomised controlled trial aimed to test the effectiveness of a community organisation-targeted BLS education and training approach.

Clusters (community organisations with 50+ members) were randomly allocated to intervention (12-month period of opportunities to access BLS education and training) or control (no intervention). Outcomes were assessed via surveys at 12 months and pre-specified analysis involved hierarchical mixed-models.

Of 165 randomised clusters (82 intervention), 58% were sports and 42% were social/faith-based. Most of the intervention clusters (74/82) participated in at least one intervention activity (15 in all activities). Factors such as the COVID-19 pandemic and organisation support impacted intervention uptake. Overall 924 members, across 93 clusters (407 from 57 intervention clusters; 517 from 36 control clusters), completed surveys. At 12-months, intervention organisation surveyed members reported higher rates of: being trained and willing to perform CPR on a stranger (primary outcome: 63.8% vs 46.9 %; Adjusted Odds Ratio (AOR) 2.22, 95% confidence interval (CI):1.50–3.30), confidence to use an automated external defibrillator (AED) (48.4% vs 26.4%; AOR:3.23, 95%CI:2.22–4.71) and willingness to use AEDs on a stranger (73.9% vs 62.9%; AOR:1.84, 95%CI:1.22–2.80).

The results should be interpreted cautiously as the survey response rates were very low. However, survey respondents showed desired outcomes and key learnings for future research were gained.

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