# 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.

## Key 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.