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.

项目概要 院外心脏骤停 (OHCA) 的存活取决于旁观者的及时救护 心肺复苏 (B-CPR)，通常由非专业社区成员实施，直到 B-CPR 参与率和紧急医疗服务人员的到达情况存在很大差异。 OHCA 在美国各地的生存，特别是在社会经济地位较低的社区。 中心假设是，参与 B-CPR 的独特可改变障碍存在于高风险社区中。 阿拉巴马州伯明翰，可用于为有针对性的社区 B-CPR 干预提供信息，以增加 B- 心肺复苏率并最终提高 OHCA 存活率 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数据的地理空间映射来识别和 描述阿拉巴马州伯明翰高风险 OHCA 社区的特征 在我们的研究中，高风险社区是 定义为 OHCA 发生率高且 B-CPR 参与率低的人。在目标 2 中，我们将利用。 定性方法来了解高风险社区参与 B-CPR 的障碍并引出 社区对当前美国心脏协会 CPR Anytimeâ 培训套件的反馈。 对旁观者支持网络成员的采访将为现实生活中的旁观者提供重要的见解 经验，这将有助于为当地利益相关者访谈和焦点小组讨论提供信息。 与居住在伯明翰高风险社区的社区成员进行讨论将确定 参与 B-CPR 的社区特定障碍，并提供有关 CPR 可用性的反馈 最后，在目标 3 中，我们将根据收到的反馈来调整 CPR Anytimeâ 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 克服 B-CPR 的可改变障碍，以提高外行 OHCA 意识、CPR 教育和在高危社区进行 B-CPR 的意愿 该项目得到了补充。 根据多学科专家的意见设计的结构化职业发展计划 导师团队致力于在该奖项颁发的 5 年期间提供指导。 Ryan Coute 博士是一位致力于减少 OHCA 治疗和结果差异的早期研究者，他将了解到 地理空间测绘、多方法定性研究、社区干预设计和实施 该 K23 奖项最终将支持 Coute 博士领导独立研究团队的转变。 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 有针对性的社区级 B-CPR 干预对 OHCA 生存的影响，(2) 一项多中心试验以确定 干预措施对其他社区的影响，或 (3) 探索社区构成的动态和 影响高危社区居民心脏骤停存活率的健康社会决定因素。