Identification of factors integral to designing community-based CPR interventions for high-risk neighborhood residents.

BACKGROUND: High-risk neighborhoods can be identified as census tracts in which cardiac arrest incidence is high and bystander cardiopulmonary resuscitation (CPR) prevalence is low. However, little is known about how best to tailor community CPR training to high-risk neighborhood residents. The objective of this study was to identify factors integral to the design and implementation of community-based CPR intervention programs targeted to these areas. METHODS: Using qualitative methods, six focus groups with 42 participants were conducted in high-risk neighborhoods in Columbus, Ohio during January and February 2011 to elicit resident views on how best to design community-based CPR educational programs for these neighborhoods. Snowball and purposeful sampling by community liaisons was used to recruit participants. Three reviewers analyzed the data in an iterative process to identify recurrent and unifying themes. RESULTS: Focus group participants identified four principal considerations for the design of community-based CPR interventions: 1) identifying lay people to serve as motivated leaders while targeting both senior citizens and school children to increase reach, 2) finding appropriate community-based locations to hold CPR training, 3) providing incentives to encourage more people to participate, and 4) identifying and addressing barriers to participation. CONCLUSION: Out-of-hospital cardiac arrest is a particular risk for minority and low-income communities. By working together with the community key factors integral to designing community-based CPR within these high-risk communities can be identified and implemented.

Barriers and facilitators to learning and performing cardiopulmonary resuscitation in neighborhoods with low bystander cardiopulmonary resuscitation prevalence and high rates of cardiac arrest in Columbus, OH.

BACKGROUND: Residents who live in neighborhoods that are primarily black, Latino, or poor are more likely to have an out-of-hospital cardiac arrest, less likely to receive cardiopulmonary resuscitation (CPR), and less likely to survive. No prior studies have been conducted to understand the contributing factors that may decrease the likelihood of residents learning and performing CPR in these neighborhoods. The goal of this study was to identify barriers and facilitators to learning and performing CPR in 3 low-income, high-risk, and predominantly black neighborhoods in Columbus, OH. METHODS AND RESULTS: Community-Based Participatory Research approaches were used to develop and conduct 6 focus groups in conjunction with community partners in 3 target high-risk neighborhoods in Columbus, OH, in January to February 2011. Snowball and purposeful sampling, done by community liaisons, was used to recruit participants. Three reviewers analyzed the data in an iterative process to identify recurrent and unifying themes. Three major barriers to learning CPR were identified and included financial, informational, and motivational factors. Four major barriers were identified for performing CPR and included fear of legal consequences, emotional issues, knowledge, and situational concerns. Participants suggested that family/self-preservation, emotional, and economic factors may serve as potential facilitators in increasing the provision of bystander CPR. CONCLUSIONS: The financial cost of CPR training, lack of information, and the fear of risking one's own life must be addressed when designing a community-based CPR educational program. Using data from the community can facilitate improved design and implementation of CPR programs.