Development of a Culturally-Adapted Graphic Novella about Emergency Communication: Collaborations with a Limited English Speaking Chinese Immigrant Community.

Bystander CPR doubles survival from cardiac arrest but limited English proficient (LEP) individuals face barriers calling 911 and performing CPR. Previous training increases the chance that an individual will perform CPR, yet access to classes in non-English speaking populations is limited. We used a cultural adaptation approach to develop a graphic novella for Chinese LEP immigrants about how to call 911 and perform bystander CPR. Collaboration with members of this community occurred through all stages of novella development. One hundred and thirty-two LEP Chinese adults read the novella and answered a survey measuring behavioral intentions. All respondents stated they would call 911 after witnessing a person's collapse, but those previously trained in CPR were more likely to say that they would perform CPR. All participants indicated that they would recommend this novella to others. Developing culturally-responsive evidence-based interventions is necessary to reduce disproportionate death and disability from cardiac arrest in LEP communities.

Preparedness for cardiac emergencies among Cambodians with limited English proficiency.

In the United Sates, populations with limited English proficiency (LEP) report barriers to seeking emergency care and experience significant health disparities, including being less likely to survive cardiac arrest than whites. Rapid utilization of 9-1-1 to access emergency services and early bystander cardiopulmonary resuscitation (CPR) is crucial for successful resuscitation of out-of-hospital cardiac arrest patients. Little is understood about Asian LEP communities' preparedness for emergencies. In this exploratory survey, we sought to assess intentions to call 9-1-1 in an emergency and knowledge of CPR in the Cambodian LEP community. We conducted an in-person interview with 667 Cambodian adults to assess their intentions to call 9-1-1 and their awareness of and training in bystander CPR. While the majority of participants stated that they would call 9-1-1 in an emergency, almost one-third of the sample would call a friend or family member. Awareness of CPR was very high but training in CPR was lower, especially for women. A higher level of English proficiency and greater proportion of time in the US was a strong predictor of CPR training and intention to call 9-1-1 in an emergency. This suggests that greater efforts need to be made to reach the most linguistically-isolated communities (those with little or no English) with emergency information in Khmer.