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提高社区对院外心脏骤停的第一反应(FirstCPR):一项集群随机对照试验的方案。

Improving community-based first response to out of hospital cardiac arrest (FirstCPR): protocol for a cluster randomised controlled trial.

机构信息

Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.

School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.

出版信息

BMJ Open. 2022 Jun 9;12(6):e057175. doi: 10.1136/bmjopen-2021-057175.

Abstract

INTRODUCTION

Out-of-hospital cardiac arrest (OHCA) is associated with poor survival outcomes, but prompt bystander action can more than double survival rates. Being trained, confident and willing-to-perform cardiopulmonary resuscitation (CPR) are known predictors of bystander action. This study aims to assess the effectiveness of a community organisation targeted multicomponent education and training initiative on being willing to respond to OHCAs. The study employs a novel approach to reaching community members via social and cultural groups, and the intervention aims to address commonly cited barriers to training including lack of availability, time and costs.

METHODS AND ANALYSIS

FirstCPR is a cluster randomised trial that will be conducted across 200 community groups in urban and regional Australia. It will target community groups where CPR training is not usual. Community groups (clusters) will be stratified by region, size and organisation type, and then randomly assigned to either immediately receive the intervention programme, comprising digital and in-person education and training opportunities about CPR and OHCA over 12 months, or a delayed programme implementation. The primary outcome is self-reported 'training and willingness-to-perform CPR' at 12 months. It will be assessed through surveys of group members that consent in intervention versus control groups and administered prior to control groups receiving the intervention. The primary analysis will follow intention-to-treat principles, use log binomial regression accounting for baseline covariates and be conducted at the individual level, while accounting for clustering within communities. Focus groups and interviews will be conducted to examine barriers and enablers to implementation and costs will also be examined.

ETHICS AND DISSEMINATION

Ethical approval was obtained from The University of Sydney. Findings from this study will be disseminated via presentations at scientific conferences, publications in peer-reviewed journals, scientific and lay reports.

TRIAL REGISTRATION NUMBER

ACTRN12621000367842.

摘要

简介

院外心脏骤停(OHCA)与较差的生存结果相关,但及时的旁观者行动可以使生存率提高一倍以上。经过培训、有信心并愿意进行心肺复苏术(CPR)是旁观者行动的已知预测因素。本研究旨在评估针对社区组织的多组分教育和培训计划在应对 OHCA 方面的有效性。该研究采用了一种新颖的方法,通过社会和文化团体接触社区成员,并且干预措施旨在解决培训中常见的障碍,包括缺乏可用性、时间和成本。

方法和分析

FirstCPR 是一项在澳大利亚城市和地区的 200 个社区团体中进行的集群随机试验。它将针对通常不进行 CPR 培训的社区团体。社区团体(集群)将按地区、规模和组织类型分层,然后随机分配到立即接受干预计划或延迟计划实施的组。主要结局是在 12 个月时自我报告的“培训和愿意进行 CPR”。它将通过对同意参与干预组和对照组的团体成员进行调查来评估,并在对照组接受干预之前进行。主要分析将遵循意向治疗原则,使用对数二项式回归考虑基线协变量,并在个体水平上进行,同时考虑社区内的聚类。将进行焦点小组和访谈,以检查实施的障碍和促进因素,并检查成本。

伦理和传播

该研究已获得悉尼大学的伦理批准。本研究的结果将通过在科学会议上的演讲、同行评议期刊上的出版物、科学和通俗报告进行传播。

试验注册号

ACTRN12621000367842。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd62/9185498/fa0b7b872c59/bmjopen-2021-057175f01.jpg

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