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Barriers and Facilitators to Community CPR Education in San José, Costa Rica

Published online by Cambridge University Press:  05 August 2016

Kristin M. Schmid
Affiliation:
University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, ColoradoUSA
Nee-Kofi Mould-Millman*
Affiliation:
University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, ColoradoUSA
Andrew Hammes
Affiliation:
Colorado School of Public Health, University of Colorado, Aurora, ColoradoUSA
Miranda Kroehl
Affiliation:
Colorado School of Public Health, University of Colorado, Aurora, ColoradoUSA
Raquel Quiros García
Affiliation:
Universidad Iberoamericana, Tibás, Costa Rica
Manrique Umaña McDermott
Affiliation:
Universidad de Costa Rica, San José, Costa Rica
Steven R. Lowenstein
Affiliation:
University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, ColoradoUSA Colorado School of Public Health, University of Colorado, Aurora, ColoradoUSA
*
Correspondence: Nee-Kofi Mould-Millman, MD Anschutz Medical Campus Leprino Building, Campus Box B215 12401 E 17th Ave Aurora, Colorado 80045 USA E-mail: Nee-Kofi.Mould-Millman@UCDenver.edu

Abstract

Background

Bystander cardiopulmonary resuscitation (CPR) improves survival after prehospital cardiac arrest. While community CPR training programs have been implemented across the US, little is known about their acceptability in non-US Latino populations.

Objectives

The purpose of this study was to identify barriers to enrolling in CPR training classes and performing CPR in San José, Costa Rica.

Methods

After consulting 10 San José residents, a survey was created, pilot-tested, and distributed to a convenience sample of community members in public gathering places in San José. Questions included demographics, CPR knowledge and beliefs, prior CPR training, having a family member with heart disease, and prior witnessing of a cardiac arrest. Questions also addressed barriers to enrolling in CPR classes (cost/competing priorities). The analysis focused on two main outcomes: likelihood of registering for a CPR class and willingness to perform CPR on an adult stranger. Odds ratios and 95% CIs were calculated to test for associations between patient characteristics and these outcomes.

Results

Among 371 participants, most were male (60%) and <40 years old (77%); 31% had a college degree. Many had family members with heart disease (36%), had witnessed a cardiac arrest (18%), were trained in CPR (36%), and knew the correct CPR steps (70%). Overall, 55% (95% CI, 50-60%) indicated they would “likely” enroll in a CPR class; 74% (95% CI, 70-78%) would perform CPR on an adult stranger. Cardiopulmonary resuscitation class enrollment was associated with prior CPR training (OR: 2.6; 95% CI, 1.6-4.3) and a prior witnessed cardiac arrest (OR: 2.0; 95% CI, 1.1-3.5). Willingness to perform CPR on a stranger was associated with a prior witnessed cardiac arrest (OR: 2.5; 95% CI, 1.2-5.4) and higher education (OR: 1.9; 95% CI, 1.1-3.2). Believing that CPR does not work was associated with a higher likelihood of not attending a CPR class (OR: 2.4; 95% CI, 1.7-7.9). Fear of performing mouth-mouth, believing CPR is against God’s will, and fear of legal risk were associated with a likelihood of not attending a CPR class and not performing CPR on a stranger (range of ORs: 2.4-3.9).

Conclusion

Most San José residents are willing to take CPR classes and perform CPR on a stranger. To implement a community CPR program, barriers must be considered, including misgivings about CPR efficacy and legal risk. Hands-only CPR programs may alleviate hesitancy to perform mouth-to-mouth.

SchmidKM, Mould-MillmanNK, HammesA, KroehlM, Quiros GarcíaR, Umaña McDermottM, LowensteinSR. Barriers and Facilitators to Community CPR Education in San José, Costa Rica. Prehosp Disaster Med. 2016;31(5):509–515.

Type
Original Research
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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References

1. Deo, R, Albert, CM. Epidemiology and genetics of sudden cardiac death. Circulation. 2012;125(4):620-637.Google Scholar
2. Jacobs, I, Nadkarni, V, Bahr, J. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries: a statement for health care professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation Heart Foundation, and Resuscitation Councils of Southern Africa). Circulation. 2004;110(21):3385-3397.CrossRefGoogle ScholarPubMed
3. Cummins, RO, Eisenberg, MS, Hallstrom, AP, Litwin, PE. Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. Am J Emerg Med. 1985;3(2):114-119.Google Scholar
4. American Heart Association. Chain of survival. http://www.heart.org/HEARTORG/ CPRAndECC/WhatisCPR/AboutUs/Chain-of-Survival_UCM_307516_Article.jsp#. Updated February 28, 2014. Accessed March 5, 2014.Google Scholar
5. Sasson, C, Haukoos, JS, Bond, C, et al. 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. Circulation: Cardiovascular Quality and Outcomes. 2013;6(5):550-558.Google Scholar
6. Benavides, DR. Costa Rica: Evolución de la mortalidad y los días de estancia por egresos hospitalarios en el periodo 2013-2030. Estado de la Nacion. October 2013: 129 [in Spanish].Google Scholar
7. World Health Organization. World Data Table on Disability Adjusted Life Years, 2004. http://www.who.int/cardiovascular_diseases/en/cvd_atlas_29_world_data_table.pdf. Accessed March 7, 2014.Google Scholar
8. Sasson, C, Meischke, H, Abella, BS, et al on behalf of the American Heart Association Council on Quality of Care and Outcomes Research, Emergency Cardiovascular Care Committee, Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, Council on Clinical Cardiology, and Council on Cardiovascular Surgery and Anesthesia. Increasing cardiopulmonary resuscitation provision in communities with low bystander cardiopulmonary resuscitation rates: a science advisory from the American Heart Association for health care providers, policymakers, public health departments, and community leaders. Circulation. 2013;127(12):1342-1350.Google Scholar
9. Molina, W. El Potgam a la luz del Censo 2011. La Nación. http://www.nacion.com/archivo/ Potgam-luz-Censo_0_1276472505.html [in Spanish]. Published June 23, 2012. Accessed February 22, 2014.Google Scholar
10. Israel, BA, Schulz, AJ, Parker, EA, Becker, AB. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173-202.Google Scholar
11. McNally, B, Robb, R, Mehta, M, et al. Out-of-hospital cardiac arrest surveillance – cardiac arrest registry to enhance survival, United States, October 1, 2005 – December 31, 2010. MMWR. 2011;60(SS08):1-19.Google ScholarPubMed
12. Pérez-Stable, EJ, Sabogal, F, Otero-Sabogal, R, Hiatt, RA, McPhee, SJ. Misconceptions about cancer among Latinos and Anglos. JAMA. 1992;268(22):3219-3223.Google Scholar
13. Instituto Nacional de Estadísticas y Censos Costa Rica. Costa Rica: Población de 5 años y más por nivel de instrucción, según provincia, cantón y sexo [in Spanish]. 2011. http://www.inec.go.cr/Web/Home/GeneradorPagina.aspx. Accessed February 22, 2014.Google Scholar
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