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Barriers to Calling 911 and Learning and Performing Cardiopulmonary Resuscitation for Residents of Primarily Latino, High-Risk Neighborhoods in Denver, Colorado - 23/04/15

Doi : 10.1016/j.annemergmed.2014.10.028 
Comilla Sasson, MD, PhD, MS a, b, c, , Jason S. Haukoos, MD, MSc b, c, e, Leila Ben-Youssef, MD, MA d, Lorenzo Ramirez, BA e, Sheana Bull, PhD c, Brian Eigel, PhD a, David J. Magid, MD, MPH f, Ricardo Padilla, MD e
a American Heart Association, Dallas, TX 
b University of Colorado School of Medicine, Aurora, CO 
c Colorado School of Public Health, Aurora, CO 
d Department of Emergency Medicine, Alameda County Hospital, Oakland, CA 
e Denver Health Medical Center, Denver, CO 
f Institute for Healthcare Research, Kaiser Permanente, Denver, CO 

Corresponding Author.

Abstract

Study objective

Individuals in neighborhoods composed of minority and lower socioeconomic status populations are more likely to have an out-of-hospital cardiac arrest event, less likely to have bystander cardiopulmonary resuscitation (CPR) performed, and less likely to survive. Latino cardiac arrest victims are 30% less likely than whites to have bystander CPR performed. The goal of this study is to identify barriers and facilitators to calling 911, and learning and performing CPR in 5 low-income, Latino neighborhoods in Denver, CO.

Methods

Six focus groups and 9 key informant interviews were conducted in Denver during the summer of 2012. Purposeful and snowball sampling, conducted by community liaisons, was used to recruit participants. Two reviewers analyzed the data to identify recurrent and unifying themes. A qualitative content analysis was used with a 5-stage iterative process to analyze each transcript.

Results

Six key barriers to calling 911 were identified: fear of becoming involved because of distrust of law enforcement, financial, immigration status, lack of recognition of cardiac arrest event, language, and violence. Seven cultural barriers were identified that may preclude performance of bystander CPR: age, sex, immigration status, language, racism, strangers, and fear of touching someone. Participants suggested that increasing availability of tailored education in Spanish, increasing the number of bilingual 911 dispatchers, and policy-level changes, including CPR as a requirement for graduation and strengthening Good Samaritan laws, may serve as potential facilitators in increasing the provision of bystander CPR.

Conclusion

Distrust of law enforcement, language concerns, lack of recognition of cardiac arrest, and financial issues must be addressed when community-based CPR educational programs for Latinos are implemented.

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Plan


 Please see page 546 for the Editor’s Capsule Summary of this article.
 Supervising editor: Robert A. De Lorenzo, MD, MSM
 Author contributions: CS, DJM, LR, SB, and RP conceived and designed the study and obtained research funding. CS, LR, SB, and RP supervised the conduct of the trial and data collection. CS, LR, LB-Y, and RP undertook recruitment of participants and managed the data, including data analysis. JSH, BE, and DJM contributed to the overall direction of the manuscript. CS drafted the manuscript, and all authors contributed substantially to its revision. CS takes responsibility for the paper as a whole.
 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist. This study was supported by National Institutes of Health (NIH)/National Center for Advancing Translational Science (NCATS) Colorado CTSI grant UL1 TR001082. Contents are the authors’ sole responsibility and do not necessarily represent official NIH views. This study was funded by the University of Colorado Clinical and Translational Sciences Institute Community Engagement Pilot Grant. Dr. Sasson is supported in part by awards from the Emergency Medicine Foundation and American Heart Association. Dr. Haukoos is supported by R01AI106057 from the National Institute of Allergy and Infectious Diseases, R01HS021749 and K02HS017526 from the Agency for Healthcare Research and Quality (AHRQ). Dr. Magid currently receives grant funding from the AHRQ, National Health Lung and Blood Institute, National Institute on Aging, NCATS, American College of Cardiology Foundation, Amgen, and the Patient Centered Outcome Research Institute.
 A podcast for this article is available at www.annemergmed.com.


© 2014  American College of Emergency Physicians. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 65 - N° 5

P. 545 - mai 2015 Retour au numéro
Article précédent Article précédent
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| Article suivant Article suivant
  • Overcoming the 911 Fear Factor
  • Hector Caraballo, Robert A. De Lorenzo

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