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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 ,
Nee-Kofi Mould-Millman ,
Andrew Hammes ,
Miranda Kroehl ,
Raquel Quiros García ,
Manrique Umaña McDermott  and
Steven R. Lowenstein
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: [email protected]
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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.

Keywords

community educationCPREMSinternational emergency medicine
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 5 , October 2016 , pp. 509 - 515
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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