Examining training and attitudes to basic life support in multi-ethnic communities residing in New South Wales, Australia: A mixed-methods investigation
Blake Angell,
Clara K Chow,
Julie Redfern,
Christopher Semsarian,
Adrian Bauman,
Simone Marschner,
Saurabh Kumar,
Janet Bray,
Guoyan Yang,
Paul M Middleton,
Pramesh Kovoor,
Garry Jennings,
Sonali Munot,
Andrew Coggins,
Linh Ngo,
Emily J Rugel,
Quan Minh Dang,
Zoe Rock
Affiliations
Blake Angell
The George Insitute of Global Health, UNSW Sydney, Sydney, NSW, Australia
Clara K Chow
1 Westmead Applied Research Centre, The University of Sydney, Westmead, New South Wales, Australia
Julie Redfern
School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
Christopher Semsarian
Agnes Ginges Centre for Molecular Cardiology at the Centenary Institute, The University of Sydney, Sydney, New South Wales, Australia
Adrian Bauman
School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
Simone Marschner
Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia
Saurabh Kumar
Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
Janet Bray
Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
Guoyan Yang
NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
Paul M Middleton
11 South Western Emergency Research Institute, Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, New South Wales, Australia
Pramesh Kovoor
Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
Garry Jennings
Sydney Health Partners, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
Sonali Munot
Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
Andrew Coggins
10 Discipline of Emergency Medicine, The University of Sydney School of Medicine, Sydney, New South Wales, Australia
Linh Ngo
Greater Brisbane Clinical School, Faculty of Medicine, The University of Queensland, Chermside, Queensland, Australia
Emily J Rugel
Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
Quan Minh Dang
Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
Zoe Rock
Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
Background Bystander response, including cardiopulmonary resuscitation (CPR), is critical to out-of-hospital cardiac arrest (OHCA) survival. Nearly 30% of Australian residents were born overseas, and little is known about their preparedness to perform CPR. In this mixed-methods study, we examined rates of training and willingness and barriers to performing CPR among immigrants in Australia.Methods First, we surveyed residents in New South Wales, Australia, using purposeful sampling to enrich immigrant populations. Multivariate logistic regression was used to examine the association between place of birth and willingness to perform CPR. Next, we conducted focus-group discussions with members of the region’s largest migrant groups to explore barriers and relevant societal or cultural factors.Results Of the 1267 survey participants (average age 49.6 years, 52% female), 60% were born outside Australia, most in Asia and 73% had lived in Australia for more than 10 years. Higher rates of previous CPR training were reported among Australian-born participants compared with South Asian-born and East Asian-born (77%, 35%, 48%, respectively, p <0.001). In adjusted models, the odds of willingness to perform CPR on a stranger were significantly lower among migrants than Australian-born (adjusted OR: 0.64; 95% CI 0.49 to 0.83); however, this association was mediated by history of training. Themes emerging from the focus-group discussions included concerns about causing harm, fear of liability, and birthplace-specific social and cultural barriers.Conclusions Targeted awareness and training interventions, which address common and culture-specific barriers to response and improved access to training, may improve confidence and willingness to respond to OHCA in multi-ethnic communities.
