1. Save More Lives with CPR FDNY-CPR Training Unit December 6th, 2006 Professor William B. Eimicke Azilomhe Akhigbe, Toshihide Aotoke, Brooke Cutler Ming-Ming Liu, Lesia Lozowy, Emmi Poteliakhoff, Gail Tang

2. Agenda Goals and Research Strategy Literature Review Geographical Analysis Survey Key Findings Recommendations Further Studies

3. Goals of the Project Assess the effectiveness of the current FDNY CPR training program. – Identify who is being reached by the program – Examine the knowledge retention rate of program participants – Determine how large the multiplier effect is Make recommendations on how to improve and expand the program.

4. Research Strategy Literature review and consultations with experts Geographical analysis using the FDNY data and publicly available data Survey of program participants

5. Literature Review Instruction methods – Video instruction is as effective as traditional course – Hands-on practice is important; online study is insufficient CPR skills acquisition and retention – Most trainees do not have adequate CPR competency after training Refresher training – Refresher courses are recommended to boost trainees’ confidence and skill retention

6. Geographical Analysis Actual FDNY CPR trainings are: – Weakly related to poverty levels – Only very weakly related to race – Not conducted in areas with older population groups Studies show people with higher CA rates are: – Low socio-economic profiles – African-Americans – 65 and older

7. Geographical Analysis Positive correlation between where CA incidents occur and where CPR trainings were conducted 10458 Bronx 10461 Bronx East 11236 Brooklyn Canarsie Pier 11691 Far Rockaway 11203 Brooklyn East Flatbush 110463 Bronx Marble Hill 10314 Staten Island CUNY

8. Survey of Program Participants Created questionnaires that ask about: – Willingness and confidence to perform CPR – CPR Knowledge – Multiplier Effect – Demographic data Performed stratified random research – Chose 28 sample groups (521 people) – Groups included kit and combo groups – From Nov. 2005 to Sep. 2006 Sent questionnaires to group leaders for processing

10. Survey Results: Response 2005 NovDec 2006 JanFebMarAprMayJunJulAugSep Kit0311111020010 Manneq20N/A 2 Total2311111020012 Received questionnaires from 12 groups or 43% of groups surveyed - 10 kit groups and 2 mannequin groups Received questionnaires from 139 participants or 27% of those surveyed

11. Survey Results: Demography Age: average is 35, ranging from 12-81 Gender: 62% female and 38% male Ethnicity: 46% Black, 30% Hispanic, 21% White Education: 46% high school, 29% college, 25% master’s or higher Time elapsed since training: average is 255 days, ranging from 96 to 349 days Household Size: On average, respondents live with three people, only 8% live alone

12. Survey Results: Geography 28% Bronx, 28% Queens, and 26% Brooklyn 11% are from outside NYC (Suffolk and Nassau)

13. Survey Results: Performing CPR in an emergency 82 percent of respondents willing to perform CPR.

14. Survey Results: Performing CPR in an emergency 85% 85 percent of respondents at least “somewhat confident” in their ability to perform CPR

15. Survey Results: Performing CPR in an emergency High levels of willingness to perform CPR in an emergency situation. High levels of confidence in ability to perform CPR FDNY’s CPR trainings inspire confidence!

16. Survey Results: Performing CPR in an emergency “The training was excellent. It was very informative and the information provided was very valuable.” “Excellent instructors” “I learned a lot, now I know how to save people” Quotes from Participants:

17. Survey Results: Retention of CPR Knowledge Average score is 3.74 (out of 6) Factors such as age, gender, education, ethnicity, have no significant impact on scores Respondents’ retention declined over time (score decreases on average by 1 point in 200 days) Refresher courses can keep the knowledge rate high

18. Survey Results: Retention of CPR Knowledge Questions most often answered incorrectly: 1. Compression-ventilation ratio – 63 percent gave wrong answer – Ventilations overestimated 2. Hand Placement – 57 percent gave wrong answers

19. Survey Results: Training Others 71% 38% 71% confident in their ability to train others but Only 38% trained others

20. Survey Results: Multiplier Effect High confidence in ability to train others Most respondents did not train anyone. Respondents who live in larger households are more likely to train others Average multiplier factor is 1.3 (or 0.7 when two outliers are removed) Multiplier effect is lower than expected (AHA assumed 2.2) 63% of kits are never used to train others. Selective distribution of kits should be considered

21. Survey Results: Kit vs. Mannequin Training No significant difference is observed in respondents’ scores and confidence Mannequin training: $4.32/person Anytime Kit training: $21.32/person Mannequin and Anytime kit training equally effective Mannequin training more cost effective

22. Summary of Recommendations 1.Increase number trained – Conduct program advocacy – Boost fundraising 2. Develop low-cost training resources 3. Increase outreach efforts and target at-risk populations 4. Introduce refresher courses

23. 1. Increase number trained Conduct greater advocacy efforts Action Items: – Assign a program coordinator responsible for marketing – Gain the New York Mayor’s support – Conduct public service announcements – Provide reward/gift from FDNY for completing CPR training Boost Fundraising Action Items: – Establish a donation-based organization – Attract corporate donors – Work with the FDNY’s Public Relations

24. 2. Develop low-cost training resources Adopt alternative training methods Action Items: – Provide more combo trainings – Offer CPR Anytime kit selectively  Charge a nominal fee of $5-10 per kit – Negotiate with AHA for a lower price – Distribute only Mini Anne, not the entire kit

25. 3. Target At-risk Population Define at-risk population Action Items: – Record trainees’ profiles – Collect geographic and demographic information Reach at-risk population Action Items: – Promote local press coverage – Engage special interest groups and community organizations

26. 4. Introduce Refresher Courses Provides refresher course six months after training Action Items: – Offer an online refresher course (develop video and post on website) – Distribute training reminders to trainees, such as key chains or magnets that list CPR steps

27. Future Studies Introduce AED training Improve data management system on cardiac arrest Develop alternative training methods Recruit volunteer CPR instructors

28. Thank You for Your Attention! Any Questions?