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Save More Lives with CPRFDNY-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
Agenda
Goals and Research Strategy Literature Review Geographical Analysis Survey Key Findings Recommendations Further Studies
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.
Research Strategy
Literature review and consultations with experts
Geographical analysis using the FDNY data and publicly available data
Survey of program participants
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
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
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
0
100
200
300
400
500
0 50 100 150 200
Cardiac Arrest and CPR documented on EPCR
Nu
mb
er
Tra
ine
d in
CP
R b
y F
DN
Y
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
Survey Results: Response
2005Nov Dec
2006Jan Feb Mar Apr May Jun Jul Aug Sep
Kit 0 3 1 1 1 1 1 0 2 0 0 10
Manneq 2 0 N/A N/A N/A N/A N/A N/A N/A N/A N/A 2
Total 2 3 1 1 1 1 1 0 2 0 0 12
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
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
Survey Results: Geography
28% Bronx, 28% Queens, and 26% Brooklyn 11% are from outside NYC (Suffolk and Nassau)
26%7%
28%
10% 1%
28%
Bronx Brooklyn Manhattan
Queens Nassau Suffolk
18%
82%
0% 20% 40% 60% 80% 100%
Not Willing toPerform CPR
Willing toperform CPR
Survey Results:Performing CPR in an emergency
82 percent of respondents willing to perform CPR.
Survey Results: Performing CPR in an emergency
0% 10% 20% 30% 40% 50% 60% 70%
Not confident atall
Not tooconfident
Somewhatconfident
Very confident85%
85 percent of respondents at least “somewhat confident” in their ability to perform CPR
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!
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:
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
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
Survey Results:Training Others
0% 10% 20% 30% 40% 50% 60%
Not confident atall
Not too confident
Somewhatconfident
Very confident71%
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7
0
1
2
3
4
5
6
15
36
# People Trained 38%
71% confident in their ability to train others
but Only 38% trained others
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
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
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
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
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
3. Target At-risk Population
Define at-risk population Action Items:
– Record trainees’ profiles– Collect geographic and demographic information
Reach at-risk populationAction Items:
– Promote local press coverage– Engage special interest groups and community
organizations
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
Future Studies
Introduce AED training
Improve data management system on cardiac arrest
Develop alternative training methods
Recruit volunteer CPR instructors
