FirstCPR - an intervention targeting clubs and organisations to increase training and willingness to respond to cardiac arrest in the community

The intervention program will be delivered across 12 months, with key outcomes assessed at the end of the 12m period. The intervention content will align with key messaging that will address: i) Awareness about OHCA, its health impact and the potential to prevent adverse outcomes through action ii) Recognition of a cardiac arrest iii) Rapid Response - the importance of a timely first response including early CPR and defibrillation. Intervention content will be drawn from some existing and some new materials developed by partners(including materials compiled by NSW Health, Heart Foundation and not-for-profit organisations -Michael Hughes Foundation, Take-Heart Australia, Surf-Life-Saving NSW). All materials to be used will undergo a review process managed by an operational committee of the steering committee to assess quality and alignment of material with current guidelines. The content has been finalised through a collaborative consultation with clinicians, experts, researchers, stakeholders, partners and consumers. The review process will involve a content review by experts as well as consumers. Intervention messages will be delivered in a variety of ways to reach out to all members of the participating organisations: (i) Digital delivery: Materials delivered in digital format will comprise of written, picture and video format and incorporate key messaging, education and information sent to members of participating organisations via text message on a fortnightly basis over a period of 12 months. It is expected that participants will spend approximately 5-10 minutes engaging in the intervention messages and accompanying video/fact-sheet material every fortnight. (ii) Information/educational sessions: A 1-hour group information session will be delivered at a venue suitable to club members in-person or as an online webinar. This will be conducted by personnel accredited in CPR who also have experience in providing CPR training to lay-persons. Training will incorporate a PowerPoint presentation(45mins) that will review key messages on responding to cardiac arrest, a demonstration on a mannikin of how to perform CPR and also demonstration of use a defibrillator. There will be a ‘Question and Answer’ time allocated. The timing of this session is not fixed and can occur at a time convenient to the organisation and by 10-months after baseline survey. There is no fixed group size, and this will depend on venue capacity and local organisation interest and requirements. A recorded version of the session will be available for members to access at request after the event. (iii) Incentives to attend accredited CPR training: This will be provided by Surf Lifesaving NSW an accredited provider of CPR training. Accredited training includes training with a mannikin. Up to 30 vouchers will be made available per organisation with the potential of more being made available to larger organisations, pending on interest and resources. Sessions, where possible, will be conducted on organisation premises or at a convenient local venue. If participants are unable to attend they can attend public accredited CPR courses. These incentive vouchers will aim to ensure participation by 10 months form baseline. (iv) Display of educational materials at participating clubs and organisations: Posters, banners, and display of educational material in other formats such as videos on LCD screens where available will be made available to participating organisations. In addition, material to post on social media or club apps or to publish in their newsletters will be made available depending on communication channels at individual clubs. Timing of delivery: Ad hoc throughout the duration of the 12month campaign period. MONITORING OF ADHERENCE TO INTERVENTION COMPONENTS: Digital: Adherence to engagement with the messages will be monitored in the participants that receive messages via email. They will be asked to score the video/factsheet material on its usefulness on a 5-point Likert scale. Participants who receive messages via SMS-platform TextcareTM as text will not be monitored as this would incur a cost to participants if they were requested to send a reply text, however, we will monitor text responses from participants. A survey item will also be included in the follow up questionnaire to assess whether participants viewed educational materials, whether by text or email and their feedback on the content. In-Person Information/educational sessions: We will record attendance at sessions including webinars and also include in our follow-up surveys questions on participation and feedback on these sessions. Incentives to attend formal CPR training: We will record use of vouchers and date of attendance to accredited CPR sessions. We will also ask in follow-up surveys on participation and feedback on these sessions. Display of educational materials at participating clubs and organisations: We will document what material was provided to organisations and record whether this material was utilised through routine audits. In addition, we will also ask in serial surveys whether participants recollect seeing the material displayed and feedback will be requested. REMINDERS IN REINFORCEMENT PERIOD: This will comprise a low-cost ongoing campaign of digital messages delivered at a lower frequency in the second year to members in the intervention group to reiterate key messages with aim of reinforcing the learning. Secondary outcomes examining sustained learning effect will be assessed at 24 months. Intervention messages will be translated where a need is indicated in multiple languages.