Dataset Information

Content validation of the HeartRunner questionnaire to volunteer responders dispatched to out-of-hospital cardiac arrests: A qualitative study.

ABSTRACT:

Aim

To increase survival after out-of-hospital cardiac arrest (OHCA) in Denmark, volunteer responders are activated through a smartphone application (HeartRunner app) to quickly locate an automated external defibrillator (AED) and assist with cardiopulmonary resuscitation (CPR). All dispatched volunteer responders who have been activated by the app receive a follow-up questionnaire to evaluate their participation in the programme. The content of the questionnaire has never been thoroughly evaluated. We therefore aimed to validate the content of the questionnaire.

Methods

Content validity was evaluated qualitatively. It was based on individual interviews with three experts, along with three focus group interviews and five individual interviews using cognitive interview technique, with a total of 19 volunteer responders. The interviews were also used to inform refinements of the questionnaire to reach improvements in content validity.

Results

The initial questionnaire consisted of 23 items. After the content validation process, the questionnaire consisted of 32 items; with the addition of 9 new items. Specifically, some original items were merged into one item or divided into separate items. Moreover, we revised the order of items, some sentences were rephrased or reworded, an introduction and headlines to different sections were added, and skip logic were incorporated to hide non-relevant items.

Conclusion

Our findings support the importance of validating questionnaires to ensure accuracy of survey instruments. Validation led to modifications of the questionnaire, and we propose a new version of the HeartRunner questionnaire. Our findings support the content validity of the final HeartRunner questionnaire. The questionnaire may allow the collection of quality data to evaluate and improve volunteer responder programmes.

SUBMITTER: Brautsch LAS

PROVIDER: S-EPMC10050778 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Publications

Content validation of the HeartRunner questionnaire to volunteer responders dispatched to out-of-hospital cardiac arrests: A qualitative study.

Brautsch Louise Ayoe Sparvath LAS Zinckernagel Line L Kragh Astrid Marie Rolin AMR Hansen Carolina Malta CM Kristensen Astrid Lykke Storgaard ALS Andersen Susan S

Resuscitation plus 20230324

<h4>Aim</h4>To increase survival after out-of-hospital cardiac arrest (OHCA) in Denmark, volunteer responders are activated through a smartphone application (HeartRunner app) to quickly locate an automated external defibrillator (AED) and assist with cardiopulmonary resuscitation (CPR). All dispatched volunteer responders who have been activated by the app receive a follow-up questionnaire to evaluate their participation in the programme. The content of the questionnaire has never been thoroughl ...[more]

PMID: 37007187

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Project description:ImportanceSmartphone dispatch of volunteer responders to nearby out-of-hospital cardiac arrests (OHCAs) has emerged in several emergency medical services, but no randomized clinical trials have evaluated the effect on bystander use of automated external defibrillators (AEDs).ObjectiveTo evaluate if bystander AED use could be increased by smartphone-aided dispatch of lay volunteer responders with instructions to collect nearby AEDs compared with instructions to go directly to patients with OHCAs to start cardiopulmonary resuscitation (CPR).Design, setting, and participantsThis randomized clinical trial assessed a system for smartphone dispatch of volunteer responders to individuals experiencing OHCAs that was triggered at emergency dispatch centers in response to suspected OHCAs and randomized 1:1. The study was conducted in 2 main Swedish regions: Stockholm and Västra Götaland between December 2018 and January 2020. At study start, there were 3123 AEDs in Stockholm and 3195 in Västra Götaland and 24 493 volunteer responders in Stockholm and 19 117 in Västra Götaland. All OHCAs in which the volunteer responder system was activated by dispatchers were included. Excluded were patients with no OHCAs, those with OHCAs not treated by the emergency medical services, and those with OHCAs witnessed by the emergency medical services.InterventionsVolunteer responders were alerted through the volunteer responder system smartphone application and received map-aided instructions to retrieve nearest available public AEDs on their way to the OHCAs. The control arm included volunteer responders who were instructed to go directly to the OHCAs to perform CPR.Main outcomes and measuresOverall bystander AED attachment, including those attached by volunteer responders and lay volunteers who did not use the smartphone application.ResultsVolunteer responders were activated for 947 patients with OHCAs. Of those, 461 were randomized to the intervention group (median [IQR] age of patients, 73 [61-81] years; 295 male patients [65.3%]) and 486 were randomized to the control group (median [IQR] age of patients, 73 [63-82] years; 312 male patients [65.3%]). Primary outcome of AED attachment occurred in 61 patients (13.2%) in the intervention arm vs 46 patients (9.5%) in the control arm (difference, 3.8% [95% CI, -0.3% to 7.9%]; P = .08). The majority of AEDs were attached by lay volunteers who were not using the smartphone application (37 in intervention arm, 28 in control). There were no significant differences in secondary outcomes. Among the volunteer responders using the application, crossover was 11% and compliance to instructions was 31%. Volunteer responders attached 38% (41 of 107) of all AEDs and provided 45% (16 of 36) of all defibrillations and 43% (293 of 666) of all CPR.Conclusions and relevanceIn this study, smartphone dispatch of volunteer responders to OHCAs to retrieve nearby AEDs vs instructions to directly perform CPR did not significantly increase volunteer AED use. High baseline AED attachement rate and crossover may explain why the difference was not significant.Trial registrationClinicalTrials.gov Identifier: NCT02992873.

Project description:BackgroundSmartphone-based emergency response apps are increasingly being used to identify and dispatch volunteer first responders (VFRs) to medical emergencies to provide faster first aid, which is associated with better prognoses. Volunteers' availability and willingness to respond are uncertain, leading in recent studies to response rates of 17% to 47%. Dispatch algorithms that select volunteers based on their estimated time of arrival (ETA) without considering the likelihood of response may be suboptimal due to a large percentage of alerts wasted on VFRs with shorter ETA but a low likelihood of response, resulting in delays until a volunteer who will actually respond can be dispatched.ObjectiveThis study aims to improve the decision-making process of human emergency medical services dispatchers and autonomous dispatch algorithms by presenting a novel approach for predicting whether a VFR will respond to or ignore a given alert.MethodsWe developed and compared 4 analytical models to predict VFRs' response behaviors based on emergency event characteristics, volunteers' demographic data and previous experience, and condition-specific parameters. We tested these 4 models using 4 different algorithms applied on actual demographic and response data from a 12-month study of 112 VFRs who received 993 alerts to respond to 188 opioid overdose emergencies. Model 4 used an additional dynamically updated synthetic dichotomous variable, frequent responder, which reflects the responder's previous behavior.ResultsThe highest accuracy (260/329, 79.1%) of prediction that a VFR will ignore an alert was achieved by 2 models that used events data, VFRs' demographic data, and their previous response experience, with slightly better overall accuracy (248/329, 75.4%) for model 4, which used the frequent responder indicator. Another model that used events data and VFRs' previous experience but did not use demographic data provided a high-accuracy prediction (277/329, 84.2%) of ignored alerts but a low-accuracy prediction (153/329, 46.5%) of responded alerts. The accuracy of the model that used events data only was unacceptably low. The J48 decision tree algorithm provided the best accuracy.ConclusionsVFR dispatch has evolved in the last decades, thanks to technological advances and a better understanding of VFR management. The dispatch of substitute responders is a common approach in VFR systems. Predicting the response behavior of candidate responders in advance of dispatch can allow any VFR system to choose the best possible response candidates based not only on ETA but also on the probability of actual response. The integration of the probability to respond into the dispatch algorithm constitutes a new generation of individual dispatch, making this one of the first studies to harness the power of predictive analytics for VFR dispatch. Our findings can help VFR network administrators in their continual efforts to improve the response times of their networks and to save lives.

Project description:Background Of the more than 250 000 emergency medical services-treated out-of-hospital cardiac arrests that occur each year in the United States, only about 8% survive to hospital discharge with good neurologic function. Treatment for out-of-hospital cardiac arrest involves a system of care that includes complex interactions among multiple stakeholders. Understanding the factors inhibiting optimal care is fundamental to improving outcomes. Methods and Results We conducted group interviews with emergency responders including 911 telecommunicators, law enforcement officers, firefighters, and transporting emergency medical services personnel (ie, emergency medical technicians and paramedics) who responded to the same out-of-hospital cardiac arrest incident. We used the American Heart Association System of Care as the framework for our analysis to identify themes and their contributory factors from these interviews. We identified 5 themes under the structure domain, which included workload, equipment, prehospital communication structure, education and competency, and patient attitudes. In the process domain, 5 themes were identified focusing on preparedness, field response and access to patient, on-scene logistics, background information acquisition, and clinical interventions. We identified 3 system themes including emergency responder culture; community support, education, and engagement; and stakeholder relationships. Three continuous quality improvement themes were identified, which included feedback provision, change management, and documentation. Conclusions We identified structure, process, system, and continuous quality improvement themes that may be leveraged to improve outcomes for out-of-hospital cardiac arrest. Interventions or programs amenable to rapid implementation include improving prearrival communication between agencies, appointing patient care and logistical leadership on-scene, interstakeholder team training, and providing more standardized feedback to all responder groups.

Project description:Background: Voluntary First Response is an important component of prehospital care for medical emergencies, particularly cardiac arrest, in many countries. This intervention entails the mobilisation of volunteers, known as Community First Responders (CFRs), by the Emergency Medical Services to respond to medical emergencies in their locality. They include lay responders and/or professional responders (e.g. police officers, fire fighters, and general practitioners). A wide variety of factors are thought to motivate CFRs to join and remain engaged in Voluntary First Response schemes, such as the availability of learning opportunities, recognition, counselling, and leadership. The aim of this review is to develop an in-depth understanding of CFR motivation, including the factors that influence the initial decision to volunteer as a CFR and the factors that sustain involvement in Voluntary First Response over time. Any factors relevant to CFR de-motivation and turnover will also be examined. Methods: This is a protocol for a qualitative systematic review of the factors that influence the motivation of individuals to participate in Voluntary First Response. A systematic search will be carried out on seven electronic databases. Qualitative studies, mixed-methods studies, and any other studies producing data relating to the review question will be eligible for inclusion. Title and abstract screening, as well as full text screening, will be completed independently by two authors. A narrative synthesis, which is an established qualitative synthesis methodology, will be performed. The quality of each of the included studies will be critically appraised. Discussion: The findings of this review will be used to optimise the intervention of Voluntary First Response. Specifically, the results will inform the design and organisation of Voluntary First Response schemes, including their recruitment, training, and psychological support processes. This could benefit a range of stakeholders, including CFRs, paramedics, emergency physicians, patients, and the public.

Dataset Information

Content validation of the HeartRunner questionnaire to volunteer responders dispatched to out-of-hospital cardiac arrests: A qualitative study.

Aim

Methods

Results

Conclusion

Publications

Content validation of the HeartRunner questionnaire to volunteer responders dispatched to out-of-hospital cardiac arrests: A qualitative study.

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