P3.162: Integration of Bystander CPR Training into Well-Child Checks

Purpose/Objectives: Each year, 15,000–25,000 children and 350,000 adults in the United States experience out-of-hospital cardiac arrest, with a survival rate of only 11% at hospital discharge. The rapid administration of bystander CPR (bCPR) can improve survival rates by up to 30%. Historically, Black, Latinx, and non-English speaking communities have had limited access to bCPR training and are less likely to receive this life-saving intervention. Training parents and community members in bCPR boosts the chances that it will be used when needed, particularly in home settings, where pediatric arrests are typically occur.

Design/Methods: A novel implementation approach with iterative change cycles integrated bCPR training into routine well-child checks at a community health center staffed by pediatric residents. This clinic serves primarily Spanish-speaking patients and those from lower socioeconomic backgrounds, and offers various additional social support services. Clinic stakeholders helped design the workflow to minimize visit time, and bCPR training was offered during existing wait times for medical appointments. The program was adapted in real-time to meet participants' and clinic needs. A set curriculum and resource toolkit ensured high-quality training, regardless of trainer experience. Participants first completed a pre-training survey assessing their knowledge of bCPR, followed by a 10-minute video in English or Spanish. They then practiced CPR on mannequins of different skin tones, guided by a trained pediatric resident in the patient’s preferred language. 12% of the Spanish trainings were completed by a Spanish-speaking trainer without use of an interpreter. Participants were provided paper resources to reinforce skills. Post-training surveys were sent on the day of training, and then at 3 and 6 months.

Results: Over two years, 64 families (128 individuals, ages 6–58) have participated in the training. More than half of the sessions were conducted in non-English languages, including Spanish, Swahili, and Dari. In the pre-participation survey, participants reported low confidence in recognizing cardiac arrest and initiating CPR, with average confidence ratings of 2.16/5 and 2.23/5, respectively. The post-training survey responses were limited, but all participants reported significant improvements, with confidence in recognizing cardiac arrest increasing to 3.95/5 (p=0.056), and likelihood of initiating bCPR in an emergency rising to 4.2/5 (p=0.042*). Both participants and clinic staff reported that the training did not extend their perception of visit times, and satisfaction was high (4.2/5). Program costs included a one-time purchase of mannequins and posters, and interpretation services when there was a provider-participant language mismatch.

Conclusion/Discussion: Integration of bCPR into well-child checks is a novel, well-received, effective program that has potential for broader integration into other outpatient settings. This approach provides convenient trainings to people who have historically not had equitable access. Widespread implementation could dramatically increase the number of individuals trained in bCPR, improving survival outcomes from pediatric out-of-hospital cardiac arrest.