Identifying and overcoming barriers to automated external defibrillator use by GoodSAM volunteer first responders in out-of-hospital cardiac arrest using the Theoretical Domains Framework and Behaviour Change Wheel: a qualitative study
Objectives GoodSAM is a mobile phone app that integrates with UK ambulance services. During a 999 call, if a call handler diagnoses cardiac arrest, nearby volunteer first responders registered with the app are alerted. They can give cardiopulmonary resuscitation (CPR) and/or use a public access auto...
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BMJ Publishing Group
2020-03-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/3/e034908.full |
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| author | Frances Griffiths Gavin D Perkins Ivo Vlaev Rachael T Fothergill Christopher M Smith |
| author_facet | Frances Griffiths Gavin D Perkins Ivo Vlaev Rachael T Fothergill Christopher M Smith |
| author_sort | Frances Griffiths |
| collection | DOAJ |
| description | Objectives GoodSAM is a mobile phone app that integrates with UK ambulance services. During a 999 call, if a call handler diagnoses cardiac arrest, nearby volunteer first responders registered with the app are alerted. They can give cardiopulmonary resuscitation (CPR) and/or use a public access automated external defibrillator (AED). We aimed to identify means of increasing AED use by GoodSAM first responders.Methods We conducted semistructured telephone interviews, using the Theoretical Domains Framework to identify and classify barriers to AED use. We analysed findings using the Capability, Opportunity, Motivation, Behaviour (COM-B) model and subsequently used the Behaviour Change Wheel to develop potential interventions to improve AED use.Setting London, UK.Participants GoodSAM first responders alerted in the previous 7 days about a cardiac arrest.Results We conducted 30 telephone interviews in two batches in July and October 2018. A public access AED was taken to scene once, one had already been attached on scene another time and three participants took their own AEDs when responding. Most first responders felt capable and motivated to use public access AEDs but were concerned about delaying CPR if they retrieved one and frustrated when arriving after the ambulance service. They perceived lack of opportunities due to unavailable and inaccessible AEDs, particularly out of hours. We subsequently developed 13 potential interventions to increase AED use for future testing.Conclusions GoodSAM first responders used AEDs occasionally, despite a capability and motivation to do so. Those operating volunteer first responder systems should consider our proposed interventions to improve AED use. Of particular clinical importance are: highlighting AED location and providing route/time estimates to the patient via the nearest AED. This would help single responders make appropriate decisions about AED retrieval. As AED collection may extend time to reach the patient, where there is sufficient density of potential responders, systems could send one responder to initiate CPR and another to collect an AED. |
| format | Article |
| id | doaj-art-c4f19b731ac742d9b02533dd464a6761 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-c4f19b731ac742d9b02533dd464a67612025-08-20T02:31:05ZengBMJ Publishing GroupBMJ Open2044-60552020-03-0110310.1136/bmjopen-2019-034908Identifying and overcoming barriers to automated external defibrillator use by GoodSAM volunteer first responders in out-of-hospital cardiac arrest using the Theoretical Domains Framework and Behaviour Change Wheel: a qualitative studyFrances Griffiths0Gavin D Perkins1Ivo Vlaev2Rachael T Fothergill3Christopher M Smith41 University of Warwick Warwick Medical School, Coventry, UKWarwick Clinical Trials Unit, University of Warwick, Coventry, UKNIHR Policy Research Unit in Behavioural Science, Newcastle University, Newcastle upon Tyne, UK7London Ambulance Service NHS Trust, UKResuscitation Council UK, London, UKObjectives GoodSAM is a mobile phone app that integrates with UK ambulance services. During a 999 call, if a call handler diagnoses cardiac arrest, nearby volunteer first responders registered with the app are alerted. They can give cardiopulmonary resuscitation (CPR) and/or use a public access automated external defibrillator (AED). We aimed to identify means of increasing AED use by GoodSAM first responders.Methods We conducted semistructured telephone interviews, using the Theoretical Domains Framework to identify and classify barriers to AED use. We analysed findings using the Capability, Opportunity, Motivation, Behaviour (COM-B) model and subsequently used the Behaviour Change Wheel to develop potential interventions to improve AED use.Setting London, UK.Participants GoodSAM first responders alerted in the previous 7 days about a cardiac arrest.Results We conducted 30 telephone interviews in two batches in July and October 2018. A public access AED was taken to scene once, one had already been attached on scene another time and three participants took their own AEDs when responding. Most first responders felt capable and motivated to use public access AEDs but were concerned about delaying CPR if they retrieved one and frustrated when arriving after the ambulance service. They perceived lack of opportunities due to unavailable and inaccessible AEDs, particularly out of hours. We subsequently developed 13 potential interventions to increase AED use for future testing.Conclusions GoodSAM first responders used AEDs occasionally, despite a capability and motivation to do so. Those operating volunteer first responder systems should consider our proposed interventions to improve AED use. Of particular clinical importance are: highlighting AED location and providing route/time estimates to the patient via the nearest AED. This would help single responders make appropriate decisions about AED retrieval. As AED collection may extend time to reach the patient, where there is sufficient density of potential responders, systems could send one responder to initiate CPR and another to collect an AED.https://bmjopen.bmj.com/content/10/3/e034908.full |
| spellingShingle | Frances Griffiths Gavin D Perkins Ivo Vlaev Rachael T Fothergill Christopher M Smith Identifying and overcoming barriers to automated external defibrillator use by GoodSAM volunteer first responders in out-of-hospital cardiac arrest using the Theoretical Domains Framework and Behaviour Change Wheel: a qualitative study BMJ Open |
| title | Identifying and overcoming barriers to automated external defibrillator use by GoodSAM volunteer first responders in out-of-hospital cardiac arrest using the Theoretical Domains Framework and Behaviour Change Wheel: a qualitative study |
| title_full | Identifying and overcoming barriers to automated external defibrillator use by GoodSAM volunteer first responders in out-of-hospital cardiac arrest using the Theoretical Domains Framework and Behaviour Change Wheel: a qualitative study |
| title_fullStr | Identifying and overcoming barriers to automated external defibrillator use by GoodSAM volunteer first responders in out-of-hospital cardiac arrest using the Theoretical Domains Framework and Behaviour Change Wheel: a qualitative study |
| title_full_unstemmed | Identifying and overcoming barriers to automated external defibrillator use by GoodSAM volunteer first responders in out-of-hospital cardiac arrest using the Theoretical Domains Framework and Behaviour Change Wheel: a qualitative study |
| title_short | Identifying and overcoming barriers to automated external defibrillator use by GoodSAM volunteer first responders in out-of-hospital cardiac arrest using the Theoretical Domains Framework and Behaviour Change Wheel: a qualitative study |
| title_sort | identifying and overcoming barriers to automated external defibrillator use by goodsam volunteer first responders in out of hospital cardiac arrest using the theoretical domains framework and behaviour change wheel a qualitative study |
| url | https://bmjopen.bmj.com/content/10/3/e034908.full |
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