Barriers to Automated External Defibrillation in volunteer first-responders

Christopher M Smith (1), Frances Griffiths (2), Gavin D. Perkins (1)

(1) Clinical Trials Unit, Warwick Medical School, University of Warwick, CV4 7AL, UK
(2) Division of Health Sciences, Warwick Medical School, University of Warwick, CV4 7AL, UK

Purpose: There are many barriers to Automated External Defibrillator (AED) use by bystanders for victims of out-of-hospital cardiac arrest (OHCA). Many of these barriers relate to poor awareness of AEDs and an unwillingness or fear around using them [1]. GoodSAM is a mobile-phone app-based first-responder system that alerts registered volunteers to a nearby OHCA once a 999/112 call has been made to the local ambulance service [2]. This study aimed to explore the factors that might influence AED use among these GoodSAM volunteers
Materials and Methods: We will conduct semi-structured telephone interviews with volunteer first-responders using the GoodSAM mobile-phone app within 7 days of them receiving a notification of a nearby OHCA in the London area (May – July 2018). This will supplemented with interviews with key stakeholders (April – May 2018) and analysis of existing protocols and documents relating to the use of GoodSAM with London Ambulance Service systems. Barriers and facilitators to AED use will be classified using the well-validated Theoretical Domains Framework [3]. This framework will subsequently be mapped to models of behavioural change [4]. 
Results: We will present the findings of 30 GoodSAM volunteer interviews and three stakeholder interviews. We will present key barriers and facilitators, as mapped to the Theoretical Domains Framework and explain which behaviours need to be targeted to overcome key barriers to AED use.
Conclusions: This work to identify potential targets for behavioural change that can increase bystander AED use. This will also future research studies to test targeted interventions and assess their effect.  

References

1.	Smith CM, Lim Choi Keung SN, Khan MO et al. Barriers and facilitators to public access defibrillation in out-of-hospital cardiac arrest: a systematic review. Eur Heart J Qual Care Clin Outcomes 2017;3:264-273

2.	Smith CM, Wilson MH, Ghorbangholi A et al. The use of trained volunteers in the response to out-of-hospital cardiac arrest - the GoodSAM experience. Resuscitation 2017;121:123-126

3.	Cane J, O'Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci 2012;7:37

4.	Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 2011;6:42

This research was funded by the National Institute for Health Research (NIHR) Doctoral Research Fellowship (DRF-2017-10-095). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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