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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 Behavour Change Wheel. A qualitative study
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Smith, Christopher Matthew, Griffiths, Frances, Fothergill, Rachael T., Vlaev, Ivo and Perkins, Gavin D. (2020) 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 Behavour Change Wheel. A qualitative study. BMJ Open, 10 . e034908. doi:10.1136/bmjopen-2019-034908 ISSN 2044-6055.
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Official URL: https://doi.org/10.1136/bmjopen-2019-034908
Abstract
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.
Item Type: | Journal Article | ||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Social Sciences > Warwick Business School Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | BMJ Open | ||||||
Publisher: | BMJ | ||||||
ISSN: | 2044-6055 | ||||||
Official Date: | 19 March 2020 | ||||||
Dates: |
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Volume: | 10 | ||||||
Article Number: | e034908 | ||||||
DOI: | 10.1136/bmjopen-2019-034908 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Reuse Statement (publisher, data, author rights): | “This article has been accepted for publication in BMJ Open, 2020 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/bmjopen-2019-034908 “© Authors (or their employer(s)) OR “© BMJ Publishing Group Ltd” ( for assignments of BMJ Case Reports) “ <year>” [Add where a funder mandates: “Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC-BY-NC 4.0) http://creativecommons.org | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Description: | THIS ARTICLE HAS A CORRECTION. PLEASE SEE: |
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Date of first compliant deposit: | 6 March 2020 | ||||||
Date of first compliant Open Access: | 24 March 2020 | ||||||
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