Meeting Abstracts

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Mass media marketing and willingness to undertake cardiopulmonary resuscitation: a cross-sectional survey of the general public in Birmingham, UK Suzanna Bull, Jonathan Shadwell, Benjamin Stewart, Ben Stride, Lara Reilly, Jonathan Warburton, Shamil Haroon

AbstractBackground In the past 10 years there has been a scarcity of published work regarding public attitudes towards bystander cardiopulmonary resuscitation (CPR). There is limited confi dence among the public in providing CPR, and use of media marketing has been proposed to improve attitudes. In 2012, the British Heart Foundation aimed to raise awareness and knowledge of chest compression only CPR. This study aimed to assess whether an association exists between campaign exposure and the public’s willingness to undertake CPR, as well as their knowledge of guidelines.

Methods We did a cross-sectional street survey in Birmingham in February, 2013, with a previously piloted questionnaire. A script was used to approach potential participants, and a systematic sampling method of approaching every fi fth person past a landmark was used to reduce selection sampling bias. Participants had to be over the age of 18 years and be able to speak and understand English to be included; exclusion criteria were the inability or refusal to give informed consent. After sample size calculation using pilot data, a decision to overpower the study to facilitate in-depth analysis was made, and 200 participants were sought. Between the six surveyors, participation rate varied between 16% and 54%. Questions assessing willingness were adapted from previous studies and scored on a discrete ordinal scale. Knowledge was assessed by fi ve multiple choice questions. Multivariable linear regression was used to assess the relation between exposure, demographic variables, and fi rst-aid training on willingness and CPR knowledge. Perceived diff erences in willingness before and after exposure were assessed with a Wilcoxon signed rank test. Reasons given for reluctance to undertake CPR were also obtained.

Findings Of 199 people who successfully completed questionnaires (appendix), 142 (71·4%) had seen the campaign. Compared with the unexposed group, the exposed group had greater proportions of women (85 of 142 [59·9%] vs 25 of 57 [43·9%]) and white individuals (117 [82·4%] vs 34 [59·6%]) but a smaller proportion of people who had received some form of fi rst-aid training (80 [56·3%] vs 40 [70·2%]). 48 (24%) of 199 participants were of non-white ethnic origin. Exposure was associated with a non-signifi cant increase in reported willingness score (increase of 0·06 of a maximum score of 1·00, 95% CI –0·01 to 0·14; p=0·111) and a signifi cantly increased knowledge score (0·57, 0·19 to 0·95; p=0·003) when compared with non-exposure. First-aid training was associated with both increased willingness and knowledge, with the greatest eff ect in those trained in the past year (increase in willingness score 0·30, 95% CI 0·19 to 0·40; p<0·0001; knowledge 1·12, 0·59 to 1·64; p<0.0001). There was also an increased perceived willingness after exposure compared with recalled willingness before the campaign (p<0·0001).

Interpretation These results suggest that the campaign was successful in increasing public knowledge and possibly willingness to undertake CPR. First-aid training has a greater eff ect on both outcomes than campaign exposure, although this eff ect decreases with time. These results must be interpreted in light of the main limitations of this study. The use of a non-random sampling method and the responder bias of street surveys mean that making inferences about the general population is diffi cult. The likely recall bias, resulting from asking participants to assess their willingness before the campaign, means that the slight increase in willingness after exposure must be interpreted with caution; an anonymised survey before intervention would have allowed more robust inferences to be made here. Even so, the data suggest that the campaign helped to maintain awareness of and confi dence to undertake CPR, and therefore further research into the effi cacy of mass media marketing campaigns in infl uencing willingness to act in an emergency might be useful.

Funding None.

ContributorsLR and JW did the literature review. SB did the questionnaire design and methods. JS did the statistical analysis. BSte and BStr interpreted data.

SH provided project supervision and support. SB wrote the abstract with input from SH. All authors have seen and approved the fi nal version

of the abstract for publication.

Confl icts of interestWe declare that we have no confl icts of interest.

Published OnlineNovember 29, 2013

University of Birmingham Medical School, Birmingham, UK (S Bull BSc, J Shadwell BA, B Stewart BSc, B Stride BSc, L Reilly BSc, J Warburton BSc, S Haroon MPH)

Correspondence to: Miss Suzanna Bull, Apartment 32, 2 Langley Walk, Birmingham B15 2EN, UK sjb191@bham.ac.uk

See Online for appendix