A key determinant of survival after out-of-hospital cardiac arrest (OHCA) is bystander cardio pulmonary resuscitation (CPR) which can more than double an individual's chances of surviving to discharge from hospital. The experience of other international OHCA survival programmes has shown that increasing bystander CPR is strongly associated with an increase in overall survival. However, existing data suggest that the more economically deprived an area is the higher the incidence of cardiac arrest. At the same time, rates of bystander CPR in the same areas are lower, which could result in lower survival rates. High-profile awareness raising campaigns that are generic focus have not specifically targeted people living in deprived communities who may require more tailored campaigns and interventions to change attitudes and improve confidence to administer bystander CPR. Therefore, this systematic review will explore the facilitators and barriers to engaging with bystander CPR which exist in deprived communities The secondary objective is to identify existing bystander OHCA social marketing and social network intervention campaigns that could inform future activities to improve the rate of bystander CPR in deprived communities.Systematic review searching the following databases: CINAHL, MEDLINE, PsycINFO, and Web of Science Core Collection Citation Indexes. Unpublished 'grey' literature will also be sourced through web searches, stakeholder interviews, and an advisory group. The reference lists of any relevant reviews will also be checked for additional studies. References will be restricted to those published in 2000 onwards. Authors will independently screen, assess data quality, and extract data for synthesis. A narrative synthesis of study findings will be conducted, with findings presented thematically.This review will focus on all studies that seek to examine the barriers and facilitators to the delivery of bystander CPR in deprived communities and identify examples of previous interventions or activities that could inform the design of a future theory-based intervention to improve the rate of bystander CPR in deprived communities.PROSPERO CRD42017081944.
The aim of this review is to identify and review evidence of the effectiveness of initiatives and interventions delivered in the community, school, or workplace setting which have been designed to encourage individuals to use their local outdoor environment to increase their physical activity, and to identify and describe similar initiatives currently being delivered in Scotland.
Postsecondary institutions need well-prepared instructors to equip students for changing economic and social realities, instructors who are also trained to address the learning needs of the many students who enter college unprepared to learn and persevere in a program of study. Unlike teacher preparation for kindergarten through twelfth grade, a preservice internship component is seldom seen in preparation for developmental education instructors for community colleges. This article details evidence-based components that should be included in effective literacy programs that prepare Developmental Reading Instructors (DRIs). Next, illustration of how community colleges actualize these evidence-based components is accomplished through analysis of similarities and differences among curricular offerings. Following this, a partnership between a four-year institution and several community colleges is examined demonstrating models of internship experiences for future DRIs. Description of the partnerships concludes with success stories from community college faculty supervisors.
Study aim Rates of out of hospital cardiac arrest are higher in deprived communities. Bystander Cardiopulmonary Resuscitation (BCPR) can double the chance of survival but occurs less often in these communities in comparison to more affluent communities. People living in deprived communities are, therefore, doubly disadvantaged and there is limited evidence to explain why BCPR rates are lower. The aim of this paper is to examine the barriers to administering BCPR in deprived communities. Method Mixed method qualitative study with ten single sex focus groups (n = 61) conducted in deprived communities across central Scotland and 18 semi-structured interviews with stakeholders from the UK, Europe and the USA. Results Two key themes related to confidence and environmental factors were identified to summarise the perceived barriers to administering BCPR in deprived communities. Barriers related to confidence included: self-efficacy; knowledge and awareness of how, and when, to administer CPR; accessing CPR training; having previous experience of administering BCPR; who required CPR; and whether the bystander was physically fit to give CPR. Environmental barriers focused on the safety of the physical environment in which people lived, and fear of reprisal from gangs or the police. Conclusions Barriers to administering BCPR identified in the general population are relevant to people living in deprived communities but are exacerbated by a range of contextual, individual and environmental factors. A one-size-fits-all approach is not sufficient to promote 'CPR readiness' in deprived communities. Future approaches to working with disadvantaged communities should be tailored to the local community.
Smoking in pregnancy can cause substantial harm and, while many women quit, others continue to smoke throughout pregnancy. The role of partners is an important but relatively under-researched factor in relation to women's smoking in pregnancy; partner's smoking status and attitudes to smoking cessation are important influences in a pregnant women's attempt to quit. Further understanding of how partners perceive the barriers and facilitators to smoking cessation in pregnancy is needed, particularly from qualitative studies where participants describe these issues in their own words. A synthesis of qualitative research of partners' views of smoking in pregnancy and post-partum was conducted using meta-ethnography. Searches were undertaken from 1990 to January 2014 using terms for partner/household, pregnancy, post-partum, smoking, qualitative in seven electronic databases. The review was reported in accordance with the 'Enhancing transparency in reporting the synthesis of qualitative research' (ENTREQ) statement. Nine studies reported in 14 papers were included, detailing the experience of 158 partners; the majority were interviewed during the post-partum period. Partners were all male, with a single exception. Socioeconomic measures indicated that most participants were socially disadvantaged. The synthesis identified recurring smoking-related perceptions and experiences that hindered (barriers) and encouraged (facilitators) partners to consider quitting during the woman's pregnancy and into the post-partum period. These were represented in five lines of argument relating to: smoking being an integral part of everyday life; becoming and being a father; the couple's relationship; perceptions of the risks of smoking; and their harm reduction and quitting strategies. The cluster of identified barriers and facilitators to quitting offers pointers for policy and practice. The workplace emerges as an important space for and influence on partners' smoking habits, suggesting alternative cessation intervention locations for future parents. Conversely, health and community settings are seen to offer little support to fathers. Interventions centred on valued personal traits, like will-power and autonomy, may have particular salience. The review points, too, to the potential for health information that directly addresses perceived weaknesses in official advice, for example, around causal mechanisms and effects and around contrary evidence of healthy babies born to smokers. PROSPERO 2013: CRD42013004170
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