Initial Development of a Tool to Measure Implementation of Community Change to Improve Out-of-Hospital Cardiac Arrest
Background: The Resuscitation Academy (RA) is a training and community change program to assist communities in implementing activities to improve survival after out-of-hospital cardiac arrest. The purpose of this paper is to present data on the development of an implementation index to measure community progress in achieving survival reduction. Methods: Community representatives who attended the RA in Seattle, WA (n=258) completed an on-line survey asking about achievement of the chain of survival program components, presented in the RA, and the most helpful things that supported communities in implementing these activities. Survival data in the Cardiac Arrest Surveillance (CARES) database was used to examine the association between implementation of chain of survival components and cardiac arrest survival rates in those agencies participating CARES. Results: The15-item scale was easily implemented in online form. Internal consistency, measured by an alpha coefficient, was 0.78. Time since RA participation was significantly related to implementation index score, indicating potential to measure change. An overall implementation index showed a positive association with independently measured survival (p < 0.001). Conclusions: These data indicate that the implementation index has acceptable properties for measuring community change in the area of implementation of cardiac survival efforts. Areas for improvement include further work on measurement and documentation of the implementation process in communities, and considering tailored feedback using the tool as way of providing assistance for communities struggling to implement this program.