FirstCPR Process Evaluation: Recruitment and Engagement in a Community-Based Intervention Aimed at Training and Willingness to Respond to Cardiac Arrest in the Community

ABSTRACT

Background: An important stage of process evaluation in community-based interventions is assessing recruitment and engagement. Such an evaluation is being conducted alongside the FirstCPR cluster-randomised trial, which aims to increase community-level training and willingness to respond to cardiac arrests by providing education and training to members of community-based organisation. FirstCPR’s process evaluation sought to (1) examine recruitment and understand barriers and enablers to organisation participation;and (2) examine the intervention’s fidelity and reach, including contextual factors related to participant engagement. Methods: A mixed-methods evaluation, integrated data collected during organisation recruitment comprising both quantitative record-keeping and qualitative coding. Quantitative data included recruitment rates, reasons for refusal, and organisational features;qualitative codes emerged from study-team observations. Descriptive analyses were used for quantitative data and thematic analyses for qualitative data. Results: In total, 220 (constituting 55% social/faith groups, 39% sports organisations, 6% workplaces/businesses) of 385 eligible organisations declined to participate. Lack of sufficient time to facilitate the project at their organisations, difficulties prioritising the program given competing activities, and COVID-related restrictions emerged as principal reasons for declining. Thematic analyses suggested that an organisation’s perception of the value of FirstCPR’s training was a key factor motivating enrolment. Conclusions: Organisational barriers included COVID restrictions, lack of perceived relevance, and staffing limitations. Obtaining adequate enrolment is essential for the generalisability of community intervention trials such as FirstCPR. Further semi-structured interviews with organisation leaders will delve into contextual factors that facilitated or impeded the intervention’s planned delivery;study records and web-analytics will inform intervention’s fidelity and reach.