Development of a Systematic Neighborhood Analysis Method for Implementation of a Targeted CPR Training Program in High-Opportunity Neighborhoods in Denver

Background: Out of hospital cardiac arrest (OHCA) affects over 300,000 people annually in the U.S. Survival rates vary widely across communities. Within a community, variation in the provision of bystander cardiopulmonary resuscitation (CPR) and survival also occurs at the neighborhood level. “High-opportunity” neighborhoods, those with a high incidence of OHCA and low provision of CPR, can be identified and targeted for focused intervention.

Objective/Purpose: No established methodology exists for systematically evaluating neighborhoods to develop strategies for implementation of public health interventions.

Method: A neighborhood analysis methodology was developed to: 1) describe high-opportunity neighborhoods in relationship to the surrounding community; 2) evaluate available resources for each neighborhood ;and 3) establish a strategy to implement public health intervention (i.e., CPR training) in high-opportunity neighborhoods.

Results: Using the Cardiac Arrest Registry to Enhance Survival (CARES) dataset, we identified five neighborhoods in Denver, Colorado with 2-3 times the incidence of OHCA as their neighbors and very low provision of bystander CPR. The neighborhood analysis used three domains (historical, demographic, and geographic ) to characterize each neighborhood in relation to OHCA incidence and provision of bystander CPR. Community-based asset mapping, which included locations of relevant professional services, was then conducted to create a framework for dissemination of CPR training. Finally, a strategy was developed for the implementation of CPR training.

Conclusion: A novel methodology for neighborhood analysis, combined with local knowledge, was used to identify targets for implementation of public health interventions to increase the provision of bystander CPR, and ultimately survival, in five high-opportunity neighborhoods in Denver. This methodology can be used in community-based research to understand relationships among neighborhoods within a community, as well as to identify resources for implementation of public health interventions.