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Developing a Culturally Tailored Bystander CPR Education Intervention for Milwaukee Hmong Community

Developing tailored bystander CPR education for the Hmong population

Full Project Name:Developing a Culturally Tailored Bystander CPR Education Intervention for Milwaukee Hmong CommunityPrincipal Investigator:Jamie Jasti, MD, MS, Emergency MedicineCo-Investigator:Aasim Padela, MD, MSc, Emergency Medicine; Tom Aufderheide, MD, MS, Emergency MedicineAward Amount:$249,991
Award Date
July2024
Project Duration:24 months

Project Description Narrative:


Sudden cardiac arrest is a condition when the heart suddenly stops beating so it can't pump blood to the rest of the body. The emergency procedure called cardiopulmonary resuscitation (CPR) attempts to keep some blood flowing to the rest of the body when the heart stops beating by performing compressions on the chest. Research has shown that when someone witnesses a person having a cardiac arrest and immediately performs chest compressions, it can triple that person's chance of survival. This is called "bystander CPR." In Milwaukee County, if a cardiac arrest is witnessed, it is most likely witnessed by a family member or household member.

Bystander CPR is only performed in 30% of the approximately 1,000 out-of-hospital cardiac arrests (OHCA) in Milwaukee County each year. Among these, Asian Americans and Pacific Islanders (AAPI) are the least likely ethnic group to receive bystander CPR: 25% in 2022. The Hmong, who are originally from Southeastern Asia, represent the largest ethnic group among Wisconsin's AAPI population. According to the 2021 American Community Survey, Wisconsin has approximately 50,000 Hmong people, ranking the state third in the United States for the size of its Hmong population, behind only California and Minnesota. The total American Hmong population is estimated to be 370,000.

With 11,000 Hmong people, Milwaukee ranks fourth among U.S. metropolitan areas with the highest Hmong populations.

Research shows that bystander CPR is not applied equitably for all patients. Compared to white populations, African American and Latinx populations are more likely to have an OHCA, but less likely to have bystander CPR performed and less likely to survive. Many studies have explored barriers to bystander CPR in these communities and then determined how to overcome them.

The team involved in this project are not aware of any research on bystander CPR for the Hmong population anywhere in the United States. Hmong have unique views towards health, illness, death, and the role of modern medicine because of their traditional religious beliefs. It is, therefore, important to understand their perspectives to create education for performing bystander CPR that is culturally appropriate.

This project aims to uncover Hmong attitudes and beliefs towards bystander CPR in order to design a culturally appropriate educational intervention. To do so, the researchers will recruit Hmong individuals to participate in focus groups and ask them about their thoughts and opinions towards bystander CPR and OHCA. These thoughts and opinions will be analyzed for common themes or ideas.

Using this knowledge, the project team will work with key leaders in the Hmong community to design an educational intervention that is culturally appropriate.

Understanding the attitudes and beliefs of this community is important for developing a culturally tailored educational intervention for bystander CPR to advance health equity in out-of-hospital cardiac arrest in Wisconsin and beyond.

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