SCA Awareness and Messaging Study: Creating a Culture of Action

The public's motivation to learn CPR/AED skills and to act in an emergency increases with a clear understanding of sudden cardiac arrest (SCA) and the impact these skills have on increasing survival, according to research conducted for the Sudden Cardiac Arrest Foundation by StrataVerve, a global consumer insights practice.

Tested definition of sudden cardiac arrestSurvival from sudden cardiac arrest (SCA) outside hospitals depends largely on bystander intervention. Building upon a baseline study of awareness and understanding of SCA, CPR and AEDs conducted in 2015, a follow-up study was conducted in November 2017 to advance learnings.

The study hypothesized that one factor in low SCA survival is public confusion and unfamiliarity with SCA, a key finding in the original baseline study. The 2017 study sought to determine the impact a layperson-friendly definition of SCA has on the public’s perceived importance of learning CPR/AED skills and their motivation to perform these skills in an emergency. In addition, the study aimed to test mutually exclusive messages to learn which ones best motivate action and grab attention as a basis for communications strategies.

The study included an online quantitative survey of a representative national sample of adults (n=2,232) and in-depth qualitative interviews among respondents from 10 states (n=20). Online respondents were exposed to framing questions, and then split into two matched panels. One panel was exposed to a layperson-friendly definition of SCA (n=1,128); the other was exposed to 11 discrete messages (n=1,104). Questions pre- and post-exposure to the SCA definition measured lift in importance to learn skills and likelihood to give CPR/use an AED. Messages were tested on relative strength in motivating action and grabbing attention. In-depth personal interviews were conducted to tease out softer insights and help bring quantitative findings to life. Video clips are shown below.

Key Findings

  1. The public is still confused about SCA—it’s not on their radar. Unaided awareness of SCA is 0%. Similarly, familiarity with SCA on an aided basis is low relative to other health conditions, with only 18% of respondents indicating they are knowledgeable about SCA. The blurring of heart attack and SCA may be contributing to unintentional consumer apathy with deadly consequences.
  2. Understanding of SCA drives motivation to learn and act. After reading a layperson-friendly definition of SCA, respondents “very likely” to give CPR jumps 26% and “very likely to use an AED” increases a staggering 38%. Similarly, the belief that learning CPR is “extremely important” increases 6% and learning how to use an AED jumps a significant 20%. Including “sudden” in the definition signals urgency and its range of impact.
  3. The SCA awareness and understanding gap extends even to those who trained in CPR as to when to use it and why.
  4. Barriers to bystander intervention include:
    • Concern for hurting victim (42%)
    • Lack of confidence (40%)
    • Belief another is more competent (34%)
    • Liability concerns (34%)
    • Notably, 20% of respondents indicate no barriers.
  5. Two messages lead in motivation to act and grabbing attention:
    • “You can double or triple a person's chance of survival from SCA by immedicately giving CPR” ranks first in attention-getting. What's more, 64% of respondents find it “extremely motivating” to give CPR or use an AED. This message connects on a rational basis simply by stating the impact of CPR.
    • “You may save the life of someone you love by giving CPR, as most sudden cardiac arrests happen at home” connects emotionally. This message ties with the first message with 65% of respondents indicating it is “extremely motivating.” 
  6. Other effective supporting messages include:
    • The dispatcher as coach builds confidence and reassures the potential rescuer.
    • “You cannot hurt a victim, you can only help” mitigates a key barrier.
    • “Don’t wait for help to arrive…every second counts” drives urgency.

Recommendations

  1. Increase public awareness and understanding of SCA, CPR and AEDs to clear confusion and raise profile. Community action is a marketing problem. It's essential to reposition SCA as a national health crisis, create a national movement in consumer-facing channels to educate, inform and generate public demand to learn CPR and make AEDs readily accessible, and secure funding commensurate with the scale of this crisis.
  2. Increase the public's understanding of SCA, as understanding drives action. Using the tested, uniform, lay-friendly definition of SCA consistently across organizations and the media is urgent. Including “sudden” in the definition signals urgency and breadth.
  3. Ensure CPR training drives understanding of SCA, and when to use CPR/AEDs and why. Quality training is a must and should include an emphasis on the definition of SCA and how it presents. It is also important to train the media to refer to the condition as “sudden cardiac arrest.”
  4. Mitigate barriers to intervention through priority messaging. Communications that inspire confidence to reduce barriers to action is recommended.
  5. Leverage the two top-performing messages that best motivate action and grab attention. The top two messages described above (“doubling or tripling SCA survival with immediate CPR” and “saving the life of a loved one as most SCAs happen at home” show greatest strength, connecting on both rational and emotional levels. They should be used in outreach communications, along with supporting points that inspire confidence.

* Tested definition of SCA: Sudden Cardiac Arrest (SCA) is a life-threatening emergency that occurs when the heart unexpectedly stops beating. It strikes seemingly healthy people of all ages, even children and teens. When SCA happens, the person collapses, becomes unresponsive, and is not breathing normally. The person may appear to be gasping, snoring or having a seizure. SCA leads to death within minutes if the person does not receive immediate help. Survival depends of the quick actions of people nearby to call 911, start CPR (cardiopulmonary resuscitation), and if available, use as AED (automated external defibrillator) as soon as possible.

*Refined definition of SCA at 8th grade level: Sudden Cardiac Arrest (SCA) is a life-threatening emergency that occurs when the heart suddenly stops beating. It strikes people of all ages who may seem to be healthy, even children and teens. When SCA happens, the person collapses and doesn’t respond or breathe normally. They may gasp or shake as if having a seizure. SCA leads to death in minutes if the person does not get help right away. Survival depends on people nearby calling 911, starting CPR¹, and using an AED² (if available) as soon as possible.

¹CPR: Cardiopulmonary resuscitation is when you push hard and fast on the center of chest to make the heart pump; compressions may be given with or without rescue breaths.

²AED: Automated external defibrillator is a device that analyzes the heart and if it detects a problem may deliver a shock to restart the heart’s normal rhythm.

Authors: Jennifer Chap, Karen Ba, Youssou Ba, Rick Chap, StrataVerve; Kelly N. Sawyer, MD, University of Pittsburgh; Mary M. Newman, MS, Sudden Cardiac Arrest Foundation

See abstract in Circulation here.

In-Depth Interviews

As part of this study, in-depth interviews were conducted in Orlando, FL among 20 respondents, ages 21-60 from 10 states. These interviews provide some glimpses into public awareness about sudden cardiac arrest.

Knowledge Gaps

CPR Perceptions and Myths

Impact of Clear Definition of SCA

Motivation to Learn Post Definition

Call-Push-Shock

Interviews conducted for the Sudden Cardiac Arrest Foundation by StrataVerve in November 2017 were used as part of the Call-Push-Shock campaign, conducted in collaboration with Parent Heart Watch, and launched in June 2018.

Acknowledgments: The Sudden Cardiac Arrest Foundation thanks the following for their invaluable contributions to this landmark research: Principal: StrataVerve; Contributing Partners: Survey Sampling International, Strategic Artifex, Dan Beckmann, Buddy CPR, Verocity Creative Communications, and Just Do Something...Anything