An evaluation of the Public Access Defibrillation (PAD) Demonstration

1.3 Methodology

Page last updated: August 2008

CR&C used a combined qualitative and quantitative methodology for the evaluation. The literature review provided the policy and evidence contexts, the stakeholder consultation and qualitative research identified specific issues relating to the PAD Demonstration and the quantitative CATI survey identified the extent to which those issues held over the population of the demonstration sites.

1.3.1 Literature review
1.3.2 Stakeholder interviews
1.3.3 Qualitative consultations
1.3.4 CATI survey

1.3.1 Literature review

The project commenced with a review of recent national and international literature exploring evidence of the public use of AEDs, their contribution to public health and how such programs are operated and funded. A similar review was conducted by Prof Ian Jacobs for the Department in 2004. CR&C has adopted the structure used in this review, and has ‘updated’ the findings with evidence that was made available after 2004. In addition, CR&C has provided additional information about alternative models for delivering AED/PAD programs, drawing evidence from The United Kingdom (UK) and the United States of America (US).

Literature for this review was obtained from two key sources:
  • Academic databases:
    • Medline 1996- (Ovid)
    • EMBASE (Ovid)
    • Social Services Abstracts (CSA Social Services Abstracts)
    • PsycINFO 1985- (Ovid)
    • APAIS Health (Informit)
    • Expanded Academic ASAP (Gale)
    • AMI (Informit Search)
  • Web searches using Google – the main focus of these searches were Governmental peak body organisation websites both Australian and overseas, a full list of websites in contained in the bibliography at the end of this chapter.
Terms used for the search were 'public access defibrillation', 'PAD', 'automated external defibrillation', 'AED', 'safety', 'training', and 'lay person'. In total, 16 articles were identified as appropriate for inclusion in the review. All searches were conducted in June, 2008. Top of page

1.3.2 Stakeholder interviews

This preliminary fieldwork stage included in-depth interviews with key stakeholders based around a discussion guide developed in collaboration with the Department. The objective was to capture a range of views from higher level stakeholders regarding the effectiveness and the PAD Demonstration.

Seven in-depth interviews were conducted with key national stakeholders representing a range of professions, peak bodies and consumer organisations including:
  • The Australian Resuscitation Council
  • The National Heart Foundation
  • Heart Support Australia
  • The Convention of Ambulance Authorities Australia and
  • A leading cardiologist.
Also consulted were Laerdal, a manufacturer of defibrillators distributed under the PAD Demonstration and a co-founder of one of the first Australian early defibrillation programs (implemented at the Melbourne Cricked Ground).

The full list of stakeholders who were consulted is provided as Appendix B. A copy of the discussion guide for interviews with stakeholders is included as Appendix C. Top of page

1.3.3 Qualitative consultations

The qualitative consultation phase consisted of a series of in-depth interviews with selected host organisations based around a discussion guide developed in collaboration with the Department (this guide is attached as Appendix C). Host organisations were interviewed to provide perspectives and feedback on the effectiveness of the PAD Demonstration from their experience with the program. Topics explored included implementation and planning, training, costs and perceived benefits of being involved.

In-depth face-to-face interviews were conducted with managers, trained staff and lay persons (who worked in the vicinity of the AEDs) at 12 selected host organisations (four in Victoria; four in New South Wales and four in Tasmania).

In-depth telephone consultations were conducted with managers from a further eight host organisations (located across the remaining states and territories). Qualitative telephone consultations were also conducted with seven organisations who had installed AEDs either through private funding, or as part of non-Department funded defibrillation projects.

All qualitative interviews (face-to-face and telephone) were conducted by senior CR&C consultants. Top of page

1.3.4 CATI survey

The final fieldwork stage for the evaluation was a CATI survey of the population of host organisations. The CATI survey was completed with managers or the site co-ordinator of the PAD Demonstration; and staff trained in the use of the AED.

CR&C was supplied with a database containing details of all organisations included in the PAD Demonstration. At the time that this research was conducted there were 147 AEDs installed throughout Australia at 98 different organisations. The database was divided into those targeted for the qualitative consultations, and the remaining 79 host organisations targeted for the CATI survey from which:
  • 53 interviews were achieved with the manager or site co-ordinator and
  • 59 interviews were achieved with staff trained in the use of the AED (representing 31 organisations).
This represents a response rate of 67% of eligible host organisations. The reasons for non-participation included the respondent being unavailable for the duration of the survey, the AED had not been installed, the AED had been installed but there had not been any training or the identified respondent was a St John employee.

The combination of interviews achieved was as follows:
  • 22 organisations with only the manager survey completed
  • 10 organisations with a manager and one staff survey completed
  • 14 organisations with a manager and two staff interviews completed and
  • 7 organisations with a manager and three staff interviews completed.
A primary approach letter was sent out on Department letterhead to all host organisations advising them of the evaluation.

Managers were interviewed first and asked to provide contact details for trained first responders in their organisations, and ideally those, if any, who had activated an AED. Up to three interviews with trained staff were conducted in any one organisation.

The areas of investigation for the CATI survey with managers broadly included: reasons for involvement, commitment and value of PAD Demonstration and improvements that could be made to implementation. The CATI survey with trained staff broadly focused on attitudes towards being a first responder, effectiveness of the implementation (including views on training and support) and experiences with activating the AED. Copies of the managers and staff questionnaires have been attached as Appendix C.

The CATI interviews were conducted by Fieldworks, an accredited fieldwork company specialising in public sector research.