Research Appraisalqualitative

Process evaluation of a basic life support educational intervention (FirstCPR cluster randomised study) delivered at community organisations in New South Wales, Australia.

BMJ openMunot, Sonali, Bauman, Adrian, Bray, Janet et al.7 Apr 2026DOI

Clinical Snapshot

75CEBM
Evidence: Moderatequalitative

PICO Framework

P — PopulationCommunity organisations and their members in New South Wales, Australia
I — InterventionMultimodal basic life support (BLS) educational intervention with digital messages and training sessions
C — ComparatorNot applicable - process evaluation of intervention implementation
O — OutcomesImplementation measures including participation, reach, uptake, engagement, barriers and enablers

Bottom Line

This process evaluation of the FirstCPR trial provides valuable insights for implementing community-based basic life support education in Australia. While 95% of participating organisations received intervention materials and 90% engaged in some activities, only 18% participated fully. Success was greatest in social and faith-based organisations and critically dependent on dedicated champions and leadership support. The findings suggest that community BLS programmes should prioritise organisational buy-in, provide brief and culturally tailored training modules, and minimise research burden. COVID-19 disruptions highlighted the need for flexible delivery methods. These insights are directly applicable to Australian community health initiatives and can inform future resuscitation education programme design and implementation strategies.

Evidence: Moderate

Key Findings

  • P Value: Not applicable - descriptive process evaluation

  • Effect Size: Variable engagement with greater success in social and faith-based organisations

  • Primary Outcome: Implementation measures: 95% clusters received materials, 90% engaged in at least one activity, 18% engaged in all activities

  • Nnt Or Sensitivity: Key enabler: dedicated liaison/champion presence most critical for member engagement

  • Confidence Interval: Not reported

Clinical Application

Feasible with strong organisational leadership support and dedicated champions, but requires tailored approach for different organisation types Directly relevant to Australian community health education initiatives, aligns with national resuscitation training goals and community engagement strategies Australian community organisations seeking to implement basic life support training programmes

Abstract

BACKGROUND: The FirstCPR cluster randomised trial delivered multimodal basic life support (BLS) learning opportunities to community organisations. An a priori process evaluation examined intervention implementation, including participation, reach, uptake and member engagement. METHODS: The study used a multimethod process evaluation. Data were collected via semistructured interviews, focus group discussions, participant surveys, study records, web analytics and in-field observations. These sources captured participation patterns and implementation measures (delivery, reach, uptake and engagement: opt-in to digital messages and attendance at training sessions), as well as reasons for refusals and withdrawals. Qualitative data were analysed thematically and organised using the UK Medical Research Council process-evaluation framework. Qualitative and quantitative data were analysed separately and subsequently interpreted collectively to contextualise implementation patterns and identify barriers and enablers that influenced trial successes and failures. RESULTS: Intervention uptake and engagement varied significantly across organisations, with greater success observed in social and faith-based groups. Of the 82 intervention clusters, 78 (95%) received intervention materials; 74 (90%) engaged in at least one activity and 15 (18%) engaged in all activities. Participation was primarily driven by the organisation's leadership interest and support in providing BLS training to members, and by the time available to facilitate intervention activities. The presence of a dedicated liaison/champion emerged as the most critical enabler of member engagement and implementation. Feedback recommended concise, simple and culturally tailored modules, with practical components delivered in shorter, convenient sessions. Intervention delivery was affected by contextual challenges, including COVID-19 disruptions that limited in-field recruitment and group activities. CONCLUSIONS: Process evaluation can strengthen community-based interventions by identifying mechanisms and contextual factors that shape implementation and engagement. Partnering with social and faith-based organisations may be an effective approach to disseminating educational programmes such as life-saving skills to lay communities. Minimising research burden and ensuring organisational leadership support may improve participation while brief, practical and culturally tailored training may enhance engagement. TRIAL REGISTRATION NUMBER: ACTRN12621000367842.

References

  1. 1.Munot, S., Bauman, A., Bray, J., Redfern, J., Angell, B., Kancijanic, D., Rock, Z., Semsarian, C., Jennings, G., Coggins, A., Denniss, A. R., & Chow, C. (2026). Process evaluation of a basic life support educational intervention (FirstCPR cluster randomised study) delivered at community organisations in New South Wales, Australia. BMJ Open, 16(4), e113343. https://doi.org/10.1136/bmjopen-2025-113343
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