Preparedness for Cardiac Emergencies Among Cambodians with Limited English Proficiency

Abstract

In the United Sates, populations with limited English proficiency (LEP) report barriers to seeking emergency care and experience significant health disparities, including being less likely to survive cardiac arrest than whites. Rapid utilization of 9-1-1 to access emergency services and early bystander CPR (cardiopulmonary resuscitation) is crucial for successful resuscitation of out-of-hospital cardiac arrest patients. Little is understood about Asian LEP communities’ preparedness for emergencies. In this exploratory survey, we sought to assess intentions to call 9-1-1 in an emergency and knowledge of CPR in the Cambodian LEP community. We conducted an in-person interview with 667 Cambodian adults to assess their intentions to call 9-1-1 and their awareness of and training in bystander CPR. While the majority of participants stated that they would call 9-1-1 in an emergency, almost one-third of the sample would call a friend or family member. Awareness of CPR was very high but training in CPR was lower, especially for women. A higher level of English proficiency and greater proportion of time in the US was a strong predictor of CPR training and intention to call 9-1-1 in an emergency. This suggests that greater efforts need to be made to reach the most linguistically-isolated communities (those with little or no English) with emergency information in Khmer.

The Need for More Prehospital Research on Language Barriers: A Narrative Review

“… 22 In specifically assessing the effects of acculturation, Meischke and colleagues found in a 2012 survey of Cambodians in King County, Washington, that increased measures of acculturation were associated with increased likelihood of calling 9-1-1 in an emergency. 26 …”

“…Eight (36%) of the publications reviewed were generated from research in King County, Washington. 8 , 9 , 12 , 26 – 28 , 35 , 36 All EMS systems practice in multi-cultural and multi-lingual communities, but the generalizability of single-site research in EMS is unclear. Themes that emerged from studies of Chinese and Cambodian communities in King County have good concordance with studies from other minority-language speaking communities in Denver, Detroit, and Kansas City.…”

Annual review of Asian American psychology, 2012.

“…For many Asian American communities, cultural and linguistic differences pose many challenges related to equitable conditions related to health care access and communication. In 2012, there were a total of seven empirical articles on health care access and communication, which included studies about health care access ( n = 3; Meischke et al, 2012; Paek & Lim, 2012; Ye, Mack, Fry-Johnson, & Parker, 2012) and health communication ( n = 4; M. T. Kim et al, 2012; Oh, Kreps, Jun, Chong, & Ramsey, 2012; Ong et al, 2012; Woo, 2012).…”

“…Meischke and colleagues (2012) studied 667 Cambodian Americans’ preparedness for cardiac emergencies in a sample with limited English proficiency. The survey included questions about participants’ intentions to call 9-1-1 as well as knowledge about CPR procedures.…”

Increasing Cardiopulmonary Resuscitation Provision in Communities With Low Bystander Cardiopulmonary Resuscitation Rates

“…Similar statements can be made about CPR training among blacks and other ethnic groups within the US population, particularly immigrant communities who have limited English proficiency (eg, Cambodian, Vietnamese, Chinese). 14,67 Besides race/ethnicity and culture, CPR education has also largely ignored considerations of a trainee's age. Considerable efforts have been made to implement CPR training in schools and in the workplace, which suggests that important disparities in training prevalence may exist among the middle-aged or elderly.…”