Scholars@Duke
Audrey L Blewer

Audrey L Blewer

Assistant Professor in Family Medicine and Community Health
Family Medicine and Community Health
audrey.blewer@duke.edu
Box 104006 DUMC, Durham, NC 27710
2200 West Main Street, Durham, NC 27705

Selected Publications

Establishing Core Elements for a Prehospital Emergency Care Systems Evaluation Tool (PECSET) for Systems in Early Stages of Development: A Delphi Consensus.

Journal Article Prehosp Emerg Care · January 13, 2025 OBJECTIVES: International Prehospital Emergency Care (PEC) standards have been primarily developed by and for high resource settings. Most PEC systems in Asia, which are still in the early stages of development, struggle to achieve these standards. There i ... Full text Link to item Cite

Impact of implementing primary care-based medication for opioid use disorder on provider and staff perceptions.

Journal Article Fam Pract · December 2, 2024 Medication for opioid use disorder (MOUD) is the management of opioid use disorder (OUD) on an outpatient basis with buprenorphine or buprenorphine/naloxone (or methadone, which is limited to federally certified opioid treatment programs). Primary care pra ... Full text Link to item Cite

RAndomized Cluster Evaluation of Cardiac ARrest Systems (RACE-CARS) trial: Study rationale and design.

Journal Article Am Heart J · November 2024 Out-of-hospital cardiac arrest (OHCA) occurs in nearly 350,000 people each year in the United States (US). Despite advances in pre and in-hospital care, OHCA survival remains low and is highly variable across systems and regions. The critical barrier to im ... Full text Open Access Link to item Cite

Race and Sex Differences in the Association of Bystander CPR for Cardiac Arrest.

Journal Article Circulation · August 27, 2024 BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) is associated with higher survival for out-of-hospital cardiac arrest, but whether its association with survival differs by patients' sex and race and ethnicity is less clear. METHODS: Within a larg ... Full text Link to item Cite

Association of hydroxyurea adherence with transcranial Doppler screenings in children with sickle cell disease.

Journal Article Pediatr Blood Cancer · July 2024 BACKGROUND: National sickle cell disease (SCD) guidelines recommend oral hydroxyurea (HU) starting at 9 months of age, and annual transcranial Doppler (TCD) screenings to identify stroke risk in children aged 2-16 years. We examined prevalence and proporti ... Full text Link to item Cite

Combinations of First Responder and Drone Delivery to Achieve 5-Minute AED Deployment in OHCA.

Journal Article JACC Adv · July 2024 BACKGROUND: Defibrillation in the critical first minutes of out-of-hospital cardiac arrest (OHCA) can significantly improve survival. However, timely access to automated external defibrillators (AEDs) remains a barrier. OBJECTIVES: The authors estimated th ... Full text Link to item Cite

Association Between Institution ZIP Code Characteristics and NIH Funding.

Journal Article Health Promot Pract · May 11, 2024 Introduction. While racial NIH funding disparities have been identified, little is known about the link between community demographics of institutions and NIH funding. We sought to evaluate the association between institution zip code characteristics and N ... Full text Link to item Cite

Incorporation of Drone Technology Into the Chain of Survival for OHCA: Estimation of Time Needed for Bystander Treatment of OHCA and CPR Performance.

Journal Article Circ Cardiovasc Qual Outcomes · April 2024 BACKGROUND: Drone-delivered automated external defibrillators (AEDs) hold promises in the treatment of out-of-hospital cardiac arrest. Our objective was to estimate the time needed to perform resuscitation with a drone-delivered AED and to measure cardiopu ... Full text Link to item Cite

Birth Prevalence of Sickle Cell Disease and County-Level Social Vulnerability - Sickle Cell Data Collection Program, 11 States, 2016-2020.

Journal Article MMWR Morb Mortal Wkly Rep · March 28, 2024 Sickle cell disease (SCD) remains a public health priority in the United States because of its association with complex health needs, reduced life expectancy, lifelong disabilities, and high cost of care. A cross-sectional analysis was conducted to calcula ... Full text Open Access Link to item Cite

Sex Differences in Receipt of Bystander Cardiopulmonary Resuscitation Considering Neighborhood Racial and Ethnic Composition.

Journal Article J Am Heart Assoc · March 5, 2024 BACKGROUND: Bystander cardiopulmonary resuscitation (B-CPR) and defibrillation for out-of-hospital cardiac arrest (OHCA) vary by sex, with women being less likely to receive these interventions in public. It is unknown whether sex differences persist when ... Full text Link to item Cite

Factors influencing support for the implementation of community-based out-of-hospital cardiac arrest interventions in high- and low-performing counties.

Journal Article Resusc Plus · March 2024 AIM OF THE STUDY: Survival to hospital discharge from out-of-hospital cardiac arrest (OHCA) after receiving treatment from emergency medical services (EMS) is less than 10% in the United States. Community-focused interventions improve survival rates, but t ... Full text Open Access Link to item Cite

Gender, Socioeconomic Status, Race, and Ethnic Disparities in Bystander Cardiopulmonary Resuscitation and Education-A Scoping Review.

Journal Article Healthcare (Basel) · February 10, 2024 BACKGROUND: Social determinants are associated with survival from out-of-hospital sudden cardiac arrest (SCA). Because prompt delivery of bystander CPR (B-CPR) doubles survival and B-CPR rates are low, we sought to assess whether gender, socioeconomic stat ... Full text Link to item Cite

Barriers and facilitators for developing a prehospital emergency care system evaluation tool (PEC-SET) for low-resource settings: a qualitative analysis.

Journal Article BMJ Open · December 9, 2023 OBJECTIVES: Strengthening of emergency care systems, including prehospital systems, can reduce death and disability. We aimed to identify perspectives on barriers and facilitators relating to the development and implementation of a prehospital emergency ca ... Full text Link to item Cite

Global prevalence of basic life support training: A systematic review and meta-analysis.

Journal Article Resuscitation · May 2023 BACKGROUND AND AIMS: Out-of-hospital cardiac arrest exerts a large disease burden, which may be mitigated by bystander cardiopulmonary resuscitation and automated external defibrillation. We aimed to estimate the global prevalence and distribution of bysta ... Full text Link to item Cite

Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort study.

Journal Article Lancet Reg Health West Pac · March 2023 BACKGROUND: Understanding the long-term outcomes and disability-adjusted life years (DALY) after out-of-hospital cardiac arrest (OHCA) is important to understand the overall health and disease burden of OHCA respectively, but data in Asia remains limited. ... Full text Link to item Cite

"Needed but lacked": Exploring demand- and supply-side determinants of access to cardiopulmonary resuscitation training for the lay public in China.

Journal Article Front Public Health · 2023 BACKGROUND: Despite years of public cardiopulmonary resuscitation (CPR) training efforts, the training rate and survival following out-of-hospital cardiac arrest (OHCA) have increased modestly in China. Access is imperative to increase the public CPR train ... Full text Link to item Cite

Evaluation of telephone-assisted cardiopulmonary resuscitation recommendations for out-of-hospital cardiac arrest.

Journal Article Resuscitation · September 2022 AIM OF THE STUDY: While out-of-hospital cardiac arrest (OHCA) is associated with poor survival, early bystander CPR (B-CPR) and telephone CPR (T-CPR) improves survival from OHCA. American Heart Association (AHA) Scientific Statements outline recommendation ... Full text Link to item Cite

Variation in community and ambulance care processes for out-of-hospital cardiac arrest during the COVID-19 pandemic: a systematic review and meta-analysis.

Journal Article Sci Rep · January 17, 2022 Bystander cardiopulmonary resuscitation (BCPR), early defibrillation and timely treatment by emergency medical services (EMS) can double the chance of survival from out-of-hospital sudden cardiac arrest (OHCA). We investigated the effect of the COVID-19 pa ... Full text Link to item Cite

Incidence, characteristics and complications of dispatcher-assisted cardiopulmonary resuscitation initiated in patients not in cardiac arrest.

Journal Article Resuscitation · January 2022 AIM: Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) can increase bystander CPR rates and improve outcomes in out-of-hospital cardiac arrest (OHCA). Despite the use of protocols, dispatchers may falsely recognise some cases to be in cardiac arre ... Full text Link to item Cite

The association of race with CPR quality following out-of-hospital cardiac arrest.

Journal Article Resuscitation · January 2022 INTRODUCTION: Previous studies have shown racial disparities in outcomes after out-of-hospital cardiac arrest. Although several treatment factors may account for these differences, there is limited information regarding differences in CPR quality and its e ... Full text Link to item Cite

Impact of the COVID-19 pandemic on the epidemiology of out-of-hospital cardiac arrest: a systematic review and meta-analysis.

Journal Article Ann Intensive Care · December 7, 2021 BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has significantly influenced epidemiology, yet its impact on out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to evaluate the impact of the pandemic on the incidence and case fatal ... Full text Link to item Cite

A hypothetical implementation of 'Termination of Resuscitation' protocol for out-of-hospital cardiac arrest.

Journal Article Resusc Plus · June 2021 BACKGROUND: Out-of-hospital cardiac arrests with negligible chance of survival are routinely transported to hospital and many are pronounced dead thereafter. This leads to some potentially avoidable costs. The 'Termination of Resuscitation' protocol allows ... Full text Open Access Link to item Cite

Dissemination of Evidence-Based Recommendations for Sickle Cell Disease to Primary Care and Emergency Department Providers in North Carolina: A Cost Benefit Analysis.

Journal Article J Health Econ Outcomes Res · April 1, 2021 Background: Sickle cell disease (SCD) is a genetic condition affecting primarily individuals of African descent, who happen to be disproportionately impacted by poverty and who lack access to health care. Individuals with SCD are at high likelihood of high ... Full text Open Access Link to item Cite

Implementation of a National 5-Year Plan for Prehospital Emergency Care in Singapore and Impact on Out-of-Hospital Cardiac Arrest Outcomes From 2011 to 2016.

Journal Article J Am Heart Assoc · November 3, 2020 Background Outcomes of patients from out-of-hospital cardiac arrest (OHCA) vary widely globally because of differences in prehospital systems of emergency care. National efforts had gone into improving OHCA outcomes in Singapore in recent years including c ... Full text Link to item Cite

Education, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.

Journal Article Resuscitation · November 2020 For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, ... Full text Link to item Cite

Racial disparities in out-of-hospital cardiac arrest interventions and survival in the Pragmatic Airway Resuscitation Trial.

Journal Article Resuscitation · October 2020 BACKGROUND: Prior studies have reported racial disparities in survival from out-of-hospital cardiac arrest (OHCA). However, these studies did not evaluate the association of race with OHCA course of care and outcomes. The purpose of this study was to evalu ... Full text Link to item Cite

Impact of bystander-focused public health interventions on cardiopulmonary resuscitation and survival: a cohort study.

Journal Article Lancet Public Health · August 2020 BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) increases an individual's chance of survival from out-of-hospital cardiac arrest (OHCA), but the frequency of bystander CPR is low in many communities. We aimed to assess the cumulative effect of CP ... Full text Open Access Link to item Cite

A pragmatic randomized trial of cardiopulmonary resuscitation training for families of cardiac patients before hospital discharge using a mobile application.

Journal Article Resuscitation · July 2020 AIM OF THE STUDY: Since over 80% of sudden cardiac arrests occur in the home, cardiopulmonary resuscitation (CPR) training for family members of high-risk cardiac patients represents a promising intervention. The use of mobile application-based (mApp) CPR ... Full text Link to item Cite

Nationwide trends in residential and non-residential out-of-hospital cardiac arrest and differences in bystander cardiopulmonary resuscitation.

Journal Article Resuscitation · June 2020 AIMS: Singapore is highly-urbanized, with >90% of the population living in high-rise apartments. She has implemented several city-wide interventions such as dispatcher-assisted CPR, community CPR training and smartphone activation of volunteers to increase ... Full text Link to item Cite

BYSTANDER PERFORMANCE DURING SIMULATED DRONE DELIVERY OF AN AED FOR MOCK OUT-OF-HOSPITAL CARDIAC ARREST

Journal Article Journal of the American College of Cardiology · March 2020 Featured Publication Full text Cite

Variation in Bystander Cardiopulmonary Resuscitation Delivery and Subsequent Survival From Out-of-Hospital Cardiac Arrest Based on Neighborhood-Level Ethnic Characteristics.

Journal Article Circulation · January 7, 2020 BACKGROUND: Bystander cardiopulmonary resuscitation (B-CPR) delivery and survival after out-of-hospital cardiac arrest vary at the neighborhood level, with lower survival seen in predominantly black neighborhoods. Although the Hispanic population is the fa ... Full text Link to item Cite

A Pilot Study of CPR Quality Comparing an Augmented Reality Application vs. a Standard Audio-Visual Feedback Manikin.

Journal Article Front Digit Health · 2020 Background: Guidelines-based cardiopulmonary resuscitation (CPR) during in-hospital cardiac arrest is a significant predictor of survival, yet the quality of healthcare provider (HCP) CPR (e.g., nurses, physicians etc.) has been shown to be poor. Studies h ... Full text Link to item Cite

Barriers and Facilitators to Performing Cardiopulmonary Resuscitation During Treatment in Outpatient Hemodialysis Clinics: A Qualitative Study.

Journal Article Nephrol Nurs J · 2020 Cardiac arrest is the leading cause of death among patients receiving hemodialysis, and major deficiencies exist in hemodialysis staff-provided cardiopulmonary resuscitation (CPR). Our study aimed to identify factors influencing CPR delivery in the outpati ... Link to item Cite

Feasibility of an augmented reality cardiopulmonary resuscitation training system for health care providers.

Journal Article Heliyon · August 2019 AIM OF THE STUDY: Augmented reality (AR) has the potential to offer a novel approach to CPR training that supplements conventional training methods with gamification and a more interactive learning experience. This is done through computer-generated imager ... Full text Link to item Cite

Association of state-level CPR training initiatives with layperson CPR knowledge in the United States.

Journal Article Resuscitation · July 2019 STUDY AIM: Recent work has demonstrated low rates of layperson CPR training across the US. In an attempt to increase rates, some states passed legislation that requires CPR training before high school graduation. We hypothesized laypeople in states with re ... Full text Link to item Cite

Hands-Only Cardiopulmonary Resuscitation Education: A Comparison of On-Screen With Compression Feedback, Classroom, and Video Education.

Journal Article Ann Emerg Med · June 2019 STUDY OBJECTIVE: We compare 3 methods of hands-only cardiopulmonary resuscitation (CPR) education, using performance scores. A paucity of research exists on the comparative effectiveness of different types of hands-only CPR education. This study also inclu ... Full text Link to item Cite

Comparing bystander response to a sudden cardiac arrest using a virtual reality CPR training mobile app versus a standard CPR training mobile app.

Journal Article Resuscitation · June 2019 BACKGROUND: Using a mobile virtual reality (VR) platform to heighten realism for cardiopulmonary resuscitation (CPR) training has the potential to improve bystander response. OBJECTIVES: We examined whether using a VR mobile application (mApp) for CPR trai ... Full text Link to item Cite

Using an Immersive Virtual Reality System to Assess Lay Provider Response to an Unannounced Simulated Sudden Cardiac Arrest in the Out-of-Hospital Setting.

Journal Article Simul Healthc · April 2019 BACKGROUND: A sudden cardiac arrest (SCA) occurs when the heart abruptly stops beating; because of the nature of SCA, capturing data in the out-of-hospital setting from actual bystander response is difficult. Current technologies such as virtual reality (V ... Full text Link to item Cite

Variability in survival and post-cardiac arrest care following successful resuscitation from out-of-hospital cardiac arrest.

Journal Article Resuscitation · April 2019 AIM OF THE STUDY: Regionalization of care for out-of-hospital cardiac arrests (OHCA) may improve patient outcomes. We evaluated inter-hospital variations in post-arrest care provision and the relation between hospital case volume and survival in Pennsylvan ... Full text Link to item Cite

Observing the stages of bystander intervention in virtual reality simulation.

Journal Article World J Emerg Med · 2019 BACKGROUND: Understanding bystander reactions to an emergency is an important component of effective training. Four stages of bystander intervention (BI) have been previously described: noticing the situation as a problem, interpreting when it is appropria ... Full text Link to item Cite

Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest: A Scientific Statement From the American Heart Association.

Journal Article Circulation · August 7, 2018 The formula for survival in resuscitation describes educational efficiency and local implementation as key determinants in survival after cardiac arrest. Current educational offerings in the form of standardized online and face-to-face courses are falling ... Full text Link to item Cite

Gender Disparities Among Adult Recipients of Bystander Cardiopulmonary Resuscitation in the Public.

Journal Article Circ Cardiovasc Qual Outcomes · August 2018 Featured Publication BACKGROUND: Bystander cardiopulmonary resuscitation (BCPR) improves survival from out-of-hospital cardiac arrest (OHCA), yet BCPR rates remain low. It is unknown whether BCPR delivery disparities exist based on victim gender. We measured BCPR rates by gend ... Full text Link to item Cite

Association of race and socioeconomic status with automatic external defibrillator training prevalence in the United States.

Journal Article Resuscitation · June 2018 AIM OF THE STUDY: Automated external defibrillators (AEDs) improve survival from out-of-hospital cardiac arrest (OHCA), however bystander use remains low. Limited AED training may contribute to infrequent use of these devices, yet no studies have assessed ... Full text Link to item Cite

Examining the Use of a Social Media Campaign to Increase Engagement for the American Heart Association 2017 Resuscitation Science Symposium.

Journal Article J Am Heart Assoc · April 13, 2018 BACKGROUND: The Resuscitation Science Symposium (ReSS) is the dedicated international forum for resuscitation science at the American Heart Association's Scientific Sessions. In an attempt to increase curated content and social media presence during ReSS 2 ... Full text Link to item Cite

Cardiopulmonary Resuscitation Training Disparities in the United States.

Journal Article J Am Heart Assoc · May 17, 2017 Featured Publication BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) is associated with increased survival from cardiac arrest, yet bystander CPR rates are low in many communities. The overall prevalence of CPR training in the United States and associated individual- ... Full text Link to item Cite

The association of layperson characteristics with the quality of simulated cardiopulmonary resuscitation performance.

Journal Article World J Emerg Med · 2017 BACKGROUND: Few studies have examined the association of layperson characteristics with cardiopulmonary resuscitation (CPR) provision. Previous studies suggested provider characteristics, including age and gender, were associated with CPR quality, particul ... Full text Link to item Cite

Video-Only Cardiopulmonary Resuscitation Education for High-Risk Families Before Hospital Discharge: A Multicenter Pragmatic Trial.

Journal Article Circ Cardiovasc Qual Outcomes · November 2016 Featured Publication BACKGROUND: Cardiopulmonary resuscitation (CPR) training rates in the United States are low, highlighting the need to develop CPR educational approaches that are simpler, with broader dissemination potential. The minimum training required to ensure long-te ... Full text Link to item Cite

Recruitment for a hospital-based pragmatic clinical trial using volunteer nurses and students.

Journal Article Clin Trials · August 2016 BACKGROUND/AIMS: Recruitment of subjects is critical to the success of any clinical trial, but achieving this goal can be a challenging endeavor. Volunteer nurse and student enrollers are potentially an important source of recruiters for hospital-based tri ... Full text Link to item Cite

Dissemination of CPR video self-instruction materials to secondary trainees: Results from a hospital-based CPR education trial.

Journal Article Resuscitation · March 2016 BACKGROUND: Cardiopulmonary resuscitation (CPR) video self-instruction (VSI) materials have been promoted as a scalable approach to increase the prevalence of CPR skills among the lay public, in part due to the opportunity for secondary training (i.e., sha ... Full text Link to item Cite

Variability in Postarrest Targeted Temperature Management Practice: Implications of the 2015 Guidelines.

Journal Article Ther Hypothermia Temp Manag · December 2015 In 2002 postarrest care was significantly altered when multiple randomized controlled trials found that therapeutic hypothermia at a goal temperature of 32-34°C significantly improved survival and neurologic outcomes. In 2013, targeted temperature manageme ... Full text Link to item Cite

Public knowledge of automatic external defibrillators in a large U.S. urban community.

Journal Article Resuscitation · July 2015 BACKGROUND: Sudden cardiac arrest (SCA) strikes over 40,000 people in the public environment annually in the U.S., but despite evidence-based interventions such as prompt CPR and defibrillation, less than 25% of patients survive public SCA events. Effectiv ... Full text Link to item Cite

Impact of the 2010 resuscitation guidelines training on layperson chest compressions.

Journal Article World J Emerg Med · 2015 BACKGROUND: Survival from cardiac arrest is sensitive to the quality of delivered CPR. In 2010, updated international resuscitation guidelines emphasized deeper chest compressions and faster rates, yet it is unknown whether training laypersons using update ... Full text Link to item Cite

A structured educational intervention to improve targeted temperature management utilization after cardiac arrest.

Journal Article J Crit Care · June 2013 PURPOSE: Post-arrest targeted temperature management (TTM) has been shown to dramatically improve outcomes after resuscitation, yet studies have revealed inconsistent and slow adoption. Little is known about barriers to TTM implementation and methods to in ... Full text Link to item Cite

Continuous chest compression cardiopulmonary resuscitation training promotes rescuer self-confidence and increased secondary training: a hospital-based randomized controlled trial*.

Journal Article Crit Care Med · March 2012 OBJECTIVE: Recent work suggests that delivery of continuous chest compression cardiopulmonary resuscitation is an acceptable layperson resuscitation strategy, although little is known about layperson preferences for training in continuous chest compression ... Full text Link to item Cite

Cardiopulmonary resuscitation training of family members before hospital discharge using video self-instruction: a feasibility trial.

Journal Article J Hosp Med · September 2011 BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) is a crucial therapy for sudden cardiac arrest (SCA), yet rates of bystander CPR are low. This is especially the case for SCA occurring in the home setting, as family members of at-risk patients are ... Full text Link to item Cite