Abstract Sun1301: Workplace-Driven CPR Training at Scale: Implementation of the HeartSafe Workplace Initiative in the RACE-CARS Trial

Background: Sudden cardiac arrest (SCA) is a leading cause of death in the U.S., yet bystander CPR rates remain low. Strategies are needed to expand CPR training to reach millions, particularly in regions most affected by SCA. In alignment with American Heart Association (AHA) guidelines, workplaces represent an underused but well-positioned setting to reach adults at scale. In 2024, the Randomized Cluster Evaluation of Cardiac Arrest Systems (RACE-CARS) trial launched the HeartSafe Workplace (HSW) initiative to deliver large-scale, community-based CPR training through employer engagement. Objectives: This study describes the development, implementation, and early process outcomes of the HSW initiative across 29 county-level sites in the RACE-CARS trial. The primary aim was to assess the feasibility and adoption of a standardized, locally driven program to train and recognize workplaces. Methods: The HSW initiative was co-developed with trial leaders and local stakeholders using two core recognition criteria: 1) commitment to train all employees in hands-only CPR, and 2) maintenance of a cardiac arrest emergency action plan. Criteria were intentionally minimal to encourage behavior change while enabling meaningful improvement. Local pre-hospital SCA leaders (e.g., emergency medical services) led the initiative in each county. A branded toolkit supported startup, training, and recognition. Results: As of June 2025, 51 workplaces across 18 of 29 counties (62%) were recognized. Workplaces included businesses (n=28), government offices (n=12), hospitals (n=7), churches (n=3), and schools (n=1). Adoption spanned counties with varied demographic profiles. Adopting counties had lower median populations than non-adopters (71,280 [IQR: 35,040–117,420] vs. 100,498 [IQR: 33,950–151,682]; p=0.55). Rurality, measured by Rural–Urban Continuum Codes (RUCC), was comparable between groups (mean RUCC: 3.89 [IQR: 2–6] vs. 3.45 [IQR: 2–4]; p=0.93). These findings support feasibility across diverse settings. Conclusion: The HSW initiative offers a feasible, scalable approach to mass CPR education by leveraging workplaces for training. Adoption was more common in smaller counties and occurred across both rural and urban settings, highlighting the initiative’s broad applicability. By engaging local implementers and existing workflows (e.g., employee onboarding), the initiative supports sustainability and aligns with broader AHA efforts to promote workplace wellness and preparedness.