Abstract Body: Introduction: Bystander defibrillation remains low throughout the US (1-4%). The REciprocal InnovationS TO ImpRovE Cardiovascular CARE in Rural America (RESTORe-CARE) project is designed to develop and pilot a drone-delivered AED program in two counties. While partners may likely be supportive of a drone-delivered AED program, understanding differences in perceived challenges by organizational role may be critical to future adoption.

Objectives: We sought to examine out-of-hospital systems of care perspectives and acceptability of the drone-delivered AED program to inform subsequent implementation.

Methods: We developed a multiple methods survey informed by the Consolidated Framework for Implementation Research, which is a conceptual framework that guides the systematic assessment of implementation. Surveys were collected from Forsyth County, NC and James City, VA. We categorized partners by role (Emergency Medical Services (EMS), Sheriff/9-1-1, Medical/9-1-1, Fire/First Responders, and Other) and examined differences in responses by role and location. The survey data were analyzed using Pearson’s Chi-squared test. Qualitative data were reported by top salient themes.

Results: From 4/2024-8/2024, 102 surveys were completed; 10% (EMS), 42% (Sheriff/9-1-1), 8% (Medical/9-1-1), 21% (Fire/Fire Responders), and 19% (Other). Experience with drones varied, with individuals expressing no experience with using drones and experience using drones in emergencies (Table 1). When queried about the extent implementing the drone program provided an advantage to their organization, responses varied by primary role (p=0.04; great extent: 22% EMS, 47% Sheriff, 50% Medical 911, 57% Fire, 18% Other) and location (p=0.01; great extent: 48% Forsyth County, 38% James City County). When asked about their expectation of drone-delivered AED program effectiveness, responses varied by primary role (p<0.01; Very effective/effective: 38% EMS, 41% Sheriff, 44% Medical 911, 68% Fire, 30% Other). Participants mentioned uncertainty in drone response times compared to those of traditional law enforcement units and concerns around insufficient staffing/resources and cost (Table 1).

Conclusion: Perspectives of the drone-delivered AED intervention differed by organizational partner role. Understanding differences by role may inform future adoption of our developing drone-delivered AED program. This process may generalize to other innovative, emergent cardiac arrest interventions.