Pay It Forward: High School Video-based Instruction Can Disseminate CPR Knowledge in Priority Neighborhoods.

Marina Del Rios,Gabriel Morales,Josiah Han,Teri Campbell,Alejandra Cano,Victor Ramirez,Terry Vanden Hoek

doi:10.5811/westjem.2017.10.35108

Abstract

IntroductionThe implementation of creative new strategies to increase layperson cardiopulmonary resuscitation (CPR) and defibrillation may improve resuscitation in priority populations. As more communities implement laws requiring CPR training in high schools, there is potential for a multiplier effect and reach into priority communities with low bystander-CPR rates.MethodsWe investigated the feasibility, knowledge acquisition, and dissemination of a high school-centered, CPR video self-instruction program with a “pay-it-forward” component in a low-income, urban, predominantly Black neighborhood in Chicago, Illinois with historically low bystander-CPR rates. Ninth and tenth graders followed a video self-instruction kit in a classroom setting to learn CPR. As homework, students were required to use the training kit to “pay it forward” and teach CPR to their friends and family. We administered pre- and post-intervention knowledge surveys to measure knowledge acquisition among classroom and “pay-it-forward” participants.ResultsSeventy-one classroom participants trained 347 of their friends and family, for an average of 4.9 additional persons trained per kit. Classroom CPR knowledge survey scores increased from 58% to 93% (p < 0.0001). The pay-it-forward cohort saw an increase from 58% to 82% (p < 0.0001).ConclusionA high school-centered, CPR educational intervention with a “pay-it-forward” component can disseminate CPR knowledge beyond the classroom. Because schools are centrally-organized settings to which all children and their families have access, school-based interventions allow for a broad reach that encompasses all segments of the population and have potential to decrease disparities in bystander CPR provision.

Highlights

The implementation of creative new strategies to increase layperson cardiopulmonary resuscitation (CPR) and defibrillation may improve resuscitation in priority populations
We investigated the feasibility, knowledge acquisition, and dissemination of a high schoolcentered, CPR video self-instruction program with a “pay-it-forward” component in a low-income, urban, predominantly Black neighborhood in Chicago, Illinois with historically low bystander-CPR rates
Classroom CPR knowledge survey scores increased from 58% to 93% (p < 0.0001)

Summary

Introduction

The implementation of creative new strategies to increase layperson cardiopulmonary resuscitation (CPR) and defibrillation may improve resuscitation in priority populations. Wide disparities in bystander CPR rates and OHCA outcomes persist, with some communities reporting a five-fold difference in survival.[1,8,9,10] Residents who live in neighborhoods that are primarily Black, Hispanic, or lowincome are more likely to have an OHCA, less likely to receive bystander CPR, and are less likely to survive.[8 11] The implementation of creative new strategies to increase layperson CPR and defibrillation may improve resuscitation in priority populations.[12,13] No single training approach is comprehensive enough to eliminate these disparities. Most communities will only improve survival through a multifaceted, community-wide approach that may include teaching hands-only CPR for bystanders,[14,15] emphasis on brief educational videos[16] and video self-instruction,[17,18] mandatory school-based training,[19] and dispatcher-assisted CPR.[20,21]

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Discussion

Conclusion