Introduction:
Hands-only CPR training via a video self-instruction (VSI) kit (DVD & manikin) or a mobile application (app, video-only) allows trainees to share the training materials with others (“secondary training”). This secondary training can amplify the number of individuals trained in CPR, thus increasing the chances of bystander intervention in an out-of-hospital cardiac arrest. Health apps are an emerging tool through which public health information and education can be disseminated. No study has examined whether laypersons trained in CPR via an app share the training as frequently as those trained via VSI.
Hypothesis:
We hypothesized that laypersons trained via mobile app will share the training material more than those trained with VSI.
Methods:
This work represents a sub-investigation of an in-hospital CPR training study for families of cardiac patients. Subjects were trained with either a VSI kit or a mobile app and completed an interview 6-month post-training that measured whether training materials were shared and with how many others they were shared. Multivariate logistic regression was performed controlling for age, race and level of education to determine the likelihood that an individual shared the training.
Results:
Of 697 participants who completed the interview between 6/2016-5/2018, 281 stated they shared the training with at least 1 person (VSI n=213/356, App n=68/341). Subjects who received VSI training were more likely to share than those trained with the app (OR: 7.16, 95% CI: 4.91-10.43, p<0.01). Subjects trained with VSI had an average multiplier rate of 2.27 ±4.13 versus 0.56 ±1.66 (p<0.01) for those trained with the app. Subject-level analysis revealed that increased age is associated with decreased likelihood that an individual shared the training in both training arms (App OR: 0.98, 95% CI: 0.96-0.99, VSI OR: 0.98, 95% CI: 0.97-0.99).
Conclusion:
Subjects in the app arm were less likely to share CPR training. While it has been widely assumed that app-based solutions may afford unique dissemination opportunities, these results suggest the most effective solution to increasing hands-only CPR training may lie in kit-based options currently available. Further work is needed to determine why app-based training is shared less.
Self-instruction in ophthalmoscopy for first-year medical students
