School-based cardiopulmonary resuscitation training for high school students in Brazil: a pre-post educational intervention with 3-month follow-up

BACKGROUND: Cardiac Arrest (CA) is considered a medical emergency and survival after CA is approximately 10%. Recognizing and providing effective intervention can have a significant impact on a patient's outcome. OBJECTIVE: To evaluate baseline knowledge of Cardiopulmonary Resuscitation (CPR) and the impact of a CPR training intervention to high school students in Aracaju, Sergipe. METHODS: This study was a pre-post educational intervention with 3-month follow-up involving 5 institutions that were chosen randomly from March to October 2023. The intervention was delivered in Portuguese, in four stages, aligned with the Kids Save Lives initiative: a pre-test was applied in 410 students before starting the course with questions regarding CPR and students' expectations; a theoretical-practical course was taught; after the course, students answered a post-test, an evaluation and satisfaction questionnaire. Finally, three months later, 343 students answered the post-test. RESULTS: The primary outcome was mean total score on a validated 14-item BLS knowledge test. We observed an increase in scores after training from 5.8 (2.2) pre-test to 10.9 (2.0) three months after. Scores decreased significantly from the immediate post-test to the 3-month follow-up, with a mean difference of 0.9-points (95% CI 0.61 to 1.13; Cohen's d = 0.354), but remained substantially higher than baseline. Self-perceived ability to perform CPR increased from 10.9% before training to 91% immediately after the course. CONCLUSION: Teaching CPR in educational institutions can improve CPR knowledge retention at 3-months following the intervention, supporting the feasibility of integrating similar programs in Brazilian schools and alignment with the trend of Brazilian education policies. INSTITUTIONAL RESEARCH BOARD APPROVAL: https://shorturl.at/u4pYb.