title: Availability and quality of cardiopulmonary resuscitation information for Spanish-speaking population on the Internet.
abstract: BACKGROUND
  Bystander cardiopulmonary resuscitation (CPR) is a vital link in the chain of survival for out-of-hospital cardiac arrest (OHCA); however, there are racial/ethnic disparities in the provision of bystander CPR. Approximately 32% of Hispanics perform CPR when confronted with cardiac arrest, whereas approximately 41% of non-Hispanics perform CPR. Public education, via the Internet, may be critical in improving the performance of bystander CPR among Hispanics. The objective of this study was to evaluate the availability and quality of CPR-related literature for primary Spanish-speaking individuals on the Internet.
  
  
  METHODS
  Two search engines (Google and Yahoo!) and a video-site (YouTube) were searched using the following terms: "resucitacion cardiopulmonar" and "reanimacion cardiopulmonar." Inclusion criteria were: education of CPR technique. Exclusion criteria were: instruction on pediatric CPR technique, failure to provide any instruction on CPR technique, or duplicated website. Data elements were collected on the content and quality of the websites and videos, such as assessing scene safety, verifying responsiveness, activating EMS, properly positioning hands on chest, performing accurate rate and depth of compressions.
  
  
  RESULTS
  Of the 515 websites or videos screened, 116 met criteria for inclusion. The majority of websites (86%; 95% Confidence Interval [CI] 79-92%) educated viewers on traditional bystander CPR (primarily, 30:2 CPR), while only 14% (95% CI 9-21%) taught hands-only CPR. Of websites that used video (N=62), 84% were conducted in Spanish and 16% in English. The quality of CPR education was generally poor (median score of 3/6, IQR of 3.0). Only half of websites properly educated on how to check responsiveness, activate EMS and position hands on chest. Eighty-eight percent of websites failed to educate viewers on assessing scene safety. The majority of websites had improper or no education on both rate and depth of compressions (59% and 63%, respectively). Only 16% of websites included 5 or more quality markers for proper bystander CPR.
  
  
  CONCLUSIONS
  A small proportion of internet resources have high quality CPR education for a Spanish-speaking population. More emphasis should be placed on improving the quality of educational resources available on the Internet for Spanish-speaking populations, and with particular emphasis on current basic life support recommendations.
authors.affiliation: Little Company of Mary Medical Center, Torrance, CA, United States.
authors.forename: Kirsten Y
authors.initials: KY
authors.lastname: Liu
authors.affiliation: Department of Emergency Medicine, Denver Health Medical Center, Denver, CO, United States; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States; Department of Epidemiology, Colorado School of Public Health, Aurora, CO, United States.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Haukoos
authors.affiliation: Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States; American Heart Association, Dallas, TX, United States. Electronic address: comilla.sasson@ucdenver.edu.
authors.forename: Comilla
authors.initials: C
authors.lastname: Sasson
mesh_terms: D016887:Cardiopulmonary Resuscitation; D054626:Consumer Health Information; D003430:Cross-Sectional Studies; D006630:Hispanic or Latino; D006801:Humans; D020407:Internet; D007802:Language
keywords: CPR; Cardiac arrest; Internet; Quality; Social media; Spanish