title: Dissemination of CPR video self-instruction materials to secondary trainees: Results from a hospital-based CPR education trial.
abstract: BACKGROUND
  Cardiopulmonary resuscitation (CPR) video self-instruction (VSI) materials have been promoted as a scalable approach to increase the prevalence of CPR skills among the lay public, in part due to the opportunity for secondary training (i.e., sharing of training materials). However, the motivations for, and barriers to, disseminating VSI materials to secondary trainees is poorly understood.
  
  
  METHODS
  This work represents an ancillary investigation of a prospective hospital-based CPR education trial in which family members of cardiac patients were trained using VSI. Mixed-methods surveys were administered to primary trainees six months after initial enrollment. Surveys were designed to capture motivations for, and barriers to, sharing VSI materials, the number of secondary trainees with whom materials were shared, and the settings, timing, and recipients of trainings.
  
  
  RESULTS
  Between 07/2012 and 05/2015, 653 study participants completed a six-month follow-up interview. Of those, 345 reported sharing VSI materials with 1455 secondary trainees. Materials were shared most commonly with family members. In a logistic regression analysis, participants in the oldest quartile (age >63 years) were less likely to share materials compared to those in the youngest quartile (age ≤ 44 years, OR 0.58, CI 0.37-0.90, p=0.02). Among the 308 participants who did not share their materials, time constraints was the most commonly cited barrier for not sharing.
  
  
  CONCLUSIONS
  VSI materials represent a strategy for secondary dissemination of CPR training, yet older individuals have a lower likelihood of sharing relative to younger individuals. Further work is warranted to remedy perceived barriers to CPR dissemination among the lay public using VSI approaches.
authors.affiliation: Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Ikeda
authors.affiliation: Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Buckler
authors.affiliation: Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Jiaqi
authors.initials: J
authors.lastname: Li
authors.affiliation: Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Amit K
authors.initials: AK
authors.lastname: Agarwal
authors.affiliation: Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Di Taranti
authors.affiliation: Penn Presbyterian Medical Center, Philadelphia, PA, USA.
authors.forename: James
authors.initials: J
authors.lastname: Kurtz
authors.affiliation: Penn Presbyterian Medical Center, Philadelphia, PA, USA.
authors.forename: Ryan Dos
authors.initials: RD
authors.lastname: Reis
authors.affiliation: Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA; School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Marion
authors.initials: M
authors.lastname: Leary
authors.affiliation: Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Abella
authors.affiliation: Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA; Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: audrey.blewer@uphs.upenn.edu.
authors.forename: Audrey L
authors.initials: AL
authors.lastname: Blewer
mesh_terms: D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000379:methods; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D033181:Information Dissemination; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011380:Programmed Instructions as Topic; D011446:Prospective Studies; D014743:Videotape Recording
keywords: Basic life support; Cardiac arrest; Cardiopulmonary resuscitation; Education