title: Cardiopulmonary Resuscitation Training in Schools Following 8 Years of Mandating Legislation in Denmark: A Nationwide Survey.
abstract: BACKGROUND
  School cardiopulmonary resuscitation (CPR) training has become mandatory in many countries, but whether legislation has translated into implementation of CPR training is largely unknown. We assessed CPR training of students following 8 years of legislative mandates in Denmark.
  
  
  RESULTS
  A nationwide cross-sectional survey of Danish school leadership (n=1240) and ninth-grade homeroom teachers (n=1381) was carried out for school year 2013-2014. Qualitative interviews and the Theory of Planned Behavior were used to construct the survey. Logistic regression models were employed to identify factors associated with completed CPR training. Information from 63.1% of eligible schools was collected: 49.3% (n=611) of leadership and 48.2% (n=665) of teachers responded. According to teachers, 28.4% (95% CI 25.0% to 32.0%) and 10.3% (95% CI 8.1% to 12.8%) of eligible classes had completed CPR and automated external defibrillator training, respectively. Among leadership, 60.2% (95% CI 56.2% to 64.1%) reported CPR training had occurred during the 3 years prior to the survey. Factors associated with completed CPR training included believing other schools were conducting training (odds ratio [OR] 9.68 [95% CI 4.65-20.1]), awareness of mandating legislation (OR 4.19 [95% CI 2.65-6.62]), presence of a school CPR training coordinator (OR 3.01 [95% CI 1.84-4.92]), teacher feeling competent to conduct training (OR 2.78 [95% CI 1.74-4.45]), and having easy access to training material (OR 2.08 [95% CI 1.57-2.76]).
  
  
  CONCLUSIONS
  Despite mandating legislation, school CPR training has not been successfully implemented. Completed CPR training was associated with believing other schools were conducting training, awareness of mandating legislation, presence of a school CPR training coordinator, teachers teacher feeling competent to conduct training, and having easy access to training material. Facilitating these factors may increase rates of school CPR training.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark carolina.hansen@duke.edu.|Duke Clinical Research Institute, Duke University, Durham, NC.
authors.forename: Carolina
authors.initials: C
authors.lastname: Malta Hansen
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
authors.forename: Line
authors.initials: L
authors.lastname: Zinckernagel
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
authors.forename: Annette Kjær
authors.initials: AK
authors.lastname: Ersbøll
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
authors.forename: Tine
authors.initials: T
authors.lastname: Tjørnhøj-Thomsen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark.
authors.forename: Mads
authors.initials: M
authors.lastname: Wissenberg
authors.affiliation: Emergency Medical Services, Copenhagen University, Copenhagen, Denmark.
authors.forename: Freddy Knudsen
authors.initials: FK
authors.lastname: Lippert
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Weeke
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark.|National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.|The Danish Heart Foundation, Copenhagen, Denmark.
authors.forename: Gunnar Hilmar
authors.initials: GH
authors.lastname: Gislason
authors.affiliation: The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.affiliation: Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark.|Emergency Medical Services, Copenhagen University, Copenhagen, Denmark.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Folke
mesh_terms: D000293:Adolescent; D016887:Cardiopulmonary Resuscitation / Q000193:education*; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D037141:Mandatory Programs / Q000458:organization & administration*; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D011159:Population Surveillance / Q000379:methods*; D015397:Program Evaluation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012574:Schools / Q000331:legislation & jurisprudence*; D013663:Teaching / Q000458:organization & administration*; D013997:Time Factors
keywords: automated external defibrillator; cardiopulmonary resuscitation; defibrillation; resuscitation; school