Simulation and educationAvailability and quality of cardiopulmonary resuscitation information for Spanish-speaking population on the Internet☆,☆☆,☆☆☆
Introduction
More than 290,000 cases of out-of-hospital cardiac arrests (OHCAs) are reported each year in the United States, with only 1 of 10 victims surviving to hospital discharge.1 A crucial link in the American Heart Association's (AHA) chain of survival is the provision of high-quality cardiopulmonary resuscitation (CPR), either by trained personnel or by lay persons. Without CPR, chances of survival decline by approximately 10% each minute.1
Although recommendations to perform CPR have been in place for over 30 years, only about 33% of OHCA victims nationwide actually receive CPR.1 In 2008, the AHA changed its guidelines to recommend lay person performance of hands-only CPR for adult with OHCA of presumed cardiac etiology. Hands-only CPR is performed by “pushing hard and fast in the middle of the victim's chest” and not stopping for ventilations.2 A study comparing bystander-initiated hands-only CPR to conventional CPR and no CPR showed an increase in survival for OHCA victims who received hands-only CPR.3 Despite the increasing evidence of the importance of both conventional and hands-only CPR in increasing survival, major health disparities currently exist, especially in Hispanic communities. A recent study in Arizona demonstrated that Hispanics perform bystander CPR 10% less than non-Hispanics (32% versus 42%, respectively).4 It is postulated that this may be linked to the lack of awareness about CPR and a relative paucity of Spanish language CPR resources. This disparity in the provision of bystander CPR in Hispanics is an important public health concern as Hispanics account for approximately 5% of the U.S. population, representing a total of 44.3 million Americans, and are the fastest growing population in the United States.5
The promulgation of CPR education through the Internet may be a way to increase access to CPR education. The Internet is an easily accessible source for health-related information.6 Self-education through internet resources is widespread in the United States7, 8 and is being used to teach bystander CPR.9 Only one prior study has examined the quality of CPR education by video-based self-instruction (VSI) using YouTube videos available in English.10 However, no studies have been conducted to examine the quantity and quality of resources for CPR education for a primarily Spanish-speaking population. As a result, the goal of this study was to evaluate the availability and quality of CPR-related literature for Spanish-speaking-only individuals on the Internet. We hypothesized that there would be a lack of quality educational resources available for this unique population.
Section snippets
Study design and search strategy
We performed a cross-sectional study using the two most widely utilized search engines (Google and Yahoo!) and the most widely utilized online video-site (YouTube). Each was queried using the following terms: “resucitacion cardiopulmonar” and “reanimacion cardiopulmonary” (both served as Spanish translation for CPR). Given the abundance of CPR-related websites on both Google and Yahoo!, the search was restricted to the following: Spanish language only, matched to exact wording of the search,
Results
The initial search resulted in >352,230 websites or videos from Google, Yahoo!, and YouTube. Based on our a priori search strategy, 515 websites were found for initial review. Of these, 399 were excluded based on a priori exclusion criteria, leaving 116 websites included in this study (Fig. 1). The final search was undertaken on April 1, 2011.
Baseline characteristics of websites are shown in Table 1. The majority of websites (86%; 95% Confidence Interval [CI] 79–92%) taught viewers traditional
Discussion
Cardiac arrest is an important public health issue, with known disparities by racial/ethnic groups.4 Studies have shown that survival from cardiac arrest is highly dependent on immediate resuscitation efforts, beginning with high-quality CPR.11 In 2008, the AHA recommended hands-only CPR for lay persons as an acceptable alternative to traditional CPR for untrained bystander.3 Efforts to disseminate this information on hands-only CPR to the public have included traditional classroom education,
Conclusions
The majority of websites for Spanish-speaking persons do not teach hands-only bystander CPR, despite 2008 AHA recommendations. Only 1 in 7 websites found on the Internet has quality CPR education for this population. Given the growing Hispanic population in the United States and in an effort to improve the dismal rates of bystander CPR in this community, more emphasis should be placed on (1) improving the quality of educational resources available on the Internet to teach CPR, (2) creating
Conflict of interest statement
None declared.
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2023, American Journal of Emergency MedicineAssociation of race and socioeconomic status with automatic external defibrillator training prevalence in the United States
2018, ResuscitationCitation Excerpt :These data are consistent with the findings of previous studies which have shown that minority groups and Latinos in particular may be less likely to be given and receive appropriate bystander assistance in the setting of OHCA [13,14,18,19]. Language may play an important role, as previous work has suggested that limited knowledge of CPR among Latinos may be the result of a lack of educational resources in Spanish [26]. While we did not find an association between language of survey and AED training, this does not imply that providing AED training in Spanish is not needed, as the selection of English for a survey may not coincide with comfort level of receiving health information in English as well.
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A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2013.08.274.
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Presented, in part, at the American College of Emergency Physicians Annual Conference, San Francisco, 2011 (Liu).
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Supported, in part, by an Independent Scientist Award (K02 HS017526) from the Agency for Healthcare Research and Quality (AHRQ) (Haukoos) and an American Heart Association Scientist Development Grant (Sasson) and Emergency Medicine Foundation Career Development Award (Sasson).