Medium-term retention and household diffusion of basic life support skills after a school-wide educational...

Early bystander intervention is a key determinant of survival after out-of-hospital cardiac arrest, and school-based cardiopulmonary resuscitation (CPR) training is widely recommended to strengthen community response. However, evidence on medium-term retention of procedural skills and on the diffusion of basic life support (BLS) knowledge from trained students to their household environment remains limited. The aim of this study was to assess medium-term retention of procedural BLS competencies in schoolchildren following a structured educational intervention, and to evaluate the diffusion of BLS knowledge and perceived capacity to act to family members.

This study evaluated students from primary, secondary, and high school and a voluntary subsample of family members in a school in Granada (Spain). Sociodemographic characteristics and cognitive and attitudinal variables were collected using an anonymized online questionnaire. Procedural basic life support (BLS) competencies were assessed approximately four months after the educational intervention through face-to-face simulation using a structured rubric applied by external evaluators trained in BLS. Household diffusion was evaluated through family-reported outcomes, including discussion of the training experience at home and perceived capacity to act in an emergency.

The intervention included 683 students and 196 family members. At medium-term follow-up, students showed high procedural performance in key BLS actions, including high rates of adequate chest compression quality (89.3%), correct AED pad placement (81.8%), and safe shock delivery (91.9%). Household diffusion was substantial, with most relatives reporting discussion of the training experience at home and approximately half reporting active teaching attempts by the student. Relatives' perceived capacity to act increased markedly.

A structured, school-wide BLS intervention delivered in the school setting supports sustained procedural competence in schoolchildren and facilitates meaningful diffusion of resuscitation knowledge and confidence to the household environment. These findings reinforce the role of schools as strategic platforms for scalable interventions aimed at strengthening community preparedness for out-of-hospital cardiac arrest.