Enhancing Equity in Schoolchildren’s Basic Life Support Education in Brazil Through Serious Games: Cohort Study
Notice bibliographique
Résumé
Background: Out-of-hospital cardiac arrests (OHCAs) predominantly occur in residential settings, often witnessed by children who could act as first responders. The World Health Organization (WHO) supports the Kids Save Lives (KSL) initiative, recommending basic life support (BLS) training for children aged ≥11 years. However, disparities in BLS education persist globally, particularly in low-resource regions where socioeconomic barriers, such as school type, malnutrition, and limited infrastructure, hinder implementation. Younger children (aged <11 years) face additional challenges due to physical limitations (eg, height, weight, and grip strength), which may compromise their ability to achieve adequate chest compression depth. While gamified learning has shown promise in improving BLS engagement and skill acquisition, its efficacy across diverse socioeconomic groups remains understudied. Objective: This study aimed to compare cardiopulmonary resuscitation (CPR) performance (compression depth, rate, and recoil) between public and private school students following a game-based BLS intervention and evaluate the feasibility of a serious game (Kids Save Hearts) in improving BLS knowledge and irrespective of socioeconomic background. Methods: We conducted an observational cohort study with 336 students aged 7-17 years from 10 public and 10 private schools in Brazil (April to November 2022). Participants received 40 minutes of video-based CPR training (American Heart Association CPR in Schools) followed by 10 minutes of gamified training using the Children Save Hearts serious game (SG). CPR quality was assessed via quality of cardiopulmonary resuscitation (QCPR) scores (Laerdal QCPR manikin), measuring compression depth (mm), compression rate (per minute), and chest recoil. Anthropometric data (height, weight, and grip strength) and socioeconomic indicators (school type) were collected. Nonparametric tests (Mann-Whitney U and chi-square tests) and multivariate regression (SPSS v27.0; IBM Corp) were used to analyze associations between demographics, physical characteristics, and CPR performance. Results: Older students (11-17 years) outperformed younger peers (7-10 years) in median compression depth (48 mm vs 37 mm; P<.001) and overall QCPR scores (84 vs 42, P<.001). Private school students had higher grip strength (24.92 vs 21.48 g/cm²; P=.001), but school type did not significantly affect CPR quality. Postintervention SG scores improved universally (P<.001), with no age or socioeconomic disparities. Multivariate analysis identified age (P<.001), height (P<.001), and grip strength (P<.001) as independent predictors of high QCPR scores (≥70). Conclusions: Age and physical development were stronger determinants of CPR quality than socioeconomic factors. The game-based intervention effectively improved BLS knowledge and skills across all participants, demonstrating its potential as an equitable training tool. These findings support the scalability of gamified BLS programs in resource-limited settings.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».