#CPR challenge: Impact of a social media campaign on awareness about cardiopulmonary resuscitation among university students

Social networking platforms have become an integral part of our lives. COVID-19 pandemic has opened up new avenues for their use, including for educational purposes. American Heart Association has acknowledged the potential applications of social media in improving emergency cardiovascular and cerebrovascular care such as public education and engagement. We aim to study the impact of using social media challenge (#CPRchallenge) to educate university students about bystander CPR.

Two colleges, one affiliated to Manipal Academy of Higher Education and other, are selected for the study. One college will be the intervention arm (college A) (sample size 133) and the other college will be in the control arm (college B) (sample size 133). Using a computer software, 135 students each will be randomly selected from both colleges. Informed consent will be taken from students. After taking consent, students will be enrolled into the study. All the students will answer a questionnaire on Qualtrics platform with questions related to knowledge regarding bystander CPR and their attitude towards it (willingness, intention).

Following this, in the intervention arm, four weeks long social media challenge (#CPRchallenge) will be initiated. This intervention is NOT directed at study participants and will be directed to the college (Manipal Institute of Communication)

A #CPRchallenge booth will be set up in a visible location of the college. The booth will consist of a backdrop of #CPRchallenge, a table and a manikin. There will be a basic life support trained volunteer who will be available to demonstrate and assist in creating video for the social media challenge for two hours every evening (3.30pm to 5.30 pm) for the 4 weeks.

Whoever is interested will participate in the #CPRchallenge and create a video of the challenge. Video may be uploaded by the participant to their social networking platform which also includes the following message:

• A personal anecdote/ bystander CPR statistic/ message regarding importance of learning CPR

• Steps of identifying cardiac arrest in a patient

• Hands-only CPR demonstration (on manikin/ pillow)

• Challenging other individuals from the same institute to take the #CPRchallenge

The social media challenge will be directed to whole institute, without particularly focusing on students who have taken the test. They will be encouraged to use the hashtag #CPRchallenge. We will note the engagement of the videos and follow the #CPRchallenge trend during these 4 weeks. The number of students who approach the booth, ask for demo, upload their video will be documented. The content of their created video will be noted as well. The participants who take their video at the booth, will be asked if they consent for a follow up to assess their retention of hands-only CPR skill along with knowledge levels at 3 months.

At the end of social media campaign at 4 weeks, 135 students will be again selected using randomization software in intervention arm (college A) for repeat assessment.

At the same time 135 students will be selected from the control arm as well. This randomization is separate from the randomization done initially, and hence we may get a different student cohort.

They will take the same questionnaire assessing their knowledge and attitude towards bystander CPR. For students from both the colleges, along with knowledge, their skills will be tested performing the CPR. Quality of CPR (rate of CPR, depth of CPR, allowing adequate chest recoil) will be noted using Laerdel qCPR manikin. The extent of their participation in social media campaign including coming across #CPRchallenge videos, seeing demo in #CPR booth and uploading video on their social media will be noted for students in college A.

At 3 months, retention of the knowledge and trend in attitude will be tested using questionnaire on Qualtrics platform among students in intervention arm.

At the end of the study, for the benefit of the control arm, CPR training session will be organized for the students, with hands-on session.