Characterizing barriers to CPR training attainment using Twitter

Study Aim: Recent investigations have suggested that CPR training rates are low within the U.S and barriers to CPR training are poorly understood. Social media holds great potential for large scale capture of the public's CPR training experiences and may illuminate barriers to CPR training. While studies have examined Twitter data for behaviors associated with cardiovascular health, no investigation has evaluated Twitter data to understand public perception of CPR training. We characterized Tweet content about CPR training and associated sentiment to better understand barriers associated with CPR training. We hypothesized that negative CPR training impressions would be identifiable as barriers to CPR training attainment. Methods: We extracted Tweets from 2011 to 2015 originating in Pennsylvania including the keyword CPR (n = 8419). A random subset of 1000 tweets was independently coded by two authors using grounded theory (mean kappa = 0.74). CPR training Tweets were analyzed for subtopic and sentiment (positive or negative). Descriptive statistics were used; a chi squared test was used to examine differences in positive and negative responses. Results: Of 8419 Tweets, CPR training was the most frequent queried result (16%). Within the coded 1000 subset, 18% referenced a CPR training experience. Upcoming CPR training (22%), CPR training curriculum (17%), job-related training (12%), and duration of training (10%) were the most discussed topics regarding CPR training experiences. Of those, the majority of CPR training experiences were negative (53% vs. 47%, p < 0.01) and barriers to CPR training emerged as the primary source of negative experiences. Conclusions: CPR training is the most referenced theme in CPR Tweets from Pennsylvania, and tweets were predominately negative, particularly referencing barriers such as time, location, and duration. Social media is useful for tracking barriers to CPR training attainment and future CPR education modalities.