Cardiopulmonary resuscitation training in schools following 19 years of mandating legislation in Denmark: a nationwide survey.

Background: Supporting the 'Kids Save Lives' initiative, cardiopulmonary resuscitation (CPR) training has been mandatory in elementary schools since 2005 in Denmark, but a study in 2013 found <one-third of school classes received CPR training. Since there have been no targeted initiatives to improve implementation, we investigated the current prevalence, and examined factors associated with CPR training in Danish elementary schools. Methods: Nationwide survey of Danish elementary schools with 9th grade classes targeting all school leadership and one 9th grade homeroom teacher at each school in 2024. The primary outcome was CPR training during 6th-9th grade. Logistic regression models were used to compare the prevalence of CPR training between 2023/24 and 2013 and to identify factors associated with CPR training. Results: Almost half (47 %, n = 629) of eligible schools were represented, with reports from 31 % (n = 418) of leadership and 28 % (n = 378) of teachers. Overall, 48.8 % of leadership reported CPR training the last three years, and 35.7 % of teachers reported their class had received CPR training. According to leadership, schools were less likely to have completed training in 2023/2024 vs 2013 (OR 0.60, 95 % CI: 0.50-0.80). Factors positively associated with CPR training included the perception that CPR training was expected (OR 3.03, 95 % CI: 1.93-4.78) and the presence of guidelines and responsibilities (OR 2.94, 95 % CI: 1.87-4.62). Conclusions: Despite mandating legislation, the prevalence of CPR training in Danish elementary schools declined over the past decade. Our results highlight the need for strategies beyond legislation to implement CPR training in schools.