Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jun 7, 2025
Date Accepted: Mar 23, 2026
Long-Term Effectiveness of a Game-Based Mobile Application for Training in Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) Use: Nonrandomized Controlled Trial
ABSTRACT
Background:
Although bystander cardiopulmonary resuscitation and automated external defibrillator (CPR-AED) use is critical for improving survival after cardiac arrest, most studies have focused solely on the technical skills required for CPR-AED.
Objective:
To assess the impact of incorporating game-based mobile applications into traditional training methods on practical knowledge, skill level, willingness and dissemination awareness of CPR-AED among university students.
Methods:
We conducted prespecified surveys 7 d and 6 months post-training in China from March 21 to September 21, 2024. Two standardized, 1-h training protocols on CPR-AED theory and application: instructor-led traditional training using CPR manikins, or traditional training combined with a game-based mobile application in the follow-up phase for the experimental group. Primary outcomes included short-term results, theoretical knowledge retention, willingness to perform CPR and dissemination awareness in the long term.
Results:
481 participants completed the entire survey and were included in the secondary analysis. After 7 d, the game-based application training group had significantly higher scores in theoretical and operational skills than those of the traditional training group (P = 0.020; P < 0.001, respectively). In the 6-month post-training survey regarding theoretical knowledge retention, the median scores were eight and nine out of 10 (P < 0.001). Overall, 70.9% (341 of 481) of participants were willing to perform CPR on strangers and 92.1% of participants (443 of 481) were willing to share first aid knowledge, with no significant difference between groups(P = 0.846; P = 0.969).
Conclusions:
The game-based mobile application training can improve the theoretical and practical knowledge of CPR-AED in a short period and shows good knowledge retention over the long term. It is a promising and effective complement to existing CPR-AED training methods. Clinical Trial: Chinese Clinical Trial Registry. ChiCTR2500102813
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