General population's intentions to perform public CPR: a structural equation modeling analysis based on the theory of...

Bystander cardiopulmonary resuscitation (CPR) plays a significant role in boosting survival rates among victims of out-of-hospital cardiac arrests. This study aimed to identify the key factors influencing the public's intentions to perform CPR based on the Theory of Planned Behavior (TPB).

A cross-sectional survey was conducted in Shanghai, China, from May 1 to June 20, 2023. Structural equation modeling (SEM) was employed to analyze the relationships between the components of the Theory of Planned Behavior (TPB)-attitude, subjective norms (SN), and perceived behavioral control (PBC)-and CPR intention.

Six hundred eighty-two participants were included in the study. All TPB constructs were found to have significant positive correlations with CPR intention (r ² > 0.36, p < 0.05). The SEM results confirmed that a favorable attitude was a strong predictor of intention (β = 0.72). SN were significantly associated with both positive attitudes (β = 0.65) and higher levels of PBC (β = 0.58). The model exhibited good fit (χ ²/df < 3.0, RMSEA < 0.07, GFI/IFI/AGFI/CFI > 0.90). Furthermore, subgroup analyses revealed significant differences in attitude scores by gender (females: 90.3% ± 15.8% vs. males: 86.6% ± 21.9%, p = 0.01) and in intention scores by educational level (senior high school: 88.4% ± 14.3% vs. undergraduate: 78.7% ± 26.0%, p = 0.004).

Attitude and SN are the primary determinants of the public's intention to perform CPR, with SN indirectly shaping intention via attitude and PBC. These findings provide support for TPB-guided interventions aimed at enhancing bystander readiness to perform CPR.